HIV/AIDS Bureau Division of State HIV/AIDS Programs (DSHAP)

1. HIV/AIDS BureauDivision of State HIV/AIDS Programs (DSHAP) Ryan White HIV/AIDS Program Part BTechnical Assistance Webinar Increasing Access to HIV Medications: Models that Work February 26, 2014

2. To provide leadership and support to States/Territories for developing and ensuring access to quality HIV prevention, health care and support services. DSHAP Mission

3. Agenda

4. Presenter Harold Phillips Deputy Director Division of State HIV/AIDS Programs

5. Announcements & Updates

6. Announcements • “Tell One” Project • Tell One Person about the Health Insurance Marketplace! • CMS FAQ on Third Party Payment of Premiums • All Grantees Meeting/Clinical Update Meeting • ADAP Data Report System Shutdown Notification • Grantees will be notified prior to shutdown • RSR Browser Compatibility Issues • See tips from the DART Team on TARGET Center Data.TA@caiglobal.org

7. Announcements Important Deadlines: • 340-B Recertification Deadline March 14th : • RSR Provider Reports Deadline March 10th • All RSRs must be in submitted status Deadline March 31st Upcoming Webinars: • “Tools for Creating ADR XML Client Report” March 5 • To register look under "Events" on the TARGET Center • “Adapting HIV Providers' Fiscal Management in a Changing Financing Landscape”: March 6 • To participate contact Jacqueline@healthiv.org

8. Questions

9. Presenter A Report on the Minority AIDS Initiative (MAI) Anita Edwards, Lieutenant Commander Senior Program Advisor Division of State HIV/AIDS Programs

10. RWHAP Part B MAI • RWHAP Part B MAI Legislative requirements • Section 2693(b)(2)(B) - For grants used for supplemental support education and outreach services to increase the number of eligible racial and ethnic minorities who have access to treatment through the program under section 2616 for therapeutics…,

11. RWHAP MAI Differences • RWHAP Part A: MAI formula grants provide core medical and related support services to improve access and reduce disparities in health outcomes in metropolitan areas hardest hit by the epidemic • RWHAP Part B: MAI formula grants fund outreach and education services designed to increase minority access to needed HIV/AIDS medications through state Part B AIDS Drug Assistance Programs (ADAP) and other medication assistance programs.

12. Reporting Requirements Reporting Requirements

13. Reporting Requirements

14. MAI Funding FY 2012 • $10,234,501 allocated for FY 2012 MAI services • $9,949,406 total service expenditures for FY 2012 MAI • $3,278,242 Education • $6,671,164 Outreach • Total Clients Served • 18,469 Education • 30,601 Outreach

15. MAI Clients served by Service Category Education Outreach Black/African American 17,841 Hispanic 8,773 Asian 880 Other Minority 242 Unknown 2,892 • Black/African American 11,283 • Hispanic 5,989 • Asian 531 • Other Minority 91 • Unknown 686

16. Increasing Access to HIV Care: Models That Work Maryland MAI Program February 26, 2014 Durkia Hudson, MSW Jami Stockdale, MA Maryland Department of Health and Mental Hygiene Prevention and Health Promotion Administration http://phpa.maryland.gov

17. Maryland MAI Overview Service Goals- To provide increased access for disproportionately impacted low-income minority individuals with HIV disease to HIV/AIDS treatment/medications available through the Part B Maryland AIDS Drug Assistance Program (MADAP). Objective 1-Through targeted outreach to racial and ethnic minority communities, the program will identify persons who are HIV positive and out-of-care. Objective 2- Provide education through focused outreach activities and advertising that target African American and Latino persons living with HIV/AIDS to increase their participation in the Maryland AIDS Drug Assistance Program.

18. Maryland MAI Overview Funding • HRSA has awarded the Center for HIV Prevention and Health Services between $415,000 -$466,000 annually since FY2011. • ½ of the funding designated to outreach • ½ of the funding designated to education • Funding was first distributed through an RFP process and has been distributed on a 3 year continuation grant since then. Sub-Grantees • Aids Interfaith Residential Services (AIRS) • Total Health Care, Inc. • Chase Brexton Health Services • Baltimore City Health Dept. Clinical Services • Baltimore City Health Department STD Prevention • Health Care for the Homeless • University of Maryland at Baltimore Institute for Human Virology ( Jacques Initiative)

19. Maryland MAI Overview Types of Organizations: • FQHC’s • City Health Department • Nonprofit Organization • University Based Health Clinic Types of Outreach: • Street Outreach • Prison/Jail Outreach • Support Groups Types of Education: • One-on-One • Groups (curriculum & non-curriculum based) • Workshops

20. Sub-Grantee Overview

21. Sub-Grantee Overview

22. Evaluation • Education and outreach activities are tracked through client tracking forms and includes: • Medical care referrals (healthcare providers, HIV primary care, CTR, and Case Managers) • Education sessions • Completion and submission of applications for pharmacy assistance programs • Demographics

23. Client Tracking Form

24. Client Tracking Form

25. Program Reach • Over 2,000 forms are submitted a year for approx.1,500 encounters with HIV+ clients. • 700 referrals are made to HIV primary medical care providers. • 400 unduplicated HIV+ clients based on Social Security Number (SSN) are served. • 220 received emergency, temporary, or full access to the Maryland AIDS Drug Assistance Program.

26. Enhanced Linkages • A cross reference of the client’s SSN and the Maryland AIDS Drug Assistance Program (MADAP) client database shows that approx. 400 were able to receive emergency, temporary, or full access to the program.

27. Data Collection Tips • Keep the form brief • Train program staff to complete the form • Share data with program staff to convey that the numbers demonstrate success of the program

28. Challenges • Reaching the target population • Staff turnover • Collecting SSN • Completion of the form • Skip patterns • When to complete the form: During encounter vs. after the encounter • Saturation of outreach venues • Estimating goals • Separating RW Part B MAI from RW Part A MAI • Access to other databases

29. Best Practices OUTREACH • Be open to diverse models and venues for Outreach COORDINATION • Designate someone with primary responsibility for coordination VERIFICATION • Establish partnerships within the State Health Department

30. Care Linkage Outreach Challenge: How to Reduce the Number of HIV-Positive Persons Who Test Repeatedly Without Disclosing Their Positive or HIV Care Status Kevin Coger Care Linkage Investigator STD/HIV Prevention Program Baltimore City Health Department

31. The Issue • BCHD STD/HIV Prevention Program provides 12,000 to 14,000 HIV conventional tests per year on street corners and fixed site locations. • Some of the clients seen, who tested HIV-positive previously, test again for HIV without disclosing their positive or HIV care status. • This has caused lost opportunities to immediately assess each client’s HIV care status.

32. Setting • The Program offers STD/HIV testing via mobile units. • Testing in neighborhoods & fixed site locations through street outreach services. • When HIV-positive persons are identified through these efforts: * We assess their HIV care status * Partner services are offered

33. The Solution • “ Do Not Test List” (DNT) • Same-day appointments. • Provide Incentives • Clients already in care identify their primary medical care provider and the date of their last kept appointment. • The HIV Reactor Coordinator verifies this information.

34. Questions

35. Contact Information • Anita Edwards, AEdwards@hrsa.gov • Durkia Hudson, durkia.hudson@maryland.gov • Jami Stockdale, jami.stockdale@maryland.gov • Kevin Coger, Kevin.Coger@baltimorecity.gov

36. 2014 Webinar Evaluation Option 1 Option 2 Kpatterson@hrsa.gov mazuine@hrsa.gov

37. Thank You