HPV Vaccination Case Study

laws and regulations. To date, 21 states provide funding for HPV education and/or vaccination and two states as well as D.C. mandate HPV vaccination (The Henry J. Kaiser Foundation, 2016). Unfortunately, Tennessee is one of 29 states that does not offer any such funding (The Henry J. Kaiser Foundation, 2016). The lack of state mandated funding coupled with the absence of guidelines for HPV screenings and surveillance has resulted in either inconsistency of care of high-risk populations among providers or a lack of appropriate care within this select population. Therefore, providing APCT in the VCSC will allow for consistent screening and care for high-risk populations. financial climate. The lack of guidelines for HPV screening and surveillance in high-risk populations may
This clinic cares for only HIV-positive individuals and offers APCT to HIV-positive patients. However, the Comprehensive Care Clinic does not offer services to HIV-negative individuals who are at high-risk for HPV, AIN, and SCCA. They also do not provide care for abnormal anal pap cytology but refer those patients to the VCSC for treatment. The offering of APCT by non-Vanderbilt affiliated colorectal surgeons within middle Tennessee is also a concern regarding direct competition. To date, these colorectal surgeons do not offer such services for HIV-positive or other individuals that are at high-risk for contraction of HPV (T. Geiger, personal communication, February 11, 2016). Many of these colorectal surgeons are in private practice and may not have nurse practitioners. Therefore, the colorectal surgeons would be more apt to provide more lucrative services rather than services that are reimbursed at a lower rate. Furthermore, many colorectal surgeons may not provide anal pap cytology due to the lack of national guidelines for such