“HRSA Program Guidance” Statewide Coordinated Statement of Need Comprehensive Plan

1. “HRSA Program Guidance”Statewide Coordinated Statement of NeedComprehensive Plan Presentation to: Kentucky HIV/AIDS Planning and Advisory Council Aug 22nd, 2006 David E. Clark Ryan White Title II Program Administrator Clifton Center, Louisville Kentucky

2. Definitions • HRSA- Health Resources and Services Administration. • Ryan White CARE Act Title II- Federal funding stream for HIV/AIDS services • SCSN- Statewide Coordinated Statement of Need • Program- ADAP, KHCCP, Insurance • Community- Infected and non-infected Cabinet for Health and Family Services

3. Title II Manual The Title II Manual is the guiding authority for the Title II Program • 11 sections and 41 chapters • Contains every component of the Title II, including community planning • This is where the SCSN and Comprehensive Planning guidance is found Cabinet for Health and Family Services

4. Why is this Presentation Important? Prevention and Care planning processes will be coordinated, where possible, over time. • We need KHPAC to help us produce better products • HRSA’s method for grantees to identify “gaps”, resources, and allow for community feedback on the perception of services Cabinet for Health and Family Services

5. HRSA Requirements • Needs Assessment (Every 2yrs) • Health Care/Service provider feedback • SCSN (Every 3yrs) • Document of community feedback about services • Comprehensive Plan (Every 3yrs) • Utilizes SCSN document to formulate a master plan Cabinet for Health and Family Services

6. SCSN 2005 Contracted through the U.K. Center for Prevention and Research • Jeff A. Jones, Ph.D. • Sharma Ray, M.A. Cabinet for Health and Family Services

7. Focus Group Planning • Venue (Public Library) • Food • Privacy • Diversity • October 19, 2005 • Group size • Room dynamics • No HIV/AIDS Services staff were present Cabinet for Health and Family Services

8. Strategy for Questions • Simple • Thought provoking • Each question should yield at least 2 usable data points Cabinet for Health and Family Services

9. Survey Phase (focus) groups • Five clients • Heartland Cares, Title III clinic, Paducah, Hopkinsville, and Carbondale, IL • Matthew 25, Title III clinic, Henderson, Owensboro, and Evansville, IN • WINGS, Title III clinic, Louisville • Northern Kentucky Health Department, Title II care coordination site • Barren River Health District, Title II care coordination site, Bowling Green • Kentucky Department for Public Health, Frankfort • Kentucky Department of Disability Determination Services, Frankfort • University of Kentucky Area Health Education Center (AHEC), Lexington • University of Louisville, dentistry program, Louisville • Bluegrass Farmworkers Health Center, Richmond • Volunteers of America, Title II care coordination site, Louisville Cabinet for Health and Family Services

10. Processing Information Phase After the focus groups convened, U.K. produced the SCSN based on the comments from participants • The SCSN is simply a format to document perceptions, opinions and realities of care services provision • There was no collaboration with Prevention or Surveillance for the 2005 process. Cabinet for Health and Family Services

11. Focus Group Questions The Questions (page.24 of the SCSN) 1. Participants were asked to allocate a total Title II budget of $100 towards various categories and to then explain why they prioritized their budget items the way they did. 2. Besides medications, what is the most important and positive aspect of the Care Coordination Program to you? Cabinet for Health and Family Services

12. Focus Group Questions, cont. 3. On the other hand, what is the least effective part of the Care Coordination Program? Cabinet for Health and Family Services

13. Focus Group Questions, cont. 4. You or your clients already access the Care Coordination Program regularly. What types of people do you know of that are not in the program but would benefit from it? How do you suggest reaching out to these people in a way to get them into services? What are some of the barriers that keep these people from coming in for services? Cabinet for Health and Family Services

14. Focus Group Questions, cont. 5. What do you think is the average education level of your community? Of clients? 6. Do you know individuals (including yourself) who are willing to advocate for getting more state dollars for HIV/AIDS treatment and prevention? Are there reasons that these individuals cannot or do not want to advocate? Cabinet for Health and Family Services

15. Comprehensive Plan The comprehensive state plan for services in Kentucky is a based on the information gained from the SCSN and other program information • The plan is a narrative that documents the general and specific directions of the program • In 2005, it was written “in house”. Cabinet for Health and Family Services

16. Feedback from HRSA The HRSA Project Officer will provide comments and recommendations as deemed appropriate • SCSN and Plan are not scripted by HRSA, each process in every state may be somewhat different • Unless there are critical failures in process or plan, HRSA does not require a state to resubmit these products. Cabinet for Health and Family Services

17. Envision Integration • Project Officers are flexible, dates can move • Survey, Process, Implement, Document (SPID) • The differences are only in the details, and can be accommodated • Merged CDC & HRSA Plans- NH, VT, DEL, MI, KY, TN, SC, IA, NE, WY, HI Cabinet for Health and Family Services