OVERVIEW - HIV HEALTH SERVICES PERFORMANCE OBJECTIVES FY

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2 erformance FY 07-8 HIV Health Services VERVIEW - HIV HEALTH SERVICES ERFRMANCE BJECTIVES FY 07-8 Measuring client improvement and successful completion of target objectives is an important part of SFDH contracting. The HIV Health Services (HHS) and Development and Technical Assistance (CDTA) sections have been working this past year to create a group of performance objectives that are standardized across most service categories. ur goal was to build from current objectives, and create meaningful, measurable, demonstrable objectives that will accurately reflect the good work that you provide to your clients, and will lead to a clearly understood and interpreted review of performance in meeting objectives. These performance objectives are effective on the first date of the contract year for For example, contracts with Ryan White funding are required to begin using the new objectives on March, 07, and contracts with General Fund dollars are required to begin using the new objectives on July, 07. s that contain more than one source of funding are required to begin using the new objectives on whichever funding cycle is earliest: in most cases this will be March, 07. If you are unsure as to when the new objectives are effective for your program please call the CDTA rogram Manager assigned to your contract. Not all objectives apply to all programs. roviders should review this document carefully to determine the objectives that are applicable to the funded program(s). ors are responsible for compliance with all applicable items in the erformance and the Declaration of Compliance. All SFDH erformance may be located at: under the link " Development Documents" i.

3 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have 70% of HIV+ clients (primary care documented in ARIES) will have had two or more medical visits during the year (one in the first half and the other in last half of the year). 85% of clients with HIV (rimary Care documented in ARIES) who received primary care services will have been prescribed HAART. 90% of clients with HIV who received primary care services (documented in ARIES) will have had at least one viral load test. Enrolled 6 months Enrolled 6 months Enrolled 6 months rogram Review) ARIES report of documentation required in database of client records ARIES report of documentation required in database of client records ARIES report of documentation required in database of client records eriod BCC Scoring Yes = artial No = 5 oints if N N NTES. % may vary; program s CDTA rogram Manager to discuss with HHS; if lower % approved, separate agreement signed, shared with HHS & BCC. Evaluate & is "Medical Visit Indicator" in ARIES/HRSA HIV/AIDS Bureau (HAB) Quality Mngmt (QM) Report NTE: bjective not applicable to DH-JHS- HIV-IS, City Clinic, and BAAC-HIVE. % may vary; program s CDTA rogram Manager to discuss with HHS; if lower % approved, separate agreement signed, shared with HHS & BCC.. Evaluation & is "Medications" checkbox in STAR Report. NTE: UC HAST rogram goal is 55%. % may vary; program s CDTA rogram Manager to discuss with HHS; if lower % approved, separate agreement signed, shared with HHS & BCC.. Evaluation & is "Viral Load Test Table" filtered by primary care services in ARIES STAR Report created

4 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES %, of clients (rimary Care documented in ARIES) will have a viral load < 00 copies/ml which will indicate viral suppression and treatment adherence. 3 80% of clients with HIV (rimary Care documented in ARIES) and a CD4 T-cell count 00 cells/mm3 will be prescribed C prophylaxis. Enrolled 6 months All rimary Care with T-cell Counts below the threshold ARIES report of documentation required in database of client records ARIES report of documentation required in database of client records N N. % may vary; program s CDTA rogram Manager to discuss with HHS; if lower % approved, separate agreement signed, shared with HHS & BCC.. For Medical Case Management rate is 75% of clients on HAART. 3. Evaluation & ment is the "Cross Tab Wizard" Report NTE: UC HAST rogram goal is 50%. Evaluate & is "Fix-It C rophylax " Report NTE: bjective not applicable to DH-JHS- HIV-IS, City Clinic, and BAAC-HIVE; UC HAST rog goal is 75% 8 70% of clients with HIV who received primary care services (documented in ARIES) will be tested for syphilis, with results documented. Enrolled 6 months ARIES report of documentation required in database of client records. % may vary; program s CDTA rogram Manager to discuss with HHS; if lower % approved, separate agreement signed, shared with HHS & BCC.. Evaluate & is "STI / Hepatitis checkbox" in the STAR Report created

5 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES % of clients with HIV who received primary care services (documented in ARIES) will have been screened for Hepatitis C. 80% of clients identified as out of care will be linked to primary care (documented in ARIES) as measured by attendance at a medical appointment 30 days of being identified as out of care. Enrolled 6 mos., except those who previously tested HepC+ All clients who are out of care ARIES report of documentation required in database of client records ARIES - rograms will provide a list of out of care clients N. % may vary; program s CDTA rogram Manager to discuss with HHS; if lower % approved, separate agreement signed; shared with HHS & BCC.. Evaluation & ment is "Hep C Screen since HIV Dx Indicator" in ARIES RSR. Values of "Hep C Screen since HIV Dx Indicator" for Yes & Not Medically Indicated qualify as screening & should be added to calculate 60% compliance. % may vary; program s CDTA rogram Manager to discuss with HHS; if lower % approved; separate agreement signed; shared with HHS & BCC. ut of Care = any client that hasn't had primary care app't. 3 or more mos. apart Also applies to SEHC 90% of clients will be assessed for mental health and substance use treatment needs 30 days of program enrollment. All New N Also applies to SEHC created

6 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 80% of individualized service plans will be developed 90 days of initial client intake. All -include acuity scale, harm reduction & tx plan N. Comprehensive individualized plan includes Mental Health & Substance Use assessment. Tx plan signed by client and clinician Also applies to SEHC 3 80% of individualized service plans will be updated at least every 6 mos. All -include acuity scale, harm reduction & tx plan N. Comprehensive individualized plan includes Mental Heath & Substance Use assessment Also applies to SEHC 4 90% of residents will be adherent to their treatment regimen. All Residents Medication logs. % may vary; program s CDTA rogram Manager to discuss with HHS. If lower % is approved, separate agreement signed, shared with HHS & BCC 5 No more than 0% of unduplicated mental health clients will be lost to follow-up. All New Receiving Services 6 Months N. Lost to follow-up = one who assigned clinician has been unable to contact or locate after several attempts (does not include clients who declines services in favor of others, relocate outside service area, or are deceased) Also applies to SEHC created

7 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have 6 TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support 90% of residents will have an "End of Life lan" and documentation will exist prominently in resident's chart. All rogram rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if N NTES Applicable to Maitri AIDS Hospice % of applicable resident records will contain documentation that referral has been made to the Alliance Health roject Dementia Team for evaluation. 70% of clients will experience a stabilization or decrease in pain resulting from implementation of the pain management plan. atients with Dementia Symptoms All Receiving ain Meds, client self report N N Applicable to Maitri AIDS Hospice. symptoms that impact physical or mental health, or pose a risk of falls or elopement Applicable only to Maitri AIDS Hospice and SFDH Health at Home. % may vary; program s CDTA rogram Manager to discuss with HHS; if lower % approved, separate agreement signed, shared with HHS & BCC. ain is assessed at entry to the program and at least every 60 days NTE: Health at Home Goal is 50%. created

8 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 9 80%¹ of clients who agree to obtain medical care will receive a primary care evaluation visit within 4 weeks of testing positive or being identified as "out-of-care".² HIV+ ut-of-care MNHC Data and ARIES - rogram provides list of clients out of care N Applicable to MNHC HIV Treatment, utreach and Linkage rogram and SFDH SEHC Bridge roject. % may vary; program s CDTA rogram Manager to discuss with HHS; if lower % approved, separate agreement signed, shared with HHS & BCC. A client identified as "out of care" is one who hasn't had at least primary care appts 3 mos. apart. NTE: MNHC Goal is 75%. 0 80% of clients who do not agree to obtain medical care will receive a follow-up contact within one week; if the client allows, follow-up will continue on a monthly basis until the client engages in medical care. HIV+ ut-of-care who've not yet Agreed to Receive MNHC Charts and Data, and ARIES N Applicable to MNHC HIV Treatment, utreach and Linkage rogram and SFDH SEHC Bridge roject 60% of clients that receive a primary care appt will remain engaged in primary care and will return for at least one follow-up primary care appointment. HIV+ Receiving rimary Care at MNHC MNHC Charts and Data, and ARIES N Applicable to MNHC HIV Treatment, utreach and Linkage rogram and SFDH SEHC Bridge roject created

9 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 50% of clients accessing HIV Testing for whom a referral for medical, mental hlth, or substance abuse counseling services is indicated, and who are willing to accept the referral, will have accessed the service(s). rogram that btain an HIV Test Tracking Sheet or Summary of MNHC Follow-Up Notes Applicable to MNHC HIV Treatment, utreach and Linkage rogram. 3 75% of HIV+ clients diagnosed with diabetes will achieve blood sugar control of 9 on the Hemoglobin AC blood test (HgbAC 9). HIV+ with Diabetes Agency Report from Internal Database of AC blood test Applicable to MNHC and UCSF 360 ositive Care Center Nutrition Services 4 90% of clients will develop an individual plan to access entitlement programs and other available resources. All rogram N Applicable to RC rog & SFAF Services NTE: HRSA Categories are Non Medical Case Management & Referral for Healthcare and Supportive Services 5 60% of clients who complete the Satisfaction Survey will report a decreased level of stress since attending/participating in the program. Completing Annual Survey Agency Report on Responses of Decreased I Feel Less Stress Now N Applicable to Shanti Emotional and ractical Support rog and UCSF 360 ositive Care African American HIV Men's Support Group (objective is in addition to other unique objectives for each prog) created

10 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 6 95% of clients will exhibit an improvement of the dental condition due to the dental disease being managed. All Receiving Dental rocedure & Completing a Tx lan Randomly Audited Records (paper or electronic) Applies to U Dental & DH HIV Dental. Sample size = 0 or 0% of annual UDC, whichever is smaller; list of random clients created via ARIES or other process; clients tracked by anonymous, unique ID; report on meeting goal for each client 7 80% of clients surveyed will report Ease of Scheduling My Appointment as rating 3, or as scored Good or "Excellent". All Receiving Dental rocedure & Completing a Tx lan Randomly Audited Records (paper or electronic) Applies to U Dental & DH HIV Dental. Sample size = 0 or 0% of annual UDC, whichever is smaller; list of random clients created via ARIES or other process; clients tracked by anonymous, unique ID; report on meeting goal for each client 8 80% of clients surveyed will report How My roposed Treatment was Explained to Me as rating 3, or as scored Good or "Excellent". All Receiving Dental rocedure & Completing a Tx lan Randomly Audited Records (paper or electronic) Applies to U Dental & DH HIV Dental. Sample size = 0 or 0% of annual UDC, whichever is smaller; list of random clients created via ARIES or other process; clients tracked by anonymous, unique ID; report on meeting goal for each client created

11 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 9 80% of clients completing a survey will show an improvement in oral health through an improvement in overall quality of life as rating 3, or as scored Good or "Excellent". All Receiving Dental rocedure & Completing a Tx lan Randomly Audited Records (paper or electronic) Applicable to SFDH HIV Dental rogram. Sample size = 0 or 0% of annual UDC, whichever is smaller; list of random clients created via ARIES or other process; clients tracked by anonymous, unique ID; report on meeting goal for each client 30 80% of clients completing a survey will show an improvement in oral health through a reduction or elimination of pain/discomfort as rating 3, or as scored Good or "Excellent". All Receiving Dental rocedure & Completing a Tx lan Randomly Audited Records (paper or electronic) Applies to U Dental & DH HIV Dental. Sample size = 0 or 0% of annual UDC, whichever is smaller; list of random clients created via ARIES or other process; clients tracked by anonymous, unique ID; report on meeting goal for each client created

12 HIV Health Services erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U TYE F BJECTIVE Ambulatory utpatient UNIQUE RGRAM BJECTIVES utpatient Mental Hlth utreach sychosocial Support Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have 95% of valid client requests for Emergency Assistance payments to 3rd party vendors will be processed within 0 business days after completion of client file documentation. 95% of valid client requests for Eviction revention payments to 3rd party vendors will be processed within 5 business days after completion of client file documentation. All All rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES Applicable to AIDS Emergency Fund Applicable to AIDS Emergency Fund 34 AEF services will prevent eviction of at least 40 clients. All Agency self report via internal monthly and quarterly reports Applicable to AIDS Emergency Fund 35 AEF services will enable at least 40 clients to move into permanent affordable or subsidized housing. All Agency self report via internal monthly and quarterly reports Applicable to AIDS Emergency Fund 36 ALR will provide at minimum 8 legal trainings or seminars to probono attorneys. ro-bono Attorneys Training Logs N Applicable to ALR HIV Legal Services: Advocacy rogram created

13 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 37 ALR will maintain a baseline of 380 active anel Attorneys by recruiting 5% of its baseline to address attrition and expand its capacity in areas of law with the greatest client demand for services. anel Attorneys Agency Report Applicable to ALR HIV Legal Services: Advocacy rogram ALR will conduct 4 outreach presentations to community based organizations and client groups on rights of people with HIV/AIDS. 90% of cases in which there is no legal remedy will be referred for a nd opinion and/or to an appropriate HIV/AIDS provider, or to another system of care to support the client through resolution of the issue. Community and Groups Cases in which ALR Determines No Legal Remedy Tracking Files Applicable to ALR HIV Legal Services: Advocacy rogram Applicable to ALR HIV Legal Services: Advocacy rogram 40 85% of closed cases will be successfully resolved. All Closed Cases Agency Report on Review of 00 Cases from Tracking Logs and Database Applicable to ALR HIV Legal Services: Advocacy rogram. Successful resolution defined as drafting client's legal documents, resolving dispute, or exhausting reasonable legal avenues created

14 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 4 HIV Consumer Advocacy roj (HCA) attorney participates in 6 continuing ed. training sessions related to active listening, mediation of consumer grievances, harm reduction, working with individuals with mental hlth issues, and other topics as needed. HCA Attorney N/A for Training Logs N Applicable to ALR HIV Consumer Advocacy roject HCA Attorney conducts consumer outreach presentations and outreach presentations to HIV/AIDS service providers. 85% of HIV consumers served will be residents of SF; 5% may be residents of San Mateo and/or Marin. 80% of provider attendees of ALR HCA outreach presentations will report that presentation was relevant & useful to work with clients. HIV Consumers and roviders HIV Consumers of Local EMA Attendees at presentation utreach Logs rogram Database Agency Attendance Lists and Survey Results N Applicable to ALR HIV Consumer Advocacy roject Applicable to ALR HIV Consumer Advocacy roject Applicable to ALR HIV Consumer Advocacy roject created

15 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 45 85% of respondents to the survey will report they were "satisfied with the service received from the HCA Attorney". Consumer Respondents of Survey Agency Summary Report of Annual Survey Applicable to ALR HIV Consumer Advocacy roject 46 < 0% of residents will need to be transferred to a higher level of care in order to meet their needs. All Applicable to Catholic Charities eter Claver and Leland Houses; and Dolores Street Services % of clients with HIV who received primary care services (documented in ARIES) will have had one viral load test. The Youth Advocate will provide 90% Aftercare rogram clients in scattered site housing with home visits, and/or practical support visits (going to appts, etc.) per month. Enrolled 6 months Receiving HIV Specialty Svcs 60 Days ARIES report of documentation required in database of client records Applicable to Larkin St Youth Services Applicable to Larkin St Youth Services 49 80% of LSYS HIV+ youth who age out of services (5 yr) will be linked to adult HIV care. HIV+ Youth that Age ut N Applicable to Larkin St Youth Services created

16 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 50 80% of youth housed in Assisted Care receiving nursing care or peer advocacy support through HIV Specialty Services will demonstrate increased medication adherence. HIV+ Youth Agency Report from Internal Database; Files (physical or electronic) rogram Entry, Updated Quartrly, Reprtd at FY End N Applicable to Larkin St Youth Services 5 75% of clients receiving money management will maintain stability in housing for 6 mos. Enrolled 6 Months Applicable to Lutheran Social Services Money Management 5 90% of clients will be able to retain housing due to guarantee that rent will be paid. All rogram N Applicable to Lutheran Social Services Money Management 53 55% of unduplicated clients referred by the SFDH will respond to the annual client satisfaction survey. All rogram Agency Summary Report of Annual Survey Applicable to Native American Hlth Center Dental rog (patients referred from DH dental svcs). This objective is in place of other dentistry services standardized objectives % of those who complete a survey will report that the dental issue they were referred for by SFDH was addressed in a satisfactory manner. Surveyed Agency Summary Report of Annual Survey Applicable to Native American Hlth Center Dental rog (patients referred from DH dental svcs). This objective is in place of other dentistry services standardized objectives. created

17 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 55 85% of client cases in which claims for benefits have been filed and have been fully adjudicated by program representation will result in a favorable decision or an award. Who Filed Benefits Claims & Which Have Been Fully Adjudicated Annual Agency Self Report to HHS and BCC Applicable to ositive Resource Center rogram. Agency Report includes % of claims awarded at initial, reconsideration, Admin Law Hearing, or Appeals level; decisions at same, and for Continuing Disability Reviews; by proof of award-notice received from SSA, or documented in SSA or CalMED data 56 30% of clients who develop an Individual Service lan will receive authorizations to work with a Dept of Rehab (DR) Vocational Counselor on an Employment lan. Who Develop an IS Applicable to ositive Resource Center Employment Services rogram 57 70% of clients who develop an Individual Service lan will enroll in single or multi-session trainings designed to increase capacity to become employed. Who Develop an IS Applicable to ositive Resource Center Employment Services rogram 58 5% of clients who develop an Individual Service lan will secure a permanent or temporary full-time or part-time job placement. Who Develop an IS, client self report Applicable to ositive Resource Center Employment Services rogram created

18 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have The Employment Specialist will track client income and benefits before and after securing a permanent placement to quantify the impact of employment, for 00% of clients securing a permanent placement. H will provide at least one nutrition education opportunity to all clients in the program. H will measure engagement rates of clients with 6 months of service. Who Secure a ermanent lacement All HIV+ All HIV+ rogram Review) Agency Database Records eriod BCC Scoring Yes = artial No = 5 oints if N NTES Applicable to ositive Resource Center Employment Services rogram Applicable to roject pen Hand Applicable to roject pen Hand 6 60% of clients who return the survey will report "program helps maintain or improve my health". HIV+ Completing Annual Survey Survey Results Applicable to roject pen Hand 63 60% of clients who return survey will report "nutrition education increased my knowledge of nutrition in addressing HIV and overall health". HIV+ Completing Annual Survey Survey Results Applicable to roject pen Hand created

19 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 64 75% of clients served with a comprehensive evaluation will demonstrate receipt of, or will be in process of receiving eligible benefits. Receiving Comp Evaluation, client self report Applicable to SFAF Non Medical Case Management & Services 65 90% of clients referred for services will be evaluated for psychosocial services, long range plans, and end of life decisions. All Applicable to SFDH Health at Home rogram 66 70% of active clients will maintain or improve function in ambulation, bathing, dressing, grooming, and transferring. All rogram, or client self report Applicable to SFDH Health at Home rogram 67 90% of clients in the Treatment Adherence rogram will demonstrate adherence to the medication regimen prescribed. All clients of Treatment Adherence rogram Records-all Rx Meds Taken Documented Applicable to SFDH Health at Home rogram 68 00% of clients exhibiting signs and symptoms of substance abuse or mental illness will be referred to a provider best suited to their needs. All rogram Applicable to SFDH Health at Home rogram created

20 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have 69 TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support Lab staff will conduct initial screening and complete confirmatory HIV test of specimens 5 working days. Tests erformed rogram Review) achievement utilizing lab database eriod BCC Scoring Yes = artial No = 5 oints if NTES Applicable to SFDH Microbiology Lab. Lab performs confirmatory testing on all preliminary positive test results 70 95% of HIV Viral Load specimens are processed, tested, and results are reviewed and reported by Sr. Microbiologist 7 business days from specimen collection date. Tests erformed Testing Accuracy per Nat'l roficiency Testing rogram Scoring 80% Applicable to SFDH Microbiology Lab 7 70% of clients with HIV (rimary Care documented in ARIES) will have had two or more medical visits at least three months apart. Enrolled 6 months ARIES report of documentation required in database of client records Applicable to SFDH Multi-Diagnosis Castro-Mission HC 7 85% of clients with HIV who received primary care services (documented in ARIES) will have had at least one viral load test. Enrolled 6 months ARIES report of documentation required in database of client records Applicable to SFDH Multi-Diagnosis Castro-Mission HC. Evaluation & is "Viral Load Test Table" filtered by primary care services in ARIES STAR Report created

21 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 73 70% of clients on HAART (rimary Care documented in ARIES) will have a viral load 00 copies/ml which will indicate viral suppression and successful treatment adherence. Enrolled 6 months ARIES report of documentation required in database of client records Applicable to SFDH Multi-Diagnosis Castro-Mission HC. Evaluation & ment is "Viral Load Values Table" filtered by primary care services in QM HAB Report NTE: UC HAST rogram goal is 50% 74 90% of clients will be assessed for mental health and substance use treatment needs 30 days of program enrollment. All New Applicable to SFDH Multi-Diagnosis Castro-Mission HC 75 90% of clients assessed as eligible for SSI Disability will have the SSI evaluation written within weeks of the initial assessment. Eligible for SSI Disability Benefits List of SSI Disability eligible clients & monthly stat form Applicable to SFDH South Van Ness Adult Behavioral Health Services 76 SF Food Bank will maintain an average product nutrition rating of.5 on a scale of 0-3 based on nutrient content provided by Nutrition Facts Label. Inventory Available to Agencies Funded by HHS nutrition evaluation tool: CHEW (Choosing Healthy Eating Well) Applicable to SF Food Bank created

22 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have 75% of the HHS funded agencies will report that food received helps their clients meet nutritional needs in response to a provider satisfaction survey. The AIDS/HIV Nightline will conduct outreach to 5 San Franciso service agencies doing HIV/AIDS work. The AIDS/HIV Nightline will exhibit at or participate in two community events. The AIDS/HIV Nightline will respond to,05 calls from LWH/A HHS-funded Service roviders Receiving SFFB Food Not Applicable Not Applicable Not Applicable rogram Review) Agency Summary Report of rovider Satisfaction Survey documentation, i.e.,sign-in sheets, confirmatory letters from CB, demonstration of participation documentation, i.e.,sign-in sheets, confirmatory letters from CB, demonstration of participation Call Logs eriod BCC Scoring Yes = artial No = 5 oints if N N NTES Applicable to SF Food Bank Applicable to SF Suicide revention Nightline (in BHS ) Applicable to SF Suicide revention Nightline (in BHS ) Applicable to SF Suicide revention Nightline (in BHS ) created

23 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U 8 8 TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have The AIDS/HIV Nightline will complete volunteer training classes assuring that each new volunteer receives 60 hours of training. 75% of new clients seeking practical and/or emotional support are matched to staff or a volunteer within 5 business days. New Volunteers New rogram Review) Training Attendance Logs eriod BCC Scoring Yes = artial No = 5 oints if NTES Applicable to SF Suicide revention Nightline (in BHS ) Applicable to Shanti Emotional and ractical Support 83 70% of clients will report a decreased level of isolation since being connected with program staff or volunteers. Completing Annual Survey Responses of "Decreased - I feel less isolated now." on client surveys. Applicable to Shanti Emotional and ractical Support 84 60% of clients will report an increased level of self sufficiency since being connected with program staff or volunteers. Completing Annual Survey Responses of "Increased - I feel more self-sufficient now." on client surveys. Applicable to Shanti Emotional and ractical Support 85 60% of clients will report a decreased level of stress since engaging with the program. Completing Annual Survey Responses of Decreased I feel less stress now Applicable to Shanti Emotional and ractical Support: Senior Survivor Support rogram created

24 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 86 70% of clients will report a decreased level of isolation since being connected with the program. Completing Annual Survey Responses of Decreased-I feel less isolated now Applicable to Shanti Emotional and ractical Support: Senior Survivor Support rogram 87 60% of clients will report an increased sense of community since being connected with the program. Completing Annual Survey Responses of Increased-I feel more connected to community now Applicable to Shanti Emotional and ractical Support: Senior Survivor Support rogram 88 rogram will generate and review a list of clients not engaged in rimary Care and will follow-up with the identified clients on a quarterly basis. All not Engaged in rimary Care ARIES Report N Applicable to Shanti Medical Case Management rogram. rog must retain all generated quarterly ARIES reports for review by BCC. NTE: Case Manager coordinates with RN(subcontractor) quarterly for follow up by the eer Advocate. 89 The Director reviews timelines in the Comprehensive lan to ensure topics for discussion are included on appropriate meeting agendas in a timely manner. Not Applicable Steering Committee Retreat Calendar N Applicable to Shanti lanning Council Support created

25 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 90 The Director coordinates various presentations to the lanning Council to ensure the materials and information reviewed fulfill all legislative requirements and council directives. Not Applicable resentation Summary during rioritization and Allocations process N Applicable to Shanti lanning Council Support 9 All new lanning Council (C) members are provided rientation Training at the beginning of their terms. 3 additional skillsdevelopment trainings are provided to new and continuing members in subjects which may include, but are not limited to: Ryan White lanning Council Members rogram Documentation - Training Logs Applicable to Shanti lanning Council Support. Robert's Rules of rder, Rules of Respective Engagement, rivacy Rights, Cultural Humility, Chairing/Leading Meetings, other trainings identified by the C Director.. No site visit required; C Director prepares written report for HHS 9 The lanning Council Director participates in the evaluation of success in meeting goals of the Comprehensive lan and provides a written report to lan Council members each year. Ryan White lanning Council Members rogram Report to Council N Applicable to Shanti lanning Council Support. No site visit required; C Director prepares written report for HHS created

26 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have 93 TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support All lanning Council members receive ongoing core competency training in areas identified by the Training Needs Analysis to be conducted and updated by the Training and Evaluation Coordinator. Ryan White lanning Council Members rogram Review) rogram Documentation - Training Logs eriod Calendar BCC Scoring Yes = artial No = 5 oints if N NTES Applicable to Shanti lanning Council Support 94 80% of treatment of care plans will be developed 90 days of client being assigned to a provider. As Defined by Agency rotocol Records, Call Logs Applicable to UCSF AH Considering Work rogram 95 No more than 0% of UDC will be lost to follow-up within the contract year. As Defined by Agency rotocol Records, Call Logs N Applicable to UCSF AH Considering Work rogram (Note: lost to follow-up defined as one who assigned clinician has been unable to contact or locate after several attempts; does not include clients who decline svcs in favor of others, relocate outside service area or are deceased.) 96 90% of neuropsychological testing findings will be reported to referring provider weeks from completion of neuropsychological testing. As Defined by Agency rotocol Records, Call Logs Applicable to UCSF AH utpatient Mental Health rogram created

27 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 97 80% of treatment plans will be developed 90 days of client being assigned to a provider As Defined by Agency rotocol Records, Call Logs N Applicable to UCSF AH utpatient Mental Health rogram 98 80% of treatment plans will be reviewed and updated for clients still engaged in care for more than one year. As Defined by Agency rotocol Records, Call Logs N Applicable to UCSF AH utpatient Mental Health rogram 99 No more than 0% of unduplicated mental health clients will be lost to follow-up within the contract year As Defined by Agency rotocol Records, Call Logs N Applicable to UCSF AH utpatient Mental Health rogram (Note: lost to follow-up defined as one who assigned clinician has been unable to contact or locate after several attempts; does not include clients who decline svcs in favor of others, relocate outside service area or are deceased.) 00 60% of clients who complete a pre- and post-test Q-45. utcome Questionnaire, and who identify problem areas on the pretest, will improve in one of these areas on the post-test. As Defined by Agency rotocol Records, Call Logs N Applicable to UCSF AH utpatient Mental Health rogram created

28 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 0 80% of clients will report the services received: a. "Helped a great deal" or "Helped somewhat" to deal more effectively with their concerns or problems. b. "Helped very much" or "Helped somewhat" to protect themselves form HIV infection. c. "Helped very much" or "Helped somewhat" to talk to their partners about their HIV infection status. who complete a Satisfaction Survey Records, Call Logs Applicable to UCSF AH utpatient Mental Health rogram 0 The number of HIV- genotypic drug resistance tests completed at the different clinic sites will be tabulated for program monitoring. Tests Completed data upon request, tabulated on Excel database N Applicable to UCSF/ARI Clinical Virology Lab 03 Key data will be tabulated for each HIV- genotypic resistance test performed under the contract, including selected patient demographics and requesting provider clinic site. Tests Completed data upon request, tabulated on Excel database N Applicable to UCSF/ARI Clinical Virology Lab created

29 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 04 90% of clients completing 3 months will have received basic HIV disease education from a Nurse ractitioner or RN. Completing 3 mos. of Service Applicable to UCSF/DSAAM W % of clients with inconsistent or no primary care will have met with a primary care provider at least once 3 mos. of initiating substance abuse treatment. Referred with Inconsistent or No rimary Care Applicable to UCSF/DSAAM W % of clients identified as needing a mental health assessment will have completed a psychiatric evaluation 6 mos. of initiating substance abuse treatment. Needing Mental Health Assessments Applicable to UCSF/DSAAM W % of clients will report increased level of understanding HIV treatments and importance of remaining engaged in medical care. Completing Annual Survey responses: Increased Understanding" of HIV Care and Tx, & "It's Important to see Dr. regularly" Applicable to UCSF 360 ositive Care Center African American HIV Men's Support Group created

30 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 08 A system will be developed to track clients on a wait list for duration on list, primary care status, and linkage to primary care on the Wait List data upon request, tabulated on Excel Spreadsheet N Applicable to Westside HIV Home Based Case Management rogram 09 90% of clients will be assessed for mental health and substance use treatment needs 30 days of progam enrolment. All ARIES report of documentation required in database of client records N Applicable to Westside HIV Home Based Case Management rogram 0 80% of indiidualized service plans wil be developed 90 days of initial client intake. All New Clents ARIES report of documentation required in database of client records N Applicable to Westside HIV Home Based Case Management rogram 80% of individualized service plans will be updated every 6 months All ARIES report of documentation required in database of client records N Applicable to Westside HIV Home Based Case Management rogram created

31 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 60% of HIV+ clients (primary care documented in ARIES) will have had two or more medical visits during the year (one in the first half and the other in last half of the year). Enrolled 6 months ARIES report of documentation required in database of client records N Applicable to Westside HIV Home Based Case Management rogram. Evaluate & via "Medical Visit Indicator" in ARIES/HRSA HIV/AIDS Bureau (HAB) Quality Mngmt (QM) Report. 3 70% of clients on the wait list that were referred for primary care will be linked to a provider on the Wait List ARIES report of documentation required in database of client records Applicable to Westside HIV Home Based Case Management rogram 4 70% of clients on HAART (rimary Care documented in ARIES) will have a viral load 00 copies/ml which will indicate viral suppression and successful treatment adherence. on HAART ARIES report of documentation required in database of client records Applicable to Westside HIV Home Based Case Management rogram. Evaluate & via "Viral Load Values Table" filtered by primary care services in HAB QM Report 5 75% of clients served for 0 days will report improved quality of life since the inception of Attendant Care or Homemaker Services. Served 0 days, client self report N Applicable to Westside HIV Home Based Case Management rogram. RN/SW observation of client and/or client self report in improvement on ability to maintain independent living created

32 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have All clients served for 90 days will demonstrate an improved home environment. All active clients will be assessed for Dementia and other cognitive impairments every 60 days. 00% of clients exhibiting signs and symptoms of substance abuse or mental illness will be referred to a provider best suited to their needs. Served 90 days with Assessments of Home Environment All Active All rogram rogram Review) Home Environment Assessment Tool sychosocial Benefits, Nursing Assess, Svc lan, rog Notes & chart review eriod BCC Scoring Yes = artial No = 5 oints if N N NTES Applicable to Westside HIV Home Based Case Management rogram. Assess client homes for safety, etc.; problems identified & efforts to improve documented by Social Worker in subsequent assessments Applicable to Westside HIV Home Based Case Management rogram Applicable to Westside HIV Home Based Case Management rogram created

33 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have 9 RGRAM BJECTIVES TRANSITINED T HIV HEALTH SERVICES FRM HUSING & URBAN HEALTH rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 0 The Stabilization rogram Coordinator will confirm that 00% of clients have an individualized service plan in place at referral. The Stabilization rogram Coordinator will confirm that 00% of clients have an individualized service plan in place within 90 days of service enrollment. 90% of clients that remain in the program for 60 days will access primary care services at least once during the contract year. All clients All clients All clients in program 60 days Agency or database. Agency or database. Agency or database, including ARIES. year year year N Applicable to Rafiki - Brandy Moore Transitional Housing Applicable to CCCY - eter Claver Applicable to: Rafiki - Brandy Moore Case Management HealthRight360 - lanetree CCCY - Rita/Hazel & Derek Silva 00% of new clients will have a individualized service plan in place within 30 days of initial assessment. All clients Agency or database. year Applicable to: Rafiki - Brandy Moore Case Management HealthRight360 - lanetree CCCY - Rita/Hazel & Derek Silva 3 created

34 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES % of individualized service plans will be updated at least every six (6) months. 00% of individualized service plans will be updated at least every three (3) months, or more frequently as the resident's condition worsens. All clients housed for 6 months or more All clients housed for 3 months or more Agency or database. Agency or database. year year Applicable to: Rafiki - Brandy Moore Transitional Housing and Case Management HealthRight360 - lanetree CCCY - Rita/Hazel & Derek Silva Applicable to CCCY - eter Claver 00% of clients will be assessed for all eligible financial and insurance coverage benefits within 30 days of enrollment in the program. All clients Agency or database. year Applicable to: Rafiki - Brandy Moore Transitional Housing and Case Management HealthRight360 - lanetree CCCY - Rita/Hazel, Derek Silva and eter Claver 6 created

35 erformance FY 07-8 A B C D E F G H I J K L M N Q R S T U Note: lease review the "Unique rogram" to determine if your program has objectives in addition to, or instead of, those that have TYE F BJECTIVE Ambulatory utpatient utpatient Mental Hlth utreach sychosocial Support rogram Review) eriod BCC Scoring Yes = artial No = 5 oints if NTES 00% of clients will be assessed for mental health and substance use treatment needs at least once per year. All clients Agency or database year N Applicable to: Rafiki - Brandy Moore Transitional Housing and Case Management HealthRight360 - lanetree CCCY - Rita/Hazel & Derek Silva % of subsidy recipients will have their eligibilty recertified at least annually. All clients Agency or database year N Applicable to: SF AIDS Foundation - Rental Subsidies CCCY - Assisted Housing 30 During the fiscal year and as documented in, 00% of new subsidy clients will have a housing plan in place within one month of subsidy recipt. All new clients Agency or database year Applicable to: CCCY - Assisted Housing 3 Less than 0% of residents will need to be transferred to a higher level of care in order to meet their needs (Inversely, 90% will not need a hospital admission). All clients Agency or database year Applicable to CCCY - eter Claver created