Houston Area HIV Services Ryan White Planning Council

Transcription

1 Houston Area HIV Services Ryan White Planning Council DRAFT 2012 Houston Area Comprehensive HIV Prevention and Care Services Plan EVALUATION WORKGROUP 2:00 p.m., Thursday, April 16, 2015 Meeting Location: 2223 W. Loop South, Room 416 Houston, Texas AGENDA I. Call to Order Nicholas Sloop and Nancy A. Welcome and Introductions Miertschin, Co-Chairs B. Moment of Reflection C. Adoption of the Agenda D. Adoption of the July 22, Meeting Minutes II. Public Comment III. Brief Overview of the Evaluation Process Amber Alvarez, Health Planner, A. Meeting Purpose and Expected Outcomes Office of Support B. Methodology and Tools IV. Year 3 Comprehensive Plan Evaluation A. Review and Discussion of: 1. Progress of System Objectives in Year 3 2. Strategies-Specific Activities and Benchmarks 3. Staff Recommendations from Year 3 Evaluation Process V. Next Steps Nicholas Sloop and Nancy A. Next meeting: Miertschin Co-Chairs Identification of Conclusions for Year 3 Evaluation Report, Including: 1. Highlights/Major Successes 2. Continued Areas of Challenge/Recommendations 3. Technical Adjustments to Activities or Benchmarks Discussion of Year 4 Implementation and Comprehensive Plan Activities for 2015 VI. Announcements VII. Adjourn J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\2015 Evaluation Wg\Agendas & Minutes\Agenda doc

2 Houston Area HIV Services Ryan White Planning Council 2012 Houston Area Comprehensive HIV Prevention and Care Services Plan EVALUATION WORKGROUP 2:00 p.m., Wednesday, July 22, 2223 West Loop South, Room 416; Houston, TX DRAFT Minutes MEMBERS PRESENT MEMBERS ABSENT OTHERS PRESENT Nancy Miertschin, Co-Chair Amana Turner Amber Alvarez, Ofc of Support Nicholas Sloop, Co-Chair Amy Leonard Diane Beck, Ofc of Support Herman Finley Aundrea Matthews Hickmon Friday Biru Yang, excused Larry Woods Camden Hallmark, excused Morénike Giwa Chris Escalante Sha Terra Johnson-Fairley Cristan Williams David Delasalle Evelio Escamilla Jeff Meyer John Humphries Judy Hung, excused Ken Malone Nike Blue Osaro Mgbere Shital Patel, excused Steven Vargas, excused Tracy Gorden Call to order: Nicholas Sloop, co-chair, called the meeting to order at 2:10 p.m. and asked for a moment of reflection. Adopt the Agenda: Motion #1: It was moved and seconded (Miertschin, Giwa) to adopt the agenda. Motion Carried. Approve the Minutes: Motion #2: It was moved and seconded (Johnson-Fairley, Giwa) to approve the June 11, meeting minutes. Motion Carried. Abstentions: Finley, Friday, Woods. Year 2 Comprehensive Plan Evaluation: See attached activities and checklists for each strategy. The workgroup reviewed activities and updated checklists for each strategy. Members offered information regarding targets that were not reached that Alvarez will note in the report. Alvarez said that the plan is designed to go through the year but HRSA says now that the J:\Committees\Comprehensive HIV Planning\ Comprehensive Plan\ Evaluation Wg\Agendas & Minutes\Minutes doc

3 DRAFT new plan isn t due until 2016; she suggested that annual activities and those that are not completed be continued for the year Motion #3: it was moved and seconded (Giwa, Johnson-Fairley) to continue the annual activities into 2015, including those that are determined to need to be continued. Motion carried. Next Steps: The Year-end Year 3 Evaluation will be done in February Announcements: None. Adjournment: Motion #5: It was moved and seconded (Johnson-Fairley, Miertschin) to adjourn the meeting at 4:08 p.m. Motion Carried. J:\Committees\Comprehensive HIV Planning\ Comprehensive Plan\ Evaluation Wg\Agendas & Minutes\Minutes doc

4 HOUSTON AREA COMPREHENSIVE HIV PREVENTION AND CARE SERVICES PLAN FOR 2012 to Staff Recommendations from Year 3 Evaluation Process DRAFT STRATEGY 1: PREVENTION AND EARLY IDENTIFICATION Activity #3: Identify and disseminate a model protocol for a layperson system navigator program to assist newlydiagnosed HIV infected individuals to enter HIV care RECOMMENDATION: Retain Activity in Year 4 Rationale: An effectiveness study of the model peer mentor program identified yielded that there were no statistically significant nor clinically useful differences in primary outcomes between the control group and the test group receiving peer mentoring, though there was some positive effect on primary outcomes among newly-diagnosed individuals with shorter hospitalization times. Additional time is needed to identify a model protocol with greater effectiveness. Activity #4: Develop a toolkit for private medical doctors for how to link newly-diagnosed HIV infected individuals into the Ryan White HIV/AIDS Program RECOMMENDATION: Retain Activity in Year 4 Rationale: Draft linkage to care brochure for providers was completed in December, finalized in January 2015, and sent to printer in March The linkage to care brochure will be featured the toolkit. STRATEGY 2: GAPS IN CARE AND REACHING THE OUT-OF-CARE Activity #2: Identify and disseminate a model protocol for a layperson system navigator program to assist newlydiagnosed HIV infected individuals to enter HIV care RECOMMENDATION: Retain Activity in Year 4 Rationale: An effectiveness study of the model peer mentor program identified yielded that there were no statistically significant nor clinically useful differences in primary outcomes between the control group and the test group receiving peer mentoring, though there was some positive effect on primary outcomes among newly-diagnosed individuals with shorter hospitalization times. Additional time is needed to identify a model protocol with greater effectiveness. Activity #4: Develop a toolkit for private medical doctors for how to link newly-diagnosed HIV infected individuals into the Ryan White HIV/AIDS Program RECOMMENDATION: Retain Activity in Year 4 Rationale: Draft linkage to care brochure for providers was completed in December, finalized in January 2015, and sent to printer in March The linkage to care brochure will be featured the toolkit. STRATEGY 3: ADDRESS THE NEEDS OF SPECIAL POPULATIONS (SP) Activity #1: Develop and adopt policies on non-discrimination toward Special Populations in the provision of HIV prevention and care services RECOMMENDATION: Change timeframe to and mark status as Complete Rationale: Policies on non-discrimination toward Special Populations have been developed and adopted as applicable. J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Staff Recommendations docx Page 1 of 2

5 Activity #2: Alter data collection and reporting methods in current local data collection systems (e.g., Testing 4 Tickets, ECLIPS, CPCDMS, etc.) to provide information on Special Populations, in particular, Homeless, IRR, and Transgender, including standard definitions for data collection and reporting requirements RECOMMENDATION: Retain activity in Y4. Rationale: DSHS upgrade of STD*MIS in Y4 will provide additional gender options; continue focus on developing reporting alignment among AAs and HDHHS as this did not occur in Y3. STRATEGY 4: COORDINATION OF EFFORT (COE) Activity #6: Translate the Houston Area HIV/AIDS Resource Guide into a real-time web- and phone-based resource locator with accompanying mobile applications (if feasible) accessible by clients and providers RECOMMENDATION: Retain Activity in Year 4. Rationale: Substantial progress was made in developing an Android mobile app in Year 3, and development on an Apple/iPhone compatible app is. Activity #13: Support ongoing regional efforts to operationalize HIV prevention and care integration as outlined by the Enhanced Comprehensive HIV Prevention Planning (ECHPP) and Early Identification of Individuals with HIV/AIDS (EIIHA) RECOMMENDATION: Remove ECHPP component of activity Rationale: ECHPP demonstration project was complete in Y2. J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Staff Recommendations docx Page 2 of 2

6 Houston Area Comprehensive HIV Prevention and Care Services Plan for System Objective Evaluation Tool Objective to Be Measured OBJECTIVE 1: Number of new HIV infections diagnosed in the Houston Area OBJECTIVE 2: Percentage of individuals with a positive HIV test result identified through targeted HIV testing who are informed of their HIV+ status OBJECTIVE 3: Proportion of newly-diagnosed individuals linked to clinical care within three months of their HIV diagnosis OBJECTIVE 4: Percentage of new HIV diagnoses with an AIDS diagnosis within one year OBJECTIVE 5: Percentage of Ryan White HIV/AIDS Program clients who are in continuous HIV care ( 2 visits for HIV medical care in 12 months 3 months apart) OBJECTIVE 6: Proportion of individuals who have tested positive for HIV but who are not in HIV care as determined by the Ryan White HIV/AIDS Program Unmet Need Framework OBJECTIVE 7: Proportion of Ryan White HIV/AIDS Program clients with undetectable viral load OBJECTIVE 8.1: Number of reports of barriers to Ryan White HIV/AIDS Program-funded Substance Abuse Services OBJECTIVE 8.2: Number of reports of barriers to Ryan White HIV/AIDS Program-funded Mental Health Services Recommended Source (Reference) DSHS ehars (2011 Epi-Profile) DSHS HIV Testing & Awareness DSHS Linkage to Care DSHS Late Diagnoses (year) 1,029 (2008) 92.9% 65.1% 34.5% CPCDMS 78.0% DSHS Unmet Need Trend Analysis 34.2% CPCDMS 57.0% Needs Assessment 58 Needs Assessment % 77.4% 28.7% 76.9% (Oct 11- Sept 12) 27.6% 72.3% (Oct 11-Sept 12) N/a 1,377 N/a 85.0% N/a 77.9% N/a 34.0% N/a 80.3% 0.8% =27.4% (local 27.5% N/a 68.3% N/a 65 N/a % =771 =93.0% 85% 25% =27.0% (DHAP 80% 0.8% =27.3% 10% =62.7% (DHAP 43.7% = % =85 1, % Notes Region is HSDA / Region is EMA Region is EMA exceeds NHAS goal of 90% */ data sources are the FY12 & FY13 RW/A progress report, EIIHA data tables 78% Region is EMA 32.8% 26.7% Region is EMA data source is HDHHS; region is Houston/Harris County. Region is EMA Part A clients only Does not include clients newly enrolled in care during the 12 month timeframe Region is EMA Revised estimates released from DSHS in 7/13. Matrix updated accordingly. Part A clients only based on available historical data (2008=103) based on available historical data (2008=161) J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Benchmarks Matrix docx Page 1 of 9

7 Houston Area Comprehensive HIV Prevention and Care Services Plan for Benchmark Evaluation Tool, By Strategy STRATEGY 1: PREVENTION AND EARLY IDENTIFICATION Benchmark to Be Measured BENCHMARK 1: Number of new HIV infections diagnosed in the Houston Area BENCHMARK 2: Number of HIV/STD brochures distributed BENCHMARK 3: Mean number of calls per day to local HIV prevention hotline BENCHMARK 4 : Number of persons reached with an HIV awareness message specific to mass testing events BENCHMARK 5: Percentage of individuals at annual mass testing event that agrees HIV/AIDS is a major health problem for my peers BENCHMARK 6: Mean score on HIV/STD knowledge test among annual mass testing event participants BENCHMARK 7: Number of publicly-funded HIV tests Recommended Source (Reference) DSHS ehars (2011 Epi-Profile) (year) 1,029 (2008) HDHHS 86,389 HDHHS 4.1 Radio One (97.9) Hip-Hop for HIV Awareness HDHHS Hip-Hop for HIV Awareness HDHHS Hip-Hop for HIV Awareness DSHS HIV Testing & Awareness 1,231, % 10.9 [95% CI: ] 165, ,541* (Jan-Nov 12) 4.1 (Mar 19- Nov ) 1,309,200 (Jan-Nov 12) PENDING (awaiting data) PENDING (awaiting data) 201,860 (Jan-Nov 12) N/a 1,377 =86,389 (local =4.1 (local 3.2% =1,311,4 71 (local =55.9% (local =10.9 (local =165,076 (local 86, % =771 =86,389 =4.1 1,237, % =1,353,438 not yet available not yet available 206,911 =55.9% =10.9 =165,076 1,361 Notes Region is HSDA / Region is EMA 88,700 based on current resources and planning *Decrease due to underreporting point not captured in * based on current resources and planning Adjusted baseline and targets in response to data cleaning; mean calculated from COH business days * Not captured due to technology system changes 1,106,300* Radio campaign only s based on available historical data (2009=1,156,700; 2010=1,166,300) *New radio partner for - Cumulus KRBE from HDHHS from HDHHS 207,272 ( Among attendees completing both pre and post test (N=2,362). is percent of respondents who marked Yes when asked if they agree with the statement. Among attendees completing both pre/post test (N=2,362). Measure is mean score on pre-test that includes 14 knowledge questions scored equally with no weighting. Mean score positively correlated with correctlyanswered questions. Region is EMA ed and opt-out testing / data sources are the FY12 & FY13 RW/A progress report, EIIHA data tables (DSHS+HDHHS) J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Benchmarks Matrix docx Page 2 of 9

8 STRATEGY 1: PREVENTION AND EARLY IDENTIFICATION Continued Benchmark to Be Measured BENCHMARK 8: Positivity rate for publicly-funded traditional HIV testing BENCHMARK 9: Positivity rate for publicly-funded opt-out HIV testing BENCHMARK 10: Percentage of individuals with a positive HIV test result identified through targeted HIV testing who are informed of their HIV+ status BENCHMARK 11: Percentage of new HIV diagnoses with an AIDS diagnosis within one year BENCHMARK 12: Proportion of newly-diagnosed individuals linked to clinical care within three months of their HIV diagnosis BENCHMARK 13: Proportion of Ryan White HIV/AIDS Program clients with undetectable viral load BENCHMARK 14: Number of new HIV infections in high HIV/STD morbidity zip codes targeted for intervention BENCHMARK 15: Rate of STD infection per 100,000 population (Chlamydia, gonorrhea, and primary and secondary syphilis) Recommended Source (Reference) DSHS HIV Testing & Awareness DSHS HIV Testing & Awareness DSHS HIV Testing & Awareness DSHS ehars (2011 Epi-Profile) DSHS Linkage to Care (year) 1.7% 1.2% 92.9% 34.5% 65.1% CPCDMS Report 57.0% HDHHS, ehars 42 HDHHS, STDMIS CT: GC: P&S: % 0.8% 87.6% 28.7% 77.4% 72.3% (Oct 11- Sept 12) 30 N/a 2.3% N/a 0.7% N/a 85.0% N/a 34.0% N/a 77.9% N/a 68.3% N/a 32 N/a CT: GC: P&S: % (ECHPP 1.0% (ECHPP =93.0% 25% =27.0% (DHAP 85% 10% =62.7% (DHAP 25% =32 CT: =510.3 GC: 0.6%/ year =146.0 P&S: 6.0 (HP 2.3% 1.01% 94.4% 32.8% 78% 32 CT: GC: P&S: 8.2 Notes Region is EMA / data sources are the FY12 & FY13 RW/A progress report, EIIHA data tables (DSHS+HDHHS); includes previously diagnosed Region is EMA / data sources are the FY12 & FY13 RW/A progress report, EIIHA data tables (DSHS+HDHHS); includes previously diagnosed Region is EMA exceeds NHAS goal of 90% / data sources are the FY12 & FY13 RW/A progress report, EIIHA data tables (DSHS+HDHHS) Region is EMA data source is HDHHS; region is Houston/Harris County. Region is EMA Region is EMA Part A clients only Comparison will be made for targeted zip codes only (033, 051) New data received 2/14. s, s, and s updated accordingly. Region is Houston/Harris County CT/GC targets based on available historical data J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Benchmarks Matrix docx Page 3 of 9

9 STRATEGY 1: PREVENTION AND EARLY IDENTIFICATION Continued Benchmark to Be Measured BENCHMARK 16: Number of condoms distributed BENCHMARK 17: Number of high-risk individuals receiving information on HIV risk reduction through community outreach BENCHMARK 18: Number of high-risk individuals that completes an evidence-based behavioral intervention to reduce risk for HIV Recommended Source (Reference) (year) HDHHS 380,000 HDHHS 7,173 HDHHS 3, ,644* (Jan-Nov 12) 7,173 on HE/RR not available =380,000 (ECHPP =7,173 (local =3,288 (ECHPP 370,700 7,760 2,973 =380,000 (ECHPP =7,173 =3,288 (ECHPP 450,000 10,612 from HDHHS* Notes Includes mass and targeted condom distribution efforts *Decrease due to underreporting reflects all CTR activities, excluding HIP HOP/Houston HITS Home New data received 2/14. s, s, and s updated accordingly. Includes completion of ILI or GLI intervention only (not CLI) * HE/RR report in ECLIPS malfunctioning STRATEGY 2: TO FILL GAPS IN CARE AND REACH THE OUT-OF-CARE Benchmark to Be Measured BENCHMARK 1: Proportion of individuals who have tested positive for HIV but who are not in HIV care as determined by the Ryan White HIV/AIDS Program Unmet Need Framework BENCHMARK 2: Percentage of PLWHA reporting being currently out-of-care (no evidence of HIV medications, viral load test, or CD4 test in 12 consecutive months) BENCHMARK 3: Percentage of PLWHA reporting prior history of being out-of-care BENCHMARK 4: Proportion of newly-diagnosed individuals linked to clinical care within three months of their HIV diagnosis BENCHMARK 5: Proportion of Ryan White HIV/AIDS Program clients who are in continuous care ( 2 visits for routine HIV medical care in 12 months 3 months apart) Recommended Source (Reference) DSHS Unmet Need Trend Analysis (year) 34.2% Needs Assessment 7.1% Needs Assessment 26% DSHS Linkage to Care 65.1% CPCDMS 78.0% % 77.4% 76.9% (Oct 11- Sept 12) 0.8% =26.9% (local 27.5% N/a 6.8% N/a N/a 77.9% N/a 80.3% 0.8% =27.3% 3.0% =4.1% =26% 85% 80% (NHAS 26.7% 6.8% 23.5% 78% Notes Region is EMA Revised estimates released in 7/13. Matrix updated accordingly. based on available historical data (2008=10.1%) based on available historical data (2008=25%) Region is EMA Part A clients only Does not include clients newly enrolled in care during the 12 month timeframe J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Benchmarks Matrix docx Page 4 of 9

10 STRATEGY 2: TO FILL GAPS IN CARE AND REACH THE OUT-OF-CARE Continued Benchmark to Be Measured BENCHMARK 6: Proportion of Ryan White HIV/AIDS Program clients who are retained in care ( 1 visit for HIV primary care in the 2 nd half of the year after also having 1 visit for HIV primary care in the 1 st half of the year) BENCHMARK 7: Proportion of Ryan White HIV/AIDS Program clients with undetectable viral load Recommended Source (Reference) CPCDMS Retention in Care Metric (year) 75.0% (2011 Period 6) CPCDMS 57.0% % (Oct 11- Sept 12) 72.3% (Oct 11- Sept 12) N/a 75.9% N/a 68.3% =75% 10% =62.7% (DHAP Notes Part A clients only Part A clients only STRATEGY 3: TO ADDRESS THE NEEDS OF SPECIAL POPULATIONS Benchmark to Be Measured BENCHMARK 1: Number of new HIV infections diagnosed among each special population: Adolescents (13-17) Homeless Recommended Source (Reference) HDHHS, HIV Surveillance System Houston/Harris County Needs Assessment (year) 18 (2009) 172 Incarcerated in Jail The Resource Group 1,097 Incarcerated in Prison TDCJ 137 IDU MSM HDHHS, HIV Surveillance System HDHHS, HIV Surveillance System 38 (2009) 563 (2009) (Jan-Nov 12) N/a 18 N/a N/a N/a Coalition data from TRG from TRG N/a 66 N/a % =13 25% =132 25% =822 25% =102 25% =28 25% =422 ) from HDHHS Coalition data from TRG from TRG Notes Region is Houston/Harris County Region is Harris/Fort Bend County 2012 actual based on needs assessment data (N=561; 8.9% self-report HIV) Harris County Jail UDC does not include December 2011 Region is Houston/Harris County Region is EMA Region is Houston/Harris County Region is EMA Transgender HDHHS, HIV Surveillance System 7 (2009) N/a 8 25% =5 from HDHHS Region is Houston/Harris County J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Benchmarks Matrix docx Page 5 of 9

11 STRATEGY 3: TO ADDRESS THE NEEDS OF SPECIAL POPULATIONS Continued Benchmark to Be Measured Recommended Source (Reference) (year) BENCHMARK 2: Proportion of newly-diagnosed individuals within each special population linked to clinical care within three months of their HIV diagnosis:* Adolescents (13-17) Needs Assessment Homeless Needs Assessment Incarcerated in Jail (*linked within 3 months of incarceration) Recently Released from Jail (*linked within 3 months of release) Recently Released from Prison (*linked within 3 months of release) IDU The Resource Group 100% The Resource Group 62.0% Texas HIV Medication Program DSHS Linkage to Care 69.7%* 51.1% 2012 N/a N/a N/a N/a 100% (Jan-Nov 12) 37%** (Jan-Nov 12) N/a, due to new baseline 76.9% N/a N/a N/a from TRG from TRG from TRG N/a 75.9% 85% 85% =100% 85% 85% 85% 50%* 67%* from TRG from TRG from TRG 91% Notes Source adjusted from original due to availability of new source Serves as *Denominator = 4 survey participants Source adjusted from original due to availability of new source Serves as *Denominator = 42 survey participants Harris County Jail UDC Harris County Jail only. Region is EMA MSM DSHS Linkage to Care 65.2% 75.4% N/a 76.7% 85% 94% Region is EMA Transgender Needs Assessment N/a N/a 85% 55.6% Source adjusted from original due to availability of new source Serves as J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Benchmarks Matrix docx Page 6 of 9

12 STRATEGY 3: TO ADDRESS THE NEEDS OF SPECIAL POPULATIONS Continued Benchmark to Be Measured BENCHMARK 3: Proportion of individuals who have tested positive for HIV but who are not in HIV care as determined by the Ryan White HIV/AIDS Program Unmet Need Framework within each special population: Recommended Source (Reference) (year) Adolescents (13-17) Needs Assessment Homeless Needs Assessment Recently Released from Jail/Prison Needs Assessment IDU MSM DSHS Unmet Need Analysis DSHS Unmet Need Analysis 37.6% 33.7% Transgender Needs Assessment BENCHMARK 4: Percentage of HIV prevention and care frontline staff receiving annual cultural competence training Ryan White Grants Administration; HDHHS 100% 2012 N/a N/a N/a N/a N/a N/a 30.2% 26.4% 1.7% =34.2% (local =33.7% (local 28.3% 27.4% N/a N/a 100% =100% (local 100% to be developed to be developed to be developed 1.7% =32.5% =33.7% to be developed =100% 0%* 16.3%* 11.9%* 28.8% 26.3% 7.4% 100% Notes Includes HIV/AIDS Region is EMA Recommend Source be adjusted from original due to availability of new source/na Serves as *Denominator = 4 survey participants Recommend Source be adjusted from original due to availability of new source/na Serves as *Denominator = 43 survey participants Recommend benchmark be revised for consistency with other Special Populations data Serves as *Denominator = 92 survey participants based on available historical data (2008=41%; 2009=48%) Region is EMA based on available historical data (2008=33.2%; 2009=41%) Recommend Source adjusted from original due to availability of new source/na Serves as *Denominator = 27 survey participants To be confirmed by annual contractor audits; and training records, respectively J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Benchmarks Matrix docx Page 7 of 9

13 STRATEGY 4: TO IMPROVE COORDINATION OF EFFORT AND PREPARE FOR HEALTHCARE SYSTEM CHANGES Benchmark to Be Measured BENCHMARK 1: Number of non-asos serving as members of the Ryan White Planning Council BENCHMARK 2: Number of non-asos requesting information about HIV services BENCHMARK 3: Number of agencies listed in Houston Area HIV/AIDS Resource Guide BENCHMARK 4: Number of reports of barriers to Ryan White Core Medical Services BENCHMARK 5: Number of reports of barriers to Ryan White Supportive Services BENCHMARK 6: Number of reports of barriers to outpatient alcohol or drug abuse treatment services by PLWHA BENCHMARK 7: Number of reports of barriers to professional mental health counseling by PLWHA Recommended Source (Reference) (year) RWPC/OS 10 RWPC/OS 42 RWPC/OS 187 ( ) Needs Assessment 1,397 Needs Assessment 2,151 Needs Assessment 58 Needs Assessment (Jan-Oct 12) 179 (2012- edition) Increase (local 23 total 7 non-infected/ affected Increase N/a 118 Increase N/a 179 (2012- edition) =187 N/a 1, % =1,017 N/a % =1,878 N/a 65 N/a % = % =85 29 total 4 non-infected/ affected 72 (office track sheets only) Additional data 152 ( edition) Notes numbers include Council and External members who do not bring HIV expertise because of their place of employment. numbers tallied using office tracking sheets and website requests. Non-ASO defined as an entity that does not state HIV prevention or care in its mission. Decrease from due to agency closures 1,620 based on available historical data (2008=1,919) 538 based on available historical data (2008=2,463) based on available historical data (2008=103) based on available historical data (2008=161) BENCHMARK 8: Percentage of PLWHA reporting housing instability BENCHMARK 9: Percentage of PLWHA reporting seeking no medical care due to inability to pay Needs Assessment 28% Needs Assessment 8% N/a 27% N/a 2% =28% =8% 27% 2% based on current resources and planning based on available historical data (2008=5%) J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Benchmarks Matrix docx Page 8 of 9

14 STRATEGY 4: TO IMPROVE COORDINATION OF EFFORT AND PREPARE FOR HEALTHCARE SYSTEM CHANGES Continued Benchmark to Be Measured BENCHMARK 10: Number of individuals working for AIDSservice organizations who receive training on health insurance reform BENCHMARK 11: Percentage of Ryan White HIV/AIDS Program clients with Medicaid enrollment BENCHMARK 12: Percentage of Ryan White HIV/AIDS Program clients with private health insurance Recommended Source (Reference) RWGA, The Resource Group (year) 200* CPCDMS 16.7% CPCDMS 5.1% ** (Jan-Nov 12) 17.4%* (Jan-Nov 12) =200 (local 99 (RWGA only) data from TRG N/a 16.8% N/a N/a 5.1% = (RWGA only) from TRG Track only 27% ( Track only 10% Notes Region is HSDA * defined as receiving a Bristol-Myers Squibb presentation. **s defined as receiving ACA-related training or presentation facilitated by an RP. Decreases from due to greater availability for training facilitated by non-rp entities. Part A clients only reflects ALL public insurance J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Benchmarks Matrix docx Page 9 of 9

15 HOUSTON AREA COMPREHENSIVE HIV PREVENTION AND CARE SERVICES PLAN FOR YEAR 3 EVALUATION CHECKLIST Strategy: 1 PREVENTION AND EARLY IDENTIFICATION *Status Key Complete (C) Complete for Year 3 () In Progress (P) Not Initiated (NI) N/A for Time Period (NA) N/A with Progress (NA/P) *Staff recommendation Activity 1. Implement training to CTR providers on integrating HIV testing with testing for other (non-hiv) STDs and Viral Hepatitis 2. Expand Disease Intervention Specialist (DIS) activities to include a readiness for care assessment at the time of DIS interview as a means of assisting with linkage to care efforts 3. Identify and disseminate a model protocol for a layperson system navigator program to assist newly-diagnosed HIV infected individuals to enter HIV care 4. Develop a toolkit for private medical doctors for how to link newly-diagnosed HIV infected individuals into the Ryan White HIV/AIDS Program Responsible Party/ Parties RWPC/CPG Committee or Other Partner Source/ Reference Timeframe Process Notes Status * See key above HDHHS N/a N/a Training conducted with city contractors on October 23,. Letter, statistics, and syphilis signs/symptoms clinical wall poster mailed to 100 dermatologists in Houston/Harris County in partnership with the Sexually Transmitted Infection Community Coalition (STICC) in December. Additional in-person visits completed with eight providers in. HDHHS N/a N/a STD Program Quality Assurance staff began including readiness assessment compliance monitoring in Y3. RWPC/OS RWPC/OS, HDHHS, RWGA RWPC Affected & QA Committees AETC N/a Results of an effectiveness study of the model protocol identified found newlydiagnosed individuals who received peer mentoring did not experience higher retention in care rates and lower viral loads than the control group. Peer mentoring had some effect among participants hospitalized for a shorter time, while those hospitalized for a longer time experienced better primary outcome regardless of mentoring. Recommendation: Retain activity in Y4 Center for AIDS Toolkit Draft linkage to care brochure for providers was completed in December, finalized in January 2015, and sent to printer in March Recommendation: Retain activity in Y4 C C P* P* J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\2015 Evaluation Wg\Meeting Packets\Meeting Packet \Y3 Comp HIV Plan Checklist - PEI docx Page 1 of 4

16 Activity 5. Develop community-wide guidelines for the use of Preexposure Prophylaxis (PrEP) and for Non-Occupational Post- Exposure Prophylaxis (npep) 6. Establish a baseline for Houston Area community viral load of individuals in HIV care 7. Educate public officials on changing governmental policies that create barriers to HIV prevention information and tools (e.g., repeal the ban on syringe access, adopt comprehensive sexuality education in schools, etc.) 8. Sustain condom distribution for: (a) the general public and (b) for high-risk populations and communities 9. Expand social marketing and other mass education activities focused on raising HIV awareness and increasing HIV testing (e.g., HIP HOP for HIV Awareness, Testing Makes Us Stronger, Greater Than AIDS, etc.) Responsible Party/ Parties HDHHS RWPC/CPG Committee or Other Partner Scientific Advisory Source/ Reference Timeframe Process Notes Status * See key above ECHPP Recommendation letters on PrEP and npep were developed in Y2. Council HDHHS N/a ECHPP Monitored viral load analysis run in December. Tables were released January HDHHS TX HIV/AIDS ECHPP Annually Bureau Chief and staff met with local elected officials regarding Coalition the recently released population, HIV in the aging population, expanded access to mobile HIV testing, and Latino mobilization/hiv awareness outreach. David Robinson (City Council) spoke at CFAR/HDHHS Scientific Advisory Council s Sharing Science Symposium. Presentation on HIV Service Linkage and Re-linkage made to Quality of Life Committee of the City Council. Bureau Chief continued to serve as UCHAPS Public Policy Workgroup Chair and on the AIDS United Public Policy. HDHHS joined the Gulf Coast Health Insurance Marketplace Collaborative, which worked with political leaders at the federal, state, and local levels to coordinate, network, and streamline efforts to efficiently engage the diverse population of greater Houston in understanding and enrolling in health care opportunities available under the ACA. Additional policy change efforts were conducted by external partners in Y3, i.e., THAC and Connect 2 Protect. HDHHS N/a ECHPP Annually 450,000condoms distributed HDHHS N/a ECHPP Annually Six social marketing and/or mass education events/campaigns were conducted in Y3, including the summer mass testing event rebranded as Houston HITS Home (formerly HIP HOP)= 2,342 educated and tested. C C J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\2015 Evaluation Wg\Meeting Packets\Meeting Packet \Y3 Comp HIV Plan Checklist - PEI docx Page 2 of 4

17 Activity 10. Expand the provision of Partner Services (PS) to HIV infected individuals (e.g. identification, notification, counseling and testing, and linkage to care for partners) 11. Sustain targeted HIV testing by community-based organizations to high-risk populations 12. Expand non-targeted routine, opt-out HIV testing in facilities serving high-risk populations and continue to document and promote the benefits of the Expanded Testing Initiative (ETI) 13. Intensify combination HIV prevention in high-risk communities Responsible Party/ Parties RWPC/CPG Committee or Other Partner Source/ Reference Timeframe Process Notes Status * See key above HDHHS N/a ECHPP Annually Expansion to those already infected continued in Y3 via HDHHS three service linkage programs. SLWs make referrals to STD Program Unit (DIS) for partners elicitation HDHHS N/a ECHPP Annually One CBO was funded to provide HE/RR services and six CBOs were funded to provide CTR services to high-risk populations in Y3. HDHHS External Partners/ ETI Providers ECHPP Annually HDHHS was not awarded routine testing funding from DSHS (DSHS now directly awards funds to agencies). HDHHS plans to re-issue routine testing RFP in 2016 for CDC routine testing funds (PS ). Routine testing planning occurred at six new HHS community health centers in, with implementation slated for Continued collaboration occurred with Test Texas. Presentation made at National CFAR/APC HIV Continuum of Care Working Group on benefits of routine screening. TA provided to HHS, Memorial Hermann, and other Texas clinical settings and hospitals for implementation of routine HIV testing reimbursement strategies. HDHHS expanded capacity to routinely detect acute HIV in CoH laboratory. Provided technical assistance and capacity building to other agencies to help them routinely detect acute HIV. ETI expanded access to HIV testing through pilot at Walgreens in areas with high HIV prevalence. HDHHS N/a ECHPP Annually Ten testing and prevention events were conducted at 22 sites in Y3 through SAFER, SOR, and collaboration with Task Forces, including 2 events specifically tailored to reach the Latino community J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\2015 Evaluation Wg\Meeting Packets\Meeting Packet \Y3 Comp HIV Plan Checklist - PEI docx Page 3 of 4

18 Activity Responsible Party/ Parties RWPC/CPG Committee or Other Partner 14. Support ongoing efforts of local HIV clinical trial networks RWPC, CPG RWPC Affected Committee, CPG Executive Source/ Reference Timeframe Process Notes Status * See key above N/a Annually RWPC/CPG members continued to serve on various CAB and research coalitions in Y3 (e.g., HMMP, ACTN, C2P, Youth Large CAB, etc.). Scientific Advisory Council s Sharing Science Symposium in Y3 featured four speakers from local HIV clinical trials. J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\2015 Evaluation Wg\Meeting Packets\Meeting Packet \Y3 Comp HIV Plan Checklist - PEI docx Page 4 of 4

19 HOUSTON AREA COMPREHENSIVE HIV PREVENTION AND CARE SERVICES PLAN FOR YEAR 3 EVALUATION CHECKLIST Strategy: 2 GAPS IN CARE AND REACHING THE OUT-OF-CARE *Status Key Complete (C) Complete for Year 3 () In Progress (P) Not Initiated (NI) N/A for Time Period (NA) N/A with Progress (NA/P) *Staff recommendation Activity 1. Expand Disease Intervention Specialist (DIS) activities to include a readiness for care assessment at the time of DIS interview as a means of assisting with linkage to care efforts 2. Identify and disseminate a model protocol for a layperson system navigator program to assist newly-diagnosed HIV infected individuals to enter HIV care 3. Add to the Ryan White HIV/AIDS Program Standards of Care that funded primary care providers will have in place a client reminder system that reflects client preferences 4. Develop a toolkit for private medical doctors for how to link newly-diagnosed HIV infected individuals into the Ryan White HIV/AIDS Program Responsible Party/ Parties RWPC/CPG Committee or Other Partner Source/ Reference Timeframe Process Notes Status * See key above HDHHS N/a N/a STD Program Quality Assurance staff began including readiness assessment compliance monitoring in Y3. RWPC/OS RWGA, TRG RWPC/OS, HDHHS, RWGA RWPC Affected & QA Committees RWPC QA Committee AETC N/a Results of an effectiveness study of the model protocol identified found newlydiagnosed individuals who received peer mentoring did not experience higher retention in care rates and lower viral loads than the control group. Peer mentoring had some effect among participants hospitalized for a shorter time, while those hospitalized for a longer time experienced better primary outcome regardless of mentoring. Recommendation: retain activity in Y4 Standards of Care Center for AIDS Toolkit General SOC 4.13 was revised in Y1. Draft linkage to care brochure for providers was completed in December, finalized in January 2015, and sent to printer in March Recommendation: Retain activity in Y4 C P* C P* J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Checklist - Gaps docx Page 1 of 3

20 Activity 5. Integrate messaging on the importance of retention in care for health outcomes and secondary prevention into evidence-based behavioral interventions (EBIs) targeting HIV infected individuals and their partners 6. Provide educational opportunities and materials to people living with and/or affected by HIV/AIDS regarding the impact of the Patient Protection and Affordable Care Act on HIV services. 7. Sustain required annual training for Ryan White HIV/AIDS Program funded case managers on effective client engagement (e.g., motivational interviewing, rapport development, assessment skills, etc.) 8. Launch a re-linkage to care project using data matching algorithms between client-level HIV surveillance (ehars) and client-level HIV care databases (CPCDMS) Responsible Party/ Parties RWPC/CPG Committee or Other Partner Source/ Reference Timeframe Process Notes Status * See key above HDHHS N/a N/a Annually Secondary prevention messaging was integrated into service linkage program in Y3. One agency was funded for HE/RR among positives in Y3. HIV manager position is vacant. Once filled, the position will create a retention messaging performance standard to be included in the observational tool CBO liaisons use when during audits. Training is planned for 2015 Contractor meetings to prepare agencies for this change. RWGA, TRG, RWPC/OS Project LEAP Advisory Committee & RWPC Affected Committee RWGA, TRG N/a Standards of Care N/a Annually Training was provided in Y3 via RWPC, frontline staff, and ASOs. Agendized discussion of the marketplace also occurred at RWPC meetings throughout Y3. New Part A/B SOC related to the marketplace became effective in Y3. RWPC/OS conducted two Special Studies in Y3 on ACA enrollment among consumers, and feasibility of a pilot project to purchase Marketplace plans for individuals below 100% Annually FPL. RW Case Management Training Program, Part D monthly meetings, and Part C bi-monthly meetings continued in Y3. HDHHS RWGA N/a Annually Re-linkage project continued in Y3 and will conclude in Y4. When Merck Foundation funding ends, re-linkage clients will continue to be served in two other service linkage programs (1115 Waiver and Ryan White funding). From project start through the end of Y3, the re-linkage project received and investigated 681 referrals. J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Checklist - Gaps docx Page 2 of 3

21 Activity Responsible Party/ Parties RWPC/OS RWPC/CPG Committee or Other Partner HDHHS, CPG & Task Forces Source/ Reference Timeframe Process Notes Status * See key above 9. Establish partnerships with existing community-wide outreach opportunities to locate PLWHA who are out-of-care particularly among Priority Populations, Special Populations, and other high-risk sub-populations N/a Annually RWPC/OS, RWGA and Planning Council members participated in the Texas HIV Syndicate Maintenance in Care group to assist in the development of a tool to help case management staff and others identify PLWHA at-risk for falling out-of-care and support continuous maintenance in care. J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp HIV Plan Checklist - Gaps docx Page 3 of 3

22 HOUSTON AREA COMPREHENSIVE HIV PREVENTION AND CARE SERVICES PLAN FOR YEAR 3 EVALUATION CHECKLIST Strategy: 3 ADDRESS THE NEEDS OF SPECIAL POPULATIONS (SP) *Status Key Complete (C) Complete for Year 3 () In Progress (P) Not Initiated (NI) N/A for Time Period (NA) N/A with Progress (NA/P) *Staff recommendation Activity 1. Develop and adopt policies on non-discrimination toward Special Populations in the provision of HIV prevention and care services 2. Alter data collection and reporting methods in current local data collection systems (e.g., Testing 4 Tickets, ECLIPS, CPCDMS, etc.) to provide information on Special Populations, in particular, Homeless, IRR, and Transgender, including standard definitions for data collection and reporting requirements Responsible Party/ Parties RWPC, CPG RWGA, HDHHS RWPC/CPG Committee or Other Partner RWPC Affected, CPG Needs & Response, QA Committees Source/ Reference RFP/ Contract Language Timeframe Process Notes Status * See key above Annually Presence of client rights cards at funded agencies added to the RWGA audit checklist in Y2. Also in Y2, RWPC members received grievance policy training and launched a client rights card project; grievance data were also reviewed. HDHHS staff and CPG found that HDHHS already maintains a non-discrimination policy that covers HDHHS and its subcontractors. Recommendation: Change timeframe to and mark status as Complete N/a N/a The following changes were made to data systems in Y2 and maintained in Y3: Homeless: T4T, ECLIPS, and STD*MIS track homeless in past 12 months. CPCDMS/ ARIES Housing Status variables are aligned. IRR: T4T and ECLIPS track jail/jd in past 12 months. CPCDMS captures data via record holder. Transgender: all systems aligned for self-reported MTF/FTM. T4T and ECLIPS also track separate birth sex/gender options. SP sections included in the ACA Enrollment Special Study. Recommendation: Retain activity in Y4. DSHS STD*MIS upgrade in Y4 will provide additional gender options; continue focus on developing reporting alignment among AAs and HDHHS. * P* J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp Plan Checklist - SP docx Page 1 of 3

23 Activity 3. Establish or maintain formal partnerships between the Houston Area HIV Planning Bodies and agencies or individuals representing Special Populations; and through these partnerships, seek technical assistance and training on how the needs of Special Populations can be advanced 4. Sustain community-based Task Forces and Coalitions focused on Special Populations (e.g., Serving the Incarcerated and Recently Released Partnership/SIRR, Task Forces, etc.) 5. Sustain training on Special Populations in current capacitybuilding efforts for frontline HIV prevention and care staff 6. Require cultural competence training for frontline HIV prevention and care staff to have: (a) standard minimum training topics; and (b) methods for measuring change in knowledge, skill, and ability 7. Ensure data on Special Populations are included in the annual process for determining Ryan White HIV/AIDS Program Part A, B, and State Services funded services, priorities and allocations (i.e., How to Best Meet the Need and Priorities & Allocations) 8. Sustain HIV care services to specific Special Populations through the Ryan White HIV/AIDS Program Part A, B, State Services, and the Minority AIDS Initiative (MAI) 9. (If selected as the local direct funded Part D grantee) Sustain HIV care services to specific Special Populations through the Ryan White HIV/AIDS Program Part D 10. Sustain HIV prevention services to specific Special Populations through contracted community-based organizations Responsible Party/ Parties RWPC CPG, TRG RWGA, TRG, HDHHS RWGA, TRG, HDHHS RWPC/OS RWPC RWPC/CPG Committee or Other Partner RWPC Comp HIV Planning & Operations Committees CPG CMRC, Task Forces, SIRR N/a N/a RWPC P&A & QA Committees RWPC P&A & QA Committees Source/ Reference Timeframe Process Notes Status * See key above N/a Annually RWPC maintained formal representation on the needs of adolescents, homeless, IRR, MSM, and transgender in Y3 via member representation on agencies, CABs, and coalitions, as well as including representatives of special populations in Workgroups ECHPP Annually SIRR continued in Y3. Also, youth, MSM, and transgender Task Forces continued in Y3. Standards of Care Standards of Care Annually Annually Frontline staff trainings in Y3 included foci on MSM, YMSM, and Transgender. All RPs maintained cultural competence training requirements for frontline staff. The adapted Tool For Assessing Cultural Competence Training (TACCT) domains and a Pre/Post-Test continued to be used in Y3 N/a Annually SP data were provided in packets and during presentations on specific service categories during HTBMN in Y3. Recommendations for SPs were considered during Service Category discussions and P&A. N/a Annually Service/allocations targeting continued in Y3 for pediatrics, IRR, and MSM. TRG N/a N/a Annually Part D contracts continued in Y3, with a focus on YMSM and adolescents. HDHHS N/a ECHPP Annually Seven CBOs were funded in Y3 to provide prevention services to SPs, including IDU, MSM, YMSM, FSM, transgender, and youth. J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp Plan Checklist - SP docx Page 2 of 3

24 Activity 11. Explore how to address bias, stigma, and discrimination against Special Populations in social marketing and other mass education activities (e.g., HIP HOP for HIV Awareness/Houston HITS Home, School Health Summit), including data collection methods 12. Develop baselines and targets for each Special Population lacking benchmark data; this may develop into Special Studies on certain populations Responsible Party/ Parties RWPC/CPG Committee or Other Partner Source/ Reference Timeframe Process Notes Status * See key above HDHHS, HISD N/a N/a Annually Bias, stigma, and discrimination continued to be queried in Houston HITS Home pre/post tests conducted in Y3. One social marketing campaign addressing stigma also continued. Scientific Advisory Council s Sharing Science Symposium included a presentation on a study of the stigma experiences in HIV positive gay men. RWPC/OS RWPC Comp HIV Planning Committee, RWGA, TRG, HDHHS N/a Annually Feasibility Special Study was conducted in Y3 evaluating the feasibility of purchasing and sustaining ACA Marketplace plans for very low income consumers (below 100% FPL). J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp Plan Checklist - SP docx Page 3 of 3

25 HOUSTON AREA COMPREHENSIVE HIV PREVENTION AND CARE SERVICES PLAN FOR YEAR 3 EVALUATION CHECKLIST Strategy: 4 COORDINATION OF EFFORT (COE) *Status Key Complete (C) Complete for Year 3 () In Progress (P) Not Initiated (NI) N/A for Time Period (NA) N/A Complete (NA/C) *Staff recommendation Activity 1. Develop a methodology for determining the need for and use of alcohol treatment services vs. drug treatment services among Ryan White HIV/AIDS Program clients 2. Partner with the AIDS Education and Training Center (AETC) to target medical and nursing education providers to promote the opportunity of HIV-related training and employment 3. Engage broad-based Houston Area health, social service, and community coalitions in order to engage new and nontraditional partners in supporting the HIV mission 4. Adopt a process to develop a Houston Area HIV media and marketing plan that encapsulates priority audiences, messages, products, outlets, and outcomes for engaging earned media on HIV prevention and care issues 5. Explore the feasibility and practicality of developing a clearinghouse of available funding opportunities to support Strategy implementation 6. Translate the Houston Area HIV/AIDS Resource Guide into a real-time web- and phone-based resource locator with accompanying mobile applications (if feasible) accessible by clients and providers Responsible Party/ Parties RWPC/OS, RWGA, TRG RWPC/CPG Committee or Other Partner Source/ Reference Timeframe Process Notes Status * See key above N/a N/a Addressed via Needs Assessment (NA) conducted in Y2; was also replicated in East Texas HASA NA process. RWPC/OS AETC N/a Defer to Activity #13 (f) and (k) below. RWPC, RWPC/OS, TRG RWPC, CPG RWPC/OS RWPC Comp HIV Planning, CPG CMRC RWPC Affected, Committee, CPG CMRC, Needs & Response, and QA Committees RWGA, TRG, HDHHS N/a Annually Continued involvement in United Way ESPN & United Way Interagency Network in Y3. N/a A process for media planning was implemented in Y2. N/a Multiple HIV prevention and care funding distribution lists were identified in Y2. Creation and maintenance of a clearing house would be duplicative. RWPC/OS N/a N/a Mobile Blue Book app created in Y3/Y4, with beta version of the app available for Android smartphones in early Y4. HDHHS/CPG membership also assisted in the planning and development of a phone application that integrates the Blue Book, information on testing/care sites, and safer sex messages with Baylor Teen Clinic. Recommendation: Retain activity in Y4 C C C P* J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp Plan Checklist - COE docx Page 1 of 4

26 Activity 7. Create an increased public health insurance coverage scenario for Ryan White Part A, B, and State Services funding allocations in anticipation of expansions in coverage occurring through health care reform 8. Work with Ryan White HIV/AIDS Program funded primary care providers to develop implementation plans for federally-compliant Electronic Medical Records platforms 9. Provide educational opportunities and materials to people living with and/or affected by HIV/AIDS regarding the impact of the Patient Protection and Affordable Care Act on HIV services. 10. Explore the feasibility of partnering with Area Agencies on Aging and Aging and Disability Resource Centers (ADRC) to provide public health insurance benefits counseling to newly eligible HIV infected consumers 11. Facilitate technical assistance and training for Administrative Agents, funded AIDS-service organizations (ASOs), and potential new ASOs such as FQHCs and Medicaid providers to prepare for health care system changes (e.g., Medicaid/Medicare eligibility and processes, expanding client pools, EMR and quality measures, fiscal diversification and sustainability, core elements of HIV care and transitioning to medical homes, etc.) 12. Continue to conduct core comprehensive HIV planning processes jointly between the Ryan White Planning Council (RWPC) and the HIV Community Planning Group (CPG) Responsible Party/ Parties RWPC RWPC/CPG Committee or Other Partner RWPC P&A Committee Source/ Reference RWGA, TRG N/a Standards of Care RWGA, TRG, RWPC/OS RWPC Affected Committee Timeframe Process Notes Status * See key above N/a The approved Level Funding Scenario for Y2 included adjusted allocations per the impact of the federal/aca marketplace. The RWPC HIA Workgroup also convened, and the HIA service definition was revised to align with ACA. Adult primary care providers have EMR systems in place per SOC adopted in Y1. N/a Annually Training was provided in Y3 via RWPC, frontline staff, and ASOs. Agendized discussion of the marketplace also occurred at RWPC meetings throughout Y3. New Part A/B SOC related to the marketplace became effective in Y3. RWPC/OS conducted two Special Studies in Y3 on ACA enrollment among consumers, and feasibility of a pilot project to purchase Marketplace plans for individuals below 100% FPL. RWPC/OS N/a N/a Partnership was found to be unnecessary as AAA and ADRC were selected for federal funding in Y2 to provide navigator services. RWGA, TRG AETC N/a Annually RWGA and RWPC/OS provided technical assistance to Dallas EMA and Dallas Planning Council Support Office on Quality Management/Quality Improvement; fostering positive relationships and participation with planning council membership, and EIIHA plan development in Y3. RWPC, CPG RWPC Comp HIV Planning, CPG Executive, Needs & Response, and QA Committees N/a Annually A Joint Epi Profile Supplement was released in Y3; Project LEAP was co-sponsored by RWPC and HDHHS, resulting in new RWPC/CPG members for Y3. C C C J:\Committees\Comprehensive HIV Planning\2015 Comprehensive Plan\YEAR 3 Evaluation Process\Y3 Comp Plan Checklist - COE docx Page 2 of 4