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SUNY Downstate Medical Center
Special Treatment and Research (STAR) Health Center
STAR Health Center (SHC)
Comprehensive primary care is provided by New York State licensed health care providers who have received advanced training in infectious disease, HIV and/or hepatitis C. Providers manage all aspects of each patient's health care are, including gynecological care and family planning. Obstetric care is co-managed by the patient's primary care provider and a nurse midwife/obstetrician team who works with the SHC.
The following services are provided by referral within the UHB outpatient department: oral health care/dentistry, cardiology (heart), dermatology (skin), gastroenterology (digestive system), hematology/oncology, neurology (brain/nervous system), renal (kidneys), rheumatology, general surgery, ophthalmology (eye doctor), otorhinolaryngology (ear, nose & throat), urology (urinary tract), orthopedics, and podiatry (foot).
The transgender community is diverse with particular health needs. At STAR Health Center , we are committed to providing high quality care for the transgender community. We offer up-to-date, evidence-based hormone therapy from knowledgeable clinicians. Our staff has had advanced training in providing medical and psychological care for the transgender community.
High-Resolution Anoscopy (HRA)
The SHC’s Anoscopy Program provides anal screenings for PLWHA to diagnose and treat anal dysplasia (including squamous cell carcinoma or anal cancer) and human papilloma virus (HPV). The program’s trained clinicians use High-Resolution Anoscopy (HRA), a minimally invasive procedure for more detailed identification, management and treatment of anal dysplasia in high-risk populations.
The SHC’s Care Coordination Program provides support to patients who have problems staying in care. Its goals are to: 1) ensure that PLWHA are promptly linked to medical services at the time of diagnosis and are provided all necessary supports and resources to safeguard lifelong and regular access to effective, quality healthcare; 2) reduce duplication of medical and social support services; and 3) reduce premature and excess morbidity and mortality by ensuring engagement in primary care and preventive services. This project ensures that PLWHA receive the support they need to maintain continuous engagement in HIV primary care and have a “medical home.” The primary strategy is medical case management, which includes assessment; treatment plan development; and regular plan updates. Patient Navigators are key to the program, providing home visits, appointment accompaniment, ongoing support, education and directly observed therapy (DOT) when needed.
Nutritional Education & Counseling
A NYS registered dietician/nutritionist provides nutritional education and counseling to assist consumers in setting nutritional goals to maintain good health. This is includes menu planning, food selection, food preparation and recipe modification and education regarding food/drug interactions. The nutritionist also conducts weekly group sessions.
Educational services are designed to build collaboration between consumers and the health care team to make the best decisions about each person's care plan. Cultural aspects of each patient's beliefs and goals are integrated into the development of personalized health plans to reduce barriers, encourage adherence to medication regimens and maintenance in care.
The Buddy Connection, created by STAR Community Advisory Group (CAG) members, offers support and motivation to current SHC patients that are having problems with their medications, keeping clinic appointments, or who need support. Members of the Buddy Connection make phone calls to check in on patients and escort patients to and from their clinic appointments when needed. Buddies speak English, Spanish, French and Haitian Creole.
Trained professionals help patients understand and obtain benefits and social services. The SHC has relationships with many community- based organizations to ensure that all aspects of patients needs are met. Case managers assist in linking patients with these agencies for services such as housing, legal services, and food pantries.
Acupuncture groups are provided by a certified acupuncture detoxification specialist as an addition to ongoing alcohol or substance abuse treatment. Acupuncture helps patients reduce cravings and other withdrawal symptoms. It helps relieve anxiety and thereby assists them in achieving and maintaining abstinence.
Buprenorphine treatment is available to patients with addictions to opioids (such as heroin). Buprenorphine is an alternative to methadone and does not involve going to clinic every day. Once a patient has been initially treated with the medication, visits are reduced and the medication can be delivered directly to the patient's home.
HIV Clinical Trials Program
The SHC offers HIV+ patients the opportunity to enroll in clinical trials of various HIV-related medications. Examples of trials offered are new antiretroviral agents, therapies for opportunistic infections, and other interventions that increase the quality of life for patients with HIV disease. Study participants are enrolled and followed in dedicated space adjacent to the SHC.
Behavioral Health Services
The SHC offers a full range of counseling services on-site, including psychosocial assessment, treatment planning, crisis intervention, ongoing psychotherapy, substance abuse counseling, buprenorphine therapy, acupuncture, specialized domestic violence/trauma counseling; and support groups. These services are provided by NYS licensed social workers and certified alcohol and substance abuse counselors. Psychiatrists are available five days a week for consultation and ongoing management of medications related to depression, anxiety and other mental health problems.
HIV Testing & Counseling
Rapid HIV testing is provided in the SHC in a private setting during regular clinic hours. Testing is also provided in the University Hospital Emergency Department until 10:00 p.m. The SHC's Educating People at Risk (EPAR) Project provides testing throughout the Brooklyn community at churches, community- based organizations (CBOs), businesses, and at community-based events such as health fairs and street fairs. Preliminary results are available in 15 minutes.Anyone identified as HIV+ is given an immediate appointment at SHC and escorted by staff for his/her first medical appointment with an SHC primary care provider.
Inpatient HIV Services
Acutely ill HIV+ patients followed in the SHC, referred from outside hospitals, or presenting to the emergency room are cared for by the Inpatient HIV Adult Services team. The team participates in the diagnosis and daily management of patients with a variety of complications. The interdisciplinary team consists of a medical director, nurse case manager, nutritionist, social worker/substance abuse counselor, prevention/education counselors, and medical staff. Together the team develops a diagnostic evaluation for the complications of HIV infection and works with patients to help them improve their overall health.