Ryan White Part A Provider Conference

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1 Ryan White Part A Provider Conference May 3, 2017 Dennis Brophy Director, Ryan White Services Division

2 Agenda MORNING SESSION 10:00 10:20 a.m. Welcoming Remarks & Ryan White Part A Update 10:20 10:35 a.m. Agency Monitoring Updates 10:35 10:50 a.m. Contract Management Updates 10:50 11:00 a.m. Planning Council Updates 11:00 11:30 a.m. Agency Highlight: Ryan White Dental Program 11:30 12:30 p.m. LUNCH AFTERNOON SESSION 1:00 2:00 p.m. Activities Round 1: Client Scenarios; Best Practices Forum 2:00 3:00 p.m. Activities Round 2: Client Scenarios; Best Practices Forum 3:00 4:00 p.m. Planning Council Networking Event 2

3 Ground Rules Stay for the entire training Set cell phones to vibrate Participate by sharing your own ideas and experiences Step up / Step back Respect each other s opinions Minimize side conversations Use the Parking Lot 3

4 Housekeeping Restrooms are located in each AV Room Wi-Fi: GRIN network Username: bphcrwtraining Password: nfhprd22 We will have short breaks during the day to allow you to stretch Lunch is not provided, BUT there are plenty of options nearby, incl. a café in the building Please return to the afternoon activity on time 4

5 Materials Conference Packet Handouts, including all PowerPoint presentations Evaluation form FY17 Provider Manual 5

6 Tell us what you think! Your feedback is used when we plan each Provider Training. Remember to write your comments and questions as we go through the presentations. We hope you can share them with us! 6

7 Ryan White Part A Update May 3, 2017 Dennis Brophy Director, Ryan White Services Division

8 BPHC Mission To protect, preserve, and promote the health and well-being of all Boston residents, particularly the most vulnerable. Through: providing and supporting accessible high quality community-based health and social services, community engagement and advocacy, development of health promoting policies and regulations, disease and injury prevention, emergency services, health promotion, and health education services. 8

9 Our goals remain the same Improve access to care Reduce health disparities Reduce new infections Help people living with HIV achieve and maintain viral suppression FY15 Rate: 81%; FY16 Rate: 85%; FY17 Rate:?? 9

10 Health Disparities New HIV Diagnoses in the United States for the Most-Affected Subpopulations, 2015 Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, HIV Surveillance Report 2016;27. Subpopulations representing 2% or less of HIV diagnoses are not reflected in this chart. Abbreviation: MSM, men who have sex with men. 10

11 How do we reach our goals? HRSA BPHC Client Planning Council Providers 11

12 How do we reach our goals? Communication Collaboration Coordination 12

13 Ryan White Part A Services AIDS Drug Assistance Food Bank & Home-delivered meals Housing Medical Case Management Medical Nutrition Therapy Medical Transportation Oral Health Psychosocial Support (Peer, Mental Health, Substance Use) Substance Abuse Residential care 13

14 Ryan White Legislation Last Reauthorized in 2009 through Public Law No Sunset Provision Payer of Last Resort 14

15 RW Part A Boston EMA In FY16, a total of ~$628M of RW Part A awarded to 52 EMAs and TGAs Boston received the 13 th highest total amount: $14.5M 15

16 Ryan White Fiscal Components Total annual award amount is made of 3 parts: Formula Award: our share of people living with HIV MAI Award: to strengthen support for minority communities Supplemental Grant Award: competitive; demonstrated need 16

17 Millions Ryan White Part A Awards $15 $14 $13 $12 $11 $10 $9 $8 $7 $6 $5 FY11 FY12 FY13 FY14 FY15 FY16 FY17 Formula Supplemental MAI 17

18 Ryan White Funding Process Funding comes from Federal Budget Federal Budget Status Partial Award Part A Fiscal Year 2017 FY17: October 1 st, 2016 September 30 th, 2017 Continuing Resolution: December April 28 th, 2017 To allow BPHC time to process contracts, HRSA issued $6,717,918 on January 17 th, (Incl. % Formula and MAI) March 1, February 28 th, 2018 Full Award Expected in next 4-8 weeks (Incl. Supplemental) 18

19 RW FY16: Closing Out Process reports, data, and invoices from agencies Annual report to Planning Council Annual report to HRSA 19

20 RW FY17: Implementation Majority of programs received renewed contracts, incl. those funded through FY16 RFP (MCM, PS, MT) Four agencies funded through FY16 HOU RFP received new contracts, with conditions: develop work plans and hire staff by May 1 st. 20

21 RW FY17: Implementation Application of Planning Council funding scenario: $500,000 full award reduction Partial award = 4 month cap on funding: March 1 st to June 30 th. Total spending capped at 30% until full award issued. 21

22 RW FY17: Implementation Full Award: Anticipated in May or June. Re-issue of all contracts. May return to level-funding or be deeper cut. 22

23 RW FY17: Adjustments Sweeps: mid-year review of spending Carryover: funds unspent from previous year to address unmet need this year 23

24 RW FY18: Planning Ranking of service priorities (March 2017). Development of FY18 funding scenarios and allocations (May 2017). Compliant programs expected to have FY18 budgets; contingent upon program performance and available funds. 24

25 RW FY18: Planning HRSA Site Visit (May 2017) may influence BPHC responsibilities and reporting requirements 25

26 Questions?

27 Thank you!

28 Agency Monitoring: Site Visit Overview, Successes and Opportunities for Collaboration May 3, 2017 Elizabeth Rios Senior Program Coordinator Ryan White Services Division

29 FY16 By the Numbers 37 Funded Agencies in 12 service categories over 10 counties in MA and NH. Total of 65 programs. 4,682 clients received at least one service from a Part A funded agency in FY % of FY16 clients are known to be virally suppressed. 29

30 Strength in Numbers Best Practices Collaborate Improved Health Outcomes 30

31 BPHC Annual Site Visits Meet National Monitoring Standards. Evaluate programs compliance to established Standards of Care. Opportunities to obtain real-world information about programs successes and challenges. Enhance relationships with providers. Provide immediate feedback to agencies. 31

32 What are we looking for? 32

33 Letter of Findings Summarizes the visit. Describes observed program strengths and progress. Clarifies BPHC policies when applicable. Specifies areas that require immediate compliance. Outlines necessary follow-up steps. 33

34 Plan of Corrective Action Formalizes response to any citations or concerns identified in the site visit. Requires the agency to offer potential solutions that fit the program. Clarifies steps and processes for agency to implement changes within a specific timeframe. Provides framework for evaluation of progress. 34

35 Monitoring Process Annual Site Visit Plan of Corrective Action Annual Site Visit March 1 April 1 May 1 May 15 March 1 Findings Produced Plan Monitoring* *Required: Quarterly reports and monthly calls Possible: Face-to-face meeting, follow-up visit, training, technical assistance, etc. 35

36 Citations: Four year break down Fiscal Year Agencies Visited Filed Reviewed Citations Issued Agencies Cited FY % FY % FY % FY % Percentage of agencies cited annually has declined since FY14 36

37 Most common citation issued in FY 2016 Proof of Insurance (9) Proof of Income (7) Evidence of Supervisory Review (6) 37

38 Highlights from FY16 Boston EMA met HRSA s requirement to conduct annual site visit for each agency BPHC conducted 33 site visits for 65 programs BPHC issued 56 citations (compared to 94 in 2015) o 16 agencies received 0 citations (compared to 4 in 2015) 38

39 Noted Improvements Service Plans and Reassessments Goal Setting and client engagement Attestation Forms 39

40 Agency Successes Internal tracking system for Eligibility Documentation Collection Notarized letters to confirm address and income Staff supporting one another through vacancies and transition QI systems to track new diagnosis and length of time to get into care. 40

41 Encouragement to Collaborate HRSA encourages information sharing among Part A providers The Boston EMA Agency Portfolio includes vast array of knowledge and expertise. Many agencies refer clients to one another Agencies can successfully collaborate without duplicating services 41

42 Tips, Tricks and New Standards Conduct Reassessments over the phone once a year (HRSA-1302) Attestation forms minimize paperwork collection among clients For FY18 Transportation logs should be present at time of site visit Supervisory Review should be conducted with a checklist 42

43 Client Communication Replacing Phone Follow-Up Defined as: Enter one (1) for each non-initial communication which provides client-centered assistance. These activities include, but are not limited to: phone calls, s, text messages, house visits. You may enter up to three units for a single day. One Unit = One communication activity.

44 Compliment one another! 44

45 Contract Management Update May 3, 2017 Cheryl Brickey, Senior Program Coordinator, Ryan White Services Division

46 Our goal This fiscal year the Contract Management Team in collaboration with all Ryan White Services Division teams will be working to create a successful support network for our funded agency s through creating venues that will allow for the sharing of information and resources. 46

47 Program Reporting & New Initiatives

48 Quarterly Reports All funded programs are required to submit quarterly reports. Quarterly reports allow BPHC to monitor each program s progress on meeting its contracted goals and objectives. Requirements include the submission three forms of client-level data: Demographic Service utilization Outcomes

49 Quarterly Reports BPHC also uses the report To gather information for HRSA reports To identify program, training and technical assistance needs To recognize trends regarding access to services, barriers to care, client demographics, and service utilization.

50 What we have identified A review of FY16 quarterly reports, monthly check-in calls, site visits and provider questions from the MCM trainings the contract management team has identified the following provider needs: Additional trainings surrounding High Acuity MCM, ISP s, e2boston, and Peer Advocate roles and responsibilities. Standards of Care and policy clarifications. Immigration and housing resources.

51 Our Response To address the identified needs the contract management team will be working with the teams within the RWSD to implement the following: Listservs Best Practice Meetings Increased Training Opportunities Webinar based resources

52 The RWSD ListServ The RWSD Listserv will provide agencies the opportunity to: Highlight Best Practices Share resources Discuss challenges Make announcements Provide updates

53 RWSD ListServs In June providers will have the opportunity to subscribe to : A general Listserv for all funded agencies that will provide important program and policy updates as well as sharing resources. Category specific ListServs for both Medical Case Management and Peer Support program staff to share best practices, challenges and resources.

54 Best Practice Meetings This fiscal year the Contract Management Team in collaboration with the BPHC MCM Training Team will host regional bi-annual Best Practice meetings. The Best Practice Meetings will provide the agencies the opportunity to meet to discuss identified challenges, best practices, resources and to hear from experts.

55 Emerging Training Needs The Contract Management will continue to monitor programs to identify any emerging training and technical assistance needs. As these needs are identified the contract management team will work with our funded training programs to ensure those identified needs are addressed.

56 Upcoming Training Opportunities MCM and Peer Support Training programs will continue to provide core trainings along with some newly added trainings. The BPHC MCM Training program will provide a series of trainings for our newly funded housing programs. The BPHC MCM and the JRI Peer Support Training programs will provide a collaborative training around the delineation of MCM and Peer roles.

57 Webinar Based Resources The RWSD will create a webinar based resource for our funded agencies that will provide agencies the opportunity to access important information regarding the requirements of their Ryan White Part A funding; important policy updates and any relevant webinar based trainings.

58 Reporting Reminder Submission Reporting Period Due Date 1 st Quarterly Report Mar 1 - May 31 June 15, nd Quarterly Report June 1 - Aug 31 Sept 15, 2017 Outcomes Report Mar 1 - Aug 31 Sept 15, rd Quarterly Report Sept 1 - Nov 30 Dec 15, th Quarterly Report Dec 1 - Feb 28 Mar 15, 2018 Outcomes Report Sept 1 - Feb 28 Mar 15, 2018

59 Thank You!!!!

60 Questions?

61 Ben Penningroth Program Manager

62

63

64

65 Application Process: Brief paper application Letter of recommendation from colleague Interview with Council members Commitment (don t be scared): Two meetings per month, September June Total of four hours Two years!

66

Ryan White Part A FY 2017 Housing RFP RFP Conference. Frequently Asked Questions (FAQ) Published November 23 rd, 2016

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