Integrated HIV Statewide Coordinated Statement of Need (SCSN)/Comprehensive Plan Update

Transcription

1 Integrated HIV Statewide Coordinated Statement of Need (SCSN)/Comprehensive Plan Update Ryan White HIV/AIDS Program Part B Administrative Reverse Site Visit November 6, 2014 Andrea Jackson, MPH, Project Officer, Division of Metropolitan HIV/AIDS Programs (DMHAP) Candace Webb, MPH, Project Officer, Division of State HIV/AIDS Programs (DSHAP) U.S. Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB)

2 Presentation Overview I. CDC/HRSA Support of Integrated SCSN/HIV Plans II. III. IV. Status of Integrated HIV Plans in the U.S. What is Integrated HIV Planning? (and why do it?) Common Goals for HIV Prevention and Care Planners V. Barriers to and Benefits of Integrated HIV Planning VI. Range of Integrated HIV Planning Activities VII. Next Steps and Resources 2

3 Upcoming Guidance on Integrated HIV SCSN/Comprehensive Plan In February 2014, the Centers for Disease Control and Prevention (CDC)/Division of HIV/AIDS Prevention (DHAP) and the Health Resources and Services Administration (HRSA)/HIV/AIDS Bureau (HAB) issued a joint letter indicating that guidance will be provided to allow grantees to submit an Integrated HIV Statewide Coordinated Statement of Need (SCSN)/Comprehensive Plan that would fulfill the legislative and programmatic requirements for the Ryan White HIV/AIDS Program (RWHAP) and the HIV Prevention Programs The guidance will address the content and structure of the Integrated HIV SCSN/Comprehensive Plan The guidance will not address the planning process that grantees use to develop the Integrated HIV SCSN/Comprehensive Plan 3

4 AK WA OR NV CA Integrated HIV Care-Prevention Jurisdictional Plans (September 2014) ID UT AZ MT WY CO NM ND SD NE KS OK MN IA MO AR WI IL MS IN MI TN AL KY OH GA WV SC VT PA VA NC NY NH ME MA RI CT NJ DE MD TX LA FL Atlanta Chicago District of Columbia HI New York City Philadelphia Guam Integrated HIV Prevention-Care Jurisdiction Plan and/or Recommendations to Address Care Continuum Gaps More information needed Los Angeles San Francisco Separate Prevention and Care Jurisdiction Plan as of September 2014 Data Source: NASTAD, National HIV Prevention Inventory, Module 3

5 CDC/HRSA Letters Supporting Integrated HIV Planning and Plans May 22, 2013 Letter (Integrated HIV Planning) o Encourages planning groups to streamline approaches to HIV planning o Supports planning as an important part of developing integrated systems of HIV care and prevention February 24, 2014 Letter (Integrated SCSN/Comprehensive Plan) o Establishes new due date for Integrated HIV SCSN/Comprehensive Plan: September 2016 o Encourages streamlining of HIV care and prevention planning activities and provides examples 5

6 Integrated Planning What is it and how can it contribute to an Integrated HIV SCSN/Comprehensive Plan? Integrated planning is the process by which HIV care and prevention planning groups work together to: Review information about the HIV epidemic in the jurisdiction Provide recommendations for and/or allocate resources for interventions and services to address the epidemic Review needs assessments and/or service utilization to further inform recommendations May be accomplished through collaboration on joint projects, sharing planning products, sharing members, or totally integrating into one planning body 6

7 Why Integrated Planning Activities? To develop a coordinated jurisdictional response to HIV To avoid duplication of processes Many points of intersection and shared knowledge, data and processes (e.g., epidemiological profile, by-laws, nominations, community involvement, address common social and structural determinants of health ) More economical (i.e., sharing resources) Increased collaboration and communication 7

8 Why Integrated Planning Activities? Prevention and care are increasingly overlapping in both activities and funding o In order to coordinate efforts and maximize funding, it is helpful if everyone is at the table Fosters integration of prevention into care services Allows monitoring of outcomes across the Continuum of Care 8

9 Why Integrated Planning Activities? Key National Policy Initiatives encourage it: o The White House s National HIV/AIDS Strategy (2010) o CDC s High-Impact Prevention (HIP) (2011) o President s Executive Order on the Continuum of Care (2013) o HHS focus on reducing reporting burden for grantees Improve efficiency and effectiveness of federal programs 9

10 Why Care & Treatment Planners Should Pay Attention to Prevention New strategies for HIV prevention impact care settings o PrEP o Treatment = Prevention Strategies to encourage knowledge of sero-status Facilitate linkages Maximize service provider capacity Maximize resources for overlapping activities 10

11 Why Prevention Planners Should Pay Attention to Care and Treatment CDC s HIP expands counseling, testing and referral (CTR) and partner services Strategies for prevention with people living with HIV (PLWH) Treatment = prevention Provide behavioral interventions in clinical care Facilitate linkages Maximize service provider capacity Maximize resources for overlapping activities 11

12 Partnerships and Collaboration HRSA and CDC expect collaboration, partnering, and coordination in planning and implementation of services between multiple sources of care, prevention, and treatment service providers o HIV testing sites o Non-Ryan White HIV/AIDS Program providers o All Ryan White HIV/AIDS Program Parts (A, B, C, D, and F) o Medicaid and Medicare o Veterans Affairs o HUD/HOPWA o SAMHSA, etc. 12

13 Common Goals of Prevention and Care To ensure that individuals learn their HIV status To ensure that people living with HIV are linked to medical care, support services, treatment, and prevention services tailored to meet their particular needs To ensure that HIV-negative individuals at increased risk for HIV are linked to prevention and other services that will keep them HIV-negative 13

14 Common Goals (cont.) Plans are comprehensive and promote coordination and linkages of services Ensure planning reflects the diversity of local epidemic Assure meaningful involvement of PLWH in planning processes Assess effectiveness of HIV plans and processes 14

15 Possible Barriers to Integrated Planning Competing agendas (turf issues, mistrust) Over-dominance by either care or prevention More meetings for members who had only been on one group prior Categorical funding/requirements from CDC and HRSA Need to establish integrated data systems/sharing agreements Transition phase requires initial influx of resources to increase knowledge about care and prevention 15

16 Benefits of Integrated Planning Allows development of common mission/vision Encourages sharing of knowledge and data Combines/maximizes limited resources Reduces planning costs in the long term Creates comprehensive services/encourages linkage of services Fosters integration of prevention into care services and vice versa 16

17 Range of Integrated Planning Activities Information Sharing Cross Representation Joint Information Gathering/Data Analysis Other Joint Projects Joint Prevention/Care Plan Joint Planning Committee Unified Prevention/Care Planning Body 17

18 HIV Planning Group Models (July 2014) AK WA MT ND OR MN ID SD WI WY NV CA UT AZ NE IA CO KS MO OK NM TX MI IL IN OH WV KY TN PA VA NC SC AR MS AL GA LA FL VT NH NY ME DE MD NJ MA RI CT Prevention Planning Integrated Prevention- Care Planning HI Directly funded city Prevention Planning Atlanta Baltimore Chicago Fort Lauderdale Houston Los Angeles Miami New York City Philadelphia San Francisco Puerto Rico U.S. Virgin Islands District of Columbia U.S. Affiliated Pacific Jurisdictions

19 Next Steps for Integrated Plans and Planning HRSA\HAB and CDC\DHAP will continue to encourage a range of integrated planning activities Jurisdictions should assess the range of activities and determine which are most beneficial and cost effective to implement Guidance on the Integrated HIV SCSN/Comprehensive and Jurisdictional Plans will be released spring 2015 Exploration of technical assistance needs and resources 19

20 References CDC/HRSA Dear Colleague Program Letters Supporting Integrated Planning and Integrated Plans May 22, 2013 Letter (Supporting Integrated Planning) February 24, 2014 Letter (Supporting Integrated SCSN/Plans) National Alliance of State and Territorial AIDS Directors (NASTAD) Integrated HIV Care-Prevention Jurisdictional Plans (as of September 2014) Map, B. Pund, 10/22/2014 NASTAD HIV Planning Group Models (as of July 2014) Map, B. Pund, 8/26/

21 Resources Target Center: Tools for the Ryan White Community, Topic: Planning, NASTAD Integrated HIV Planning Webinar, February 2013, 13.pdf NASTAD Toolkit: Integrated, Collaborative or Merged Prevention and Care Planning Processes, May 2007, kit%20may% pdf Trends in Collaborative Care and Prevention Planning PowerPoint Presentation, NASTAD, C. Aldridge and C. Jorstad, 6/05/2006, esentation%20% ppt 21

22 Questions? Comments? 22

23 Contact Information Candace Webb, MPH Division of State HIV/AIDS Programs (Part B) (301) Andrea Jackson, MPH Division of Metropolitan HIV/AIDS Programs (Part A) (301)