2018 HEI Case Management and HIV Street Outreach Supervisors Meeting Collaborative Notes from January 29 th, 2018

Transcription

1 2018 HEI Case Management and HIV Street Outreach Supervisors Meeting Collaborative Notes from January 29 th, 2018 What to do with the $7.4 million? Outreach and engagement focused on substance use and overdose prevention Housing for S.U. Transportation for S.U. services Support groups for S.U. clients Education for clients and family General outreach Put it back into substance abuse or mental health Make sure the programs include care management and some form of outreach Move funds to SUD and prevention grants to include outreach, case management, and recovery coaches Putting money into programs for at risk S.U. clients such as case management, RH, education for program staff that will expand their knowledge about at risk clients. Take the time to see what has been working and the fund those programs Difficult to Say: 1. No other program is attending to the actual needs of the population 2. $7.4 million will not educate or create a new infrastructure 3. We educate the wrong people I don t know that s my answer COPSD case management for the medically vulnerable Adding a community based nurse to outreach for medical purposes and health education Outreach in TRA and TRY Outreach in MAT Money should be distributed towards other programs focused on behavioral health and substance abuse programs TTOR SA outreach Medical case management for clients who have substance abuse and mental disorders. The team would include case managers, a community based nurse, and a peer recovery specialist. Case management for MAT Still focus on substance abuse (a sub category pretreatment, post treatment, homeless) Disburse to areas of highest disparity leading to infection, SUD, and MH. Support recovery programming Comprehensive integrated prevention

2 Education series 1. HIV 2. TB 3. STD 4. HEP 5. Overdose prevention 6. EBI trainings Treatment and intervention programs All HEI CM clients have SUD. Continue same CM services with priority on SUD. CM s are already trained for it. Distribute money to other substance abuse programs with a portion dedicated to prevention services Look for the needs of clients/community under-served and help those communities Change focus of education from HIV and STI s to SUD. Keep structure and staff that already exist. Keep the money in prevention and intervention Develop substance abuse program The funds should be used to promote innovative ideas in substance abuse prevention within high-risk communities. Programs should be developed that use innovative approaches to target potential substance users and deter them from substance abuse. More programs to address substance abuse as a chronic disorder Since target population has always been SA users (at risk of HIV), why not allocate funds to conduct outreach and case management for SA misuse. That is to seek out and find these individuals, provide education, and link to treatment. There is a HUGE need for rural opioid treatment clinics. The state is in crisis and there aren t enough OTS clinics to help. These clinics should be multifunctioning in providing MAT, counseling, prevention education, with recovery coaches. Need a rehab in-patient facility in the valley, otherwise you have to cross the checkpoint (Peer providers) Case management for high risk HIV negative substance users Rural methadone clinics (funded sites) We currently have people traveling five hours a day round trip for funded slots Provide access to medications and healthcare and no cost to all Texans J Develop case management programs for all chronic health conditions Syringe/needle exchange

3 Keep money in outreach activities with the focus being substance abuse and connecting and tracking treatment Make sure all areas including rural and smaller urban areas have equitable access Homeless shelter that is accessible to the homeless Allocate to prevention and expand to focus on adults What are the key messages for the state? Consider the individuals and communities that they belong to. How would the funding change the environment? Disproportionately affect those already at risk for chronic medical problems. Unless this funding continues to be used to support the clients we currently serve, they will fall through the cracks, fall out of medical care, incarceration rates will go up, and our overdose rates will rise. The cost to the community will be great. Community based services for people with co-occurring substance use disorders and medical conditions is imperative in order to keep people engaged in medical care, on psych meds, out of jail, in housing, out of the ER and connected to other support services. Provide Transition TA/site visits Since this funding cut was due to decrease in AIDS, why can t money transition to HIV only? It s two different subjects. AIDS diagnoses have decreased, in part, via services like HEI/prevention. Removing those services is counter-productive. Include us in decision-making. Help fund the organizations that are losing the funding. Who else will take care of this, specifically catering to the population at their focus? Are you prepared for the short- and long-term fall out for taking the HEI/HIV? Current status of client with behavioral health and SACD issues. Should have more clinical provided services in a SA prevention COPSD prevention. This will disproportionately affect minorities. A clear timeline, adaptation and strategy training are needed to support these changes. Be inclusive and get input when writing to feds. Know the community needs! Reductions in HIV/AIDS cases are a direct reflection of prevention programing impact- To de-fund without successfully integrating these activities into other programs is a dis-services to TX residents. If you want HIV rate to stay down, then you will have to continue funding some sort of program (HIV). Loss of expertise/experience and resources of qualified staff in the field. Translates into loss of revenue.

4 Gaps in services that will result in increase in mortality. Too many people fall through gaps. There needs to be a bridge to cover them for all. Focus on attention to at-risk populations. Get input directly by those affected. (Clients etc.) What are questions for the state? How effective with change of program scopes will truly provide the essence of the population not to go underserved? What are the state s strategies, goals and objectives for SA misuse in Texas? How does plan to allocate funds align with these goals/obj.? Are there any new goals to treat substance misuse disorders? What are the prevention strategies now the funding is changing? How would you like to be involved/provide feedback? Dedicated or website to send suggestions Notice of open meetings Listening sessions and forums Visit current programs to see what we do and receive direct input Legislators Ryan White DSHS representatives visit current areas to see first-hand clients and their needs Speak with politicians Committee Conference Calls Conferences (in person) Focus groups with clients Community needs assessments Research current clients and their needs to be documented to write in strategic plans for the allocation of funds to be distributed appropriately Regional meetings so everyone can participate in person SUD needs our programs as support to enhance and improve quality of live In person meetings Webinars Conference calls Surveys Funding hearings Focus groups Town/state hall meetings? The people who make decisions, basically the state.

5 Several town hall meetings organized by the agencies so everyone has a chance to talk Advocacy: contact local and state officials Localized planning committees Austin monthly planning meeting for supervisory staff Letters Funding hearings Congress, state legislature Hospital Districts- Like a state board Let our voice be heard Individual organization leadership meet with HHSC (it s only 16 in the room right) Town halls Client surveys Conference calls Meetings Webinars Focus groups collect quantitative data and report out Get everyone involved with the discussion (clients, agencies, community, political) Focus groups are inaccessible for most clients and different regions have different needs. We need diversity in options. Conference calls Groups Specialized committees Who else should be at the table (allies, partners, etc.)? Partners Health Department City of Beaumont Hospitals Substance Abuse Centers Advocacy groups for highest at risk population leading to infection The staff from CEO s to direct care Clients Staff Stake Holders All agencies, organizations, community groups, stakeholders, etc. that serve individuals within target areas and individuals who are at a high risk of becoming person with substance abuse issues.

6 Police department for Red Cord program. (Nueces County) Persons who are infected and affected should have a voice to help impart the need of care Local political figures FQHCs Hospital Districts Other HEI HIV providers Clients and the organizations that we service Board of Directors Community partners; such as other SUD Providers Health departments FQHC Clients Community based organizations - treatment and prevention Health care organizations Consumers/Clients Schools Health Department