Transcript Ryan White Act Part A Major Themes

HIV/AIDS Bureau
Division of State HIV/AIDS Programs (DSHAP)
Ryan White HIV/AIDS Program Part B
Technical Assistance Webinar
Increasing Access to HIV Medications:
Models that Work
February 26, 2014
DSHAP Mission
To provide leadership and support to
States/Territories for developing and
ensuring access to quality HIV prevention,
health care and support services.
2
Agenda
Opening Remarks/ Announcements
Harold Phillips
Question and Answer
A Report on the Minority AIDS Initiative (MAI)
Anita Edwards
Maryland MAI Program
Jami Stockdale
Durkia Hudson
Care Linkage Challenge
Kevin Coger
Questions and Answer
Closing Remarks
Harold Phillips
3
Presenter
Harold Phillips
Deputy Director
Division of State HIV/AIDS Programs
4
Announcements
& Updates
5
Announcements
• “Tell One” Project
• Tell One Person about the Health Insurance Marketplace!
• CMS FAQ on Third Party Payment of Premiums
• All Grantees Meeting/Clinical Update Meeting
• ADAP Data Report System Shutdown Notification
• Grantees will be notified prior to shutdown
• RSR Browser Compatibility Issues
• See tips from the DART Team on TARGET Center
[email protected]
6
Announcements
Important Deadlines:
• 340-B Recertification Deadline March 14th :
• RSR Provider Reports Deadline March 10th
• All RSRs must be in submitted status Deadline March 31st
Upcoming Webinars:
• “Tools for Creating ADR XML Client Report” March 5
• To register look under "Events" on the TARGET Center
• “Adapting HIV Providers' Fiscal Management in a
Changing Financing Landscape”: March 6
• To participate contact [email protected]
7
Questions
8
Presenter
A Report on the Minority AIDS Initiative (MAI)
Anita Edwards, Lieutenant Commander
Senior Program Advisor
Division of State HIV/AIDS Programs
9
RWHAP Part B MAI
• RWHAP Part B MAI Legislative requirements
• Section 2693(b)(2)(B) - For grants used for
supplemental support education and outreach
services to increase the number of eligible racial
and ethnic minorities who have access to
treatment through the program under section
2616 for therapeutics…,
10
RWHAP MAI Differences
• RWHAP Part A: MAI formula grants provide core
medical and related support services to improve
access and reduce disparities in health outcomes
in metropolitan areas hardest hit by the epidemic
• RWHAP Part B: MAI formula grants fund outreach
and education services designed to increase
minority access to needed HIV/AIDS medications
through state Part B AIDS Drug Assistance
Programs (ADAP) and other medication
assistance programs.
11
Reporting Requirements
Reporting Requirements
Reporting Requirements
13
MAI Funding FY 2012
• $10,234,501 allocated for FY 2012 MAI services
• $9,949,406 total service expenditures for FY 2012
MAI
• $3,278,242 Education
• $6,671,164 Outreach
• Total Clients Served
• 18,469 Education
• 30,601 Outreach
14
MAI Clients served by Service Category
Education
Outreach
• Black/African American
11,283
• Hispanic 5,989
• Asian 531
• Other Minority 91
• Unknown 686
• Black/African American
17,841
• Hispanic 8,773
• Asian 880
• Other Minority 242
• Unknown 2,892
15
Increasing Access to HIV Care: Models That Work
Maryland MAI Program
February 26, 2014
Durkia Hudson, MSW
Jami Stockdale, MA
Maryland Department of Health and Mental Hygiene
Prevention and Health Promotion Administration
http://phpa.maryland.gov
Maryland MAI Overview
Service Goals- To provide increased access for disproportionately
impacted low-income minority individuals with HIV disease to HIV/AIDS
treatment/medications available through the Part B Maryland AIDS
Drug Assistance Program (MADAP).
Objective 1-Through targeted outreach to racial and ethnic minority
communities, the program will identify persons who are HIV positive
and out-of-care.
Objective 2- Provide education through focused outreach activities and
advertising that target African American and Latino persons living with
HIV/AIDS to increase their participation in the Maryland AIDS Drug
Assistance Program.
Prevention and Health Promotion Administration
[Date]
17
Maryland MAI Overview
Funding

HRSA has awarded the Center for HIV Prevention and Health Services between
$415,000 -$466,000 annually since FY2011.
– ½ of the funding designated to outreach
– ½ of the funding designated to education
 Funding was first distributed through an RFP process and has been distributed on
a 3 year continuation grant since then.
Sub-Grantees
 Aids Interfaith Residential Services (AIRS)
 Total Health Care, Inc.
 Chase Brexton Health Services
 Baltimore City Health Dept. Clinical Services
 Baltimore City Health Department STD Prevention
 Health Care for the Homeless
 University of Maryland at Baltimore Institute for Human Virology ( Jacques
Initiative)
Prevention and Health Promotion Administration
[Date]
18
Maryland MAI Overview
Types of Organizations:
•
•
•
•
FQHC’s
City Health Department
Nonprofit Organization
University Based Health Clinic
Types of Outreach:
• Street Outreach
• Prison/Jail Outreach
• Support Groups
Types of Education:
• One-on-One
• Groups (curriculum & non-curriculum based)
• Workshops
Prevention and Health Promotion Administration
[Date]
19
Sub-Grantee Overview
Agency
Target Population
Program Description
AIRS
HIV+ person who are
receiving primary
care services
Engages HIV infected persons in educational
sessions that focus on services that are readily
available to them. AIRS uses both group and oneon-one curriculum based interventions to educate
clients about health & wellness, pharmacy
assistance, housing, and other social service
programs.
Total Health Care,
Inc. & Chase
Brexton Health
Services
HIV+ persons who
will soon be released
from incarceration
Both sub-grantees engage HIV positive persons
while in prison/jail. While in prison outreach workers
work with soon to be released persons to identify
and address any barriers to care that may limit their
ability to reengage in care. Upon release they are
linked to care at their clinic where they are
connected to primary medical care, as well as, linked
to pharmacy assistance.
Health Care for
The Homeless
Homeless
Targets persons experiencing homelessness through
street outreach and groups to engage newly
diagnosed and HIV positive persons who may have
fallen out of or are not in care. The outreach worker
and case manager assists clients with barriers to
Prevention and Health Promotion Administration
care and pharmacy
assistance applications.
[Date]
20
Sub-Grantee Overview
Agency
Target Population Program Description
Baltimore City
Health Department
Clinical Services
Latino
Provides street outreach services that target
and engage HIV positive Latinos into primary
care and pharmacy assistance services.
Baltimore City
Health Department
STD Prevention
HIV+ persons who
have fallen out of
care
Engages clients that have been out of care for
6 months or more in direct linkage to care.
The outreach worker will assist in scheduling
the first medical appointment, as well as,
transporting clients to their first appointment.
UMB IHV (Jacques
Initiative)
HIV+ persons
and/or high risk
groups
Engages clients at outreach sites that serve
populations that are actual or
disproportionately at risk for HIV. These
clients are engaged in treatment
preparedness workshops with a medical
professional and an HIV person living well
with the disease. The outreach worker is there
Prevention the
and Health
Promotion
Administration
to assist in connecting
clients
to their
clinic
[Date]
and pharmacy assistance.
21
Evaluation

Education and outreach activities are
tracked through client tracking forms and
includes:
– Medical care referrals (healthcare providers,
HIV primary care, CTR, and Case Managers)
– Education sessions
– Completion and submission of applications for
pharmacy assistance programs
– Demographics
Prevention and Health Promotion Administration
[Date]
22
Client Tracking Form
Prevention and Health Promotion Administration
[Date]
23
Client Tracking Form
Prevention and Health Promotion Administration
[Date]
24
Program Reach
Over 2,000 forms are submitted a year for
approx.1,500 encounters with HIV+ clients.
 700 referrals are made to HIV primary
medical care providers.
 400 unduplicated HIV+ clients based on
Social Security Number (SSN) are served.
 220 received emergency, temporary, or full
access to the Maryland AIDS Drug
Assistance Program.

Prevention and Health Promotion Administration
[Date]
25
Enhanced Linkages

A cross reference of the client’s SSN
and the Maryland AIDS Drug
Assistance Program (MADAP) client
database shows that approx. 400 were
able to receive emergency, temporary,
or full access to the program.
Prevention and Health Promotion Administration
[Date]
26
Data Collection Tips
Keep the form brief
 Train program staff to complete the form
 Share data with program staff to convey
that the numbers demonstrate success
of the program

Prevention and Health Promotion Administration
[Date]
27
Challenges

Reaching the target population
 Staff turnover
 Collecting SSN
 Completion of the form
– Skip patterns
 When to complete the form: During encounter vs.
after the encounter
 Saturation of outreach venues
 Estimating goals
 Separating RW Part B MAI from RW Part A MAI
 Access to other databases
Prevention and Health Promotion Administration
[Date]
28
Best Practices
OUTREACH
 Be open to diverse models and venues
for Outreach
COORDINATION
 Designate someone with primary
responsibility for coordination
VERIFICATION
 Establish partnerships within the State
Health Department
Prevention and Health Promotion Administration
[Date]
29
Care Linkage Outreach Challenge: How to
Reduce the Number of HIV-Positive Persons
Who Test Repeatedly Without Disclosing Their
Positive or HIV Care Status
Kevin Coger
Care Linkage Investigator
STD/HIV Prevention Program
Baltimore City Health Department
The Issue

BCHD STD/HIV Prevention Program provides
12,000 to 14,000 HIV conventional tests per
year on street corners and fixed site
locations.
 Some of the clients seen, who tested HIVpositive previously, test again for HIV without
disclosing their positive or HIV care status.
 This has caused lost opportunities to
immediately assess each client’s HIV care
status.
Prevention and Health Promotion Administration
[Date]
31
Setting

The Program offers STD/HIV testing via
mobile units.
 Testing in neighborhoods & fixed site
locations through street outreach services.
 When HIV-positive persons are identified
through these efforts:
* We assess their HIV care status
* Partner services are offered
Prevention and Health Promotion Administration
[Date]
32
The Solution

“ Do Not Test List” (DNT)

Same-day appointments.

Provide Incentives

Clients already in care identify their primary medical
care provider and the date of their last kept
appointment.

The HIV Reactor Coordinator verifies this information.
Prevention and Health Promotion Administration
[Date]
33
Questions
34
Contact Information
•
•
•
•
Anita Edwards, [email protected]
Durkia Hudson, [email protected]
Jami Stockdale, [email protected]
Kevin Coger, [email protected]
35
2014 Webinar Evaluation
Option 1
Option 2
[email protected]
[email protected]
36
Thank You
37