St. Louis Regional HIV Health Services Planning Council Overview for Prevention and Care Subcommittee Presented by: Montara Renee November, MPA Program Coordinator, PC Support February 2, 2015
Overview will cover: Ryan White Part A Program Ryan White Part A Mandated Funding Expectations St. Louis TGA Mission and Vision St. Louis TGA Council/Committee Structure St. Louis TGA PSRA Process Challenges Questions 2
Ryan White Part A Program The Ryan White CARE Act o The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act o Enacted in 1990 o Largest Federal government program specifically designed to provide services for people living with HIV/AIDS The Ryan White CARE Act was amended and reauthorized in 1996, 2000, 2006, and 2009. o The Ryan White HIV/AIDS Treatment Extension Act of 2009 3
Ryan White Part A Program Eligible Metropolitan Areas (EMAs) To qualify for EMA designation, an area must have reported at least 2,000 AIDS cases in the most recent 5 years and have a population of at least 50,000. Transitional Grant Area (TGA) To be eligible for TGA status, an area must have reported 1,000 to 1,999 new AIDS cases in the most recent 5 years and have a population of at least 50,000. 4
Ryan White Part A Program The St. Louis Transitional Grant Area consists of 12 counties in the bi-state St. Louis metro area. Illinois Counties Jersey County Clinton County Madison County Monroe County St. Clair County Clinton County Missouri Counties City of St. Louis Franklin County Jefferson County Lincoln County St. Charles County St. Louis County Warren County 5
Ryan White Part A Mandated Funding Expectations Ryan White Act has five parts of funding for HIV/AIDS-related services. Part A: Emergency relief grants program for cities and counties Part B: Grants for states (includes ADAP) Part C: Community-Based Programs Part D: Woman, Infants, Children, Youth with HIV/AIDS and their Families Part F: SPNS, AETC, Dental Reimbursement, and Minority AIDS Initiative Plan* *Minority AIDS Initiative (MAI) Used to modify or expand HIV care services for disproportionately impacted communities of color. Subject to the same requirements as Part A funds. 6
Ryan White Part A Mandated Funding Expectations Part A and Minority AIDS Initiative (MAI) funds support: Core Medical Services A set of essential, direct health care services provided to Ryan White HIV/AIDS Program Clients. At least 75% of allocated funding Support Services A set of services that are needed by individuals with HIV/AIDS to achieve medical outcomes related their HIV/AIDSrelated clinical status. No more than 25% of allocated funding 7
Ryan White Part A Mandated Funding Expectations 8
Ryan White Part A Mandated Funding Expectations HRSA/HAB CEO (Mayor of the City of St. Louis) Planning Council (Up to 37 Members Appointed By CEO) Grants Administration (Grantee, City of St. Louis Dept. of Health) Federal Government- Health Resources and Services Administration (HRSA) CEO- Chief Elected Official Mayor Francis Slay Grantee- City of St. Louis Department of Health 9
Ryan White Part A Mandated Funding Expectations Ryan White Part A Planning Councils are responsible for Priority Setting and Resource Allocation. Priority Setting is the process of deciding which HIV/AIDS services are the most needed and ranked as important in the EMA / TGA. Resource Allocation is deciding how much funding is needed for each of the priority service categories. o Develop a comprehensive plan for service delivery o Monitor overall service provision o Assess efficiency of administrative mechanism in fund distribution o Assure community participation o Participate in the Statewide Part B process 10
Ryan White Part A Mandated Funding Expectations Key Players Roles and Responsibilities TASK PLANNING COUNCIL MEMBERSHIP CEO/ GRANTEE PLANNING COUNCIL NEEDS ASSESSMENT COMPREHENSIVE PLANNING PRIORITY SETTING PROCUREMENT (RFP AND CONTRACT AWARDS) 11
Ryan White Part A Mandated Funding Expectations Key Players Roles and Responsibilities CEO/ TASK GRANTEE ASSESSING ADMINISTRATIVE MECHANISM EVALUATION ACTIVITIES Evaluate Services Monitor Contracts Evaluate Planning Council functioning Statewide Coordinated Statement of Need (SCSN) CONFLICT OF INTEREST - PLANNING COUNCIL - GRIEVANCE PROCEDURES 12
FY2015 Service Prioritization Order Service Category 1 Outpatient / Ambulatory Health Services Core Service 2 Medical Case Management (including treatment adherence) Core Service 3 AIDS Pharmaceutical Assistance (local) Core Service 4 Oral Health Care Core Service 5 AIDS Drug Assistance Program (ADAP) treatments Core Service 6 Housing Services Support Service 7 Case Management (non-medical) Support Service 8 Mental Health Services Core Service 9 Health Insurance Premium & Cost Sharing Assistance Core Service 10 Food Bank / Home-delivered Meals Support Service 11 Medical Transportation Services Support Service 12 Medical Nutrition Therapy Core Service 13 Treatment Adherence Counseling Support Service 14 Early Intervention Services Core Service 15 Psychosocial Support Services Support Service 16 Emergency Financial Assistance Support Service 17 Substance Abuse - Outpatient Core Service 18 Health Education / Risk Reduction Support Service 19 Substance Abuse-Residential Support Service 20 Referral for Health Care / Supportive Services Support Service 21 Child Care Services Support Service 22 Linguistics Services Support Service 23 Home and Community-based Health Services Core Service 24 Rehabilitation services Support Service 25 Home Health Care Core Service 26 Legal Services Support Service 27 Respite Care Support Service 28 Hospice Care Core Service 13
St. Louis TGA Mission/Vision Mission: Develop and coordinate an effective and comprehensive community-wide response to HIV/AIDS in the St. Louis Regional area. Vision: Plan for and design the present and future system of care for persons with HIV, in a way that is comprehensive, culturally sensitive, and reflective of the regional St. Louis HIV community. 14
St. Louis TGA Council/Committee Structure HRSA Requirements Must reflect the local HIV/AIDS epidemic Must fill HRSA mandated representative categories At least 33% of voting members must be people living with HIV (PLWH) Must have an open nomination process and grievance procedures 15
St. Louis TGA Council/Committee Structure HRSA mandated representative categories Health care providers CBOS and ASOs Social service providers Mental health providers Substance abuse providers Local public health agencies Hospital planning agencies or health care planning agencies Affected communities Non-elected community leaders State Medicaid agency State agency administering the program under Part B Grantees of Part C Grantees of Part D Grantees of other Federal HIV programs Representative of individuals who formerly were Federal, State or local prisoners 16
St. Louis TGA Council/Committee Structure Committee Structure 2014-2015 Planning Council Executive Committee Planning Committees Needs Assessment and Comprehensive Planning Committee Operations Committees Membership and Training Committee Priority Setting and Resource Allocation Committee Policies and Procedures Committee Consumer Advocacy Committee Care Strategy Committee Prevention and Care Subcommittee 17
St. Louis TGA PSRA Process Needs Assessment Summary EPI Profile Card Sort Prioritization RW Part A Grant Cycle Service Category Presentation Resource Allocation RW Part A Grant Due 18
St. Louis TGA PSRA Process JANUARY: JULY: PSRA Process Presentation-January 14th Brainstorm for FY2015 FEBRUARY: Availability of Other Funding Sources Presentation- July 8th Resource Allocation FY2016- July 8th Review Directives to the Grantee- July 8th FY2015 Partial Award Budget- February 11th AUGUST : Presentation on HIV Care Continuum- February 11th Present the AAM August 12th MARCH: Approve Directives to the Grantee- August 12th Service Category Presentation FY2016- March 11th SEPTEMBER: MAI Plan FY2015/MAI/ EIIHA Report FY2014- March 11th Approve Grant Attachments- September 9th Membership Orientation FY2016 Ryan White Part A Grant Due Assessment of the Administrative Mechanism Sign-up March 11 th OCTOBER: APRIL: Presentation of Ryan White Part A Grant Deliverables Oct 14th Implementation Plan Part A and MAI FY2015 April 8 th Review PSRA Timeline- October 2014 Prevention Planning Priorities and Activities- April 8th NOVEMBER: Quality Management Update- April 8th Flat Funded Budget FY2016 November 11th AAM Workgroup Begins Final-Current Year Reallocations- November 11 th MAY: PSRA Timeline November 11th EPI Profile- May 13th DECEMBER: Implementation Plan Results FY2014-May 13th Card Sort Explanation May 13 th AAM Timeline- May 13 th JUNE: Needs Assessment Presentation- June 10 th Complete Card Sort- June 10th Reduced-Funded Budget FY2016 December 9 th Directives to the Grantee Results Report- December 9th 19
St. Louis TGA PSRA Process RW Part A Comprehensive Plan submitted every 3 years RW Part A Grant- submitted every year EPI Profile completed every year Needs Assessment completed every year Service Prioritization- completed every year AAM completed every year Resource Allocation- submitted every year FY Implementation Plan- submitted every year MAI Plan- submitted every year 20
Challenges HIV Care Continuum MAI Allocation Early Identification of Individuals with HIV/AIDS (EIIHA reporting) EPI Data retrieval Filling all HRSA mandated membership categories 21
Questions??? 22