Connection to Care Key Element in HIV Battle
MetroPlus’ Todd Canning oversees managed care for especially vulnerable New Yorkers
BY PAUL SCHINDLER
For Todd Canning, who
has spent more than two
decades providing HIV
care across the city, the
joy of his job is in addressing the
critical healthcare needs of everyday
New Yorkers.
“It’s a pleasure to work with a
company like MetroPlus that as a
company is set up to serve a population
that mirrors what the city
looks like,” he told Gay City News.
MetroPlus Health Plan, which
was the presenting sponsor of
the 2020 Gay City News Impact
Awards, provides managed care to
more than half a million Medicaideligible
New Yorkers. It is a whollyowned
subsidiary of NYC Health
+ Hospitals, the largest municipal
healthcare system in the US.
Canning, who rejoined MetroPlus
early this year after an eight-year
tenure with the group from 2006 to
2014, is the director of clinical services
for the Partnership in Care
Program, which serves roughly
9,000 clients who are living with
HIV or are of transgender experience
or homeless experience.
A registered nurse, Canning
is a graduate of the University of
Pennsylvania School of Nursing,
and has also served in management
posts at EmblemHealth, the
Visiting Nurse Service of New York,
NYC Health + Hospitals, the city’s
Department of Health and Mental
Hygiene, Bailey House, and Housing
Works.
All three of the major demographic
groups that the Partnership
in Care Program serves have
specifi c vulnerabilities. For HIVpositive
folks, connection to care
is critical in reducing their viral
load, not only giving them better
health outcomes but also reducing
Todd Canning, the director of clinical services for the Partnership in Care Program at MetroPlus Health
Plan, at the 2020 Gay City News Impact Awards.
or eliminating the risk they will
be infectious to their sexual partners.
For transgender clients, connection
to care that is medically and
culturally sensitive is vital — and
may be diffi cult to obtain without
case management. New Yorkers
who experience homelessness often
have health challenge co-factors,
including poverty, substance
use, and mental health issues.
Trans and homeless New Yorkers,
as well, face greater likelihood of
becoming infected with HIV than
the average city resident.
Canning’s program does not tally
specifi c demographic data on its
clients, though he said that generally
speaking, like NYC Health +
Hospitals, it serves a population
that is largely African-American
and Latinx. Designation of sexual
orientation and gender identity are
also not part of the client intake
process, though the program does
do signifi cant outreach regarding
its transgender care services and
its HIV-positive population undoubtedly
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is skewed toward many
gay and bisexual men.
For clients who are living with
HIV, a primary goal is connecting
them with consistent care, including
the antiretroviral treatment
most appropriate to their circumstances.
Comparing what he sees
in that population with the state
of care during his earlier years at
MetroPlus, Canning noted the signifi
cant improvement not only in
connection to care and in treatment
compliance but also in suppression
of viral load.
“Issues of side effects and the
complexity of timing of meds have
been mitigated,” he explained. “Now
that regimens are manageable for
so many clients, we can focus our
time and attention on other, more
problematic groups such as those
dealing with mental health challenges
and housing instability.”
Because housing instability often
goes hand in hand with mental
health challenges or substances
use, Canning continued, one key
goal among those clients is the
GAY CITY NEWS IMPACT AWARDS
identifi cation of housing opportunities
that provide supportive services.
Stabilizing a client’s living
situation and beginning to address
mental health issues are often prerequisites
to getting them into and
keeping them in appropriate medical
care, especially among those
living with HIV.
Among clients who are HIVnegative
but consider themselves
at risk for infection, PrEP — or, in
situations where potential infection
just occurred, PEP (post-exposure
prophylaxis) — is a big part of
the conversation. Noting the state’s
Plan to End the Epidemic, which
has been embraced by both Governor
Andrew Cuomo and Mayor
Bill de Blasio, Canning said the
treatment is so cost-effective from
a public health standpoint that Albany
will pay for it and MetroPlus
has “fully embraced it” in its managed
care plans.
“Removing the barriers,” he
said, is the most important factor
in advancing good public health
policies.
Canning noted that New York’s
transgender community is “a very
specifi c population” for whom getting
connected to the right care
is absolutely essential but too
frequently diffi cult to navigate.
Through managed care, however,
MetroPlus is able to make that
navigation straightforward, even
seamless. The company’s trans
clients, he said, “are connected to
folks with trans experience.”
From that foundational connection,
the Partnership in Care
Program provides comprehensive
transition-related benefi ts “including
an unlimited amount of community
support and counseling
support.”
“And then,” Canning added,
“that takes care of itself.”
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