in + care Campaign Kick-Off Webinar October 26, 2011

1. in+care CampaignKick-Off Webinar October 26, 2011

2. Laura W. Cheever, MD, ScM Chief Medical Officer, HAB Deputy Associate Administrator

3. Agenda • Welcome & Introductions, 5min • Campaign Expectations and Update, 10min • Intro to Campaign Measures, 20min • Data Reporting, 10min • Local Quality Champions, 5min • Consumer Involvement, 5min • Q & A Session, 5min

4. in+care Campaign Expectations & Update Clemens Steinbock

5. This in+care Campaign is designed to facilitate local, regional and state-level efforts to retain more HIV patients in care and to prevent HIV patients falling out of care while building and sustaining a community of learners among Ryan White providers.

6. Campaign Framework participation in the Campaign is voluntary and Ryan White grantees across all funding streams and sub-grantees are invited to join participating agencies enroll for a 12-month commitment routine reporting of performance data on up to 4 uniform Campaign-related measures routine submission of a simple progress report to highlight improvement strategies and challenges

7. Campaign Framework monthly webinars provide content expertise and promote peer sharing routine retention journal clubs by renowned researchers to review recent publications participating agencies have access to coaches for support regional/local meetings of Campaign participants are held with the help of Quality Champions, where possible content-specific affinity group webinars/Study Groups are conducted and facilitated by peer providers consumer are involved as partners in this Campaign

8. in+care Participants by Zip Code (as per Oct 26, 2011)

9. Alaska Native Tribal Health Consortium, Anchorage, AK Franklin Primary Health, Inc., Mobile, AL Montgomery AIDS Outreach, Inc., Montgomery, AL St. George's Clinic, Birmingham, AL Whatley Health Services, Inc., Tuscaloosa, AL ARcare, Kensett, AR Jefferson Comprehensive Care System, Inc., Pine Bluff, AR Arizona Dept of Health Services, Phoenix, AZ El Rio Santa Cruz Neighborhood Health Center, Inc., Tucson, AZ Phoenix Children's Hospital, Phoenix, AZ AltaMed Health Services, Los Angeles, CA Center for AIDS, Research Education & Services, Sacramento, CA Charles Drew University of Medicine and Science, Los Angeles, CA County of San Diego HIV, STD and Hepatitis Branch, San Diego, CA Los Angeles Gay & Lesbian Center, Los Angeles, CA Mendocino Community Health Clinic, Inc., Lakeport, CA Mission Neighborhood Health Center, San Francisco, CA Opiate Treatment Outpatient Program, DSAAM, San Francisco, CA Positive Health Program, San Francisco, CA Santa Rosa Community Health Centers/ Southwest Health Center, Santa Rosa, CA Shasta Community Health Center, Redding, CA Tom Waddell Health Center, San Francisco, CA UCSD Mother-Child Adolescent HIV Program, San Diego, CA UCSD Owen Clinic, San Diego, CA University of Southern California/ Maternal, Child & Adolescent Health Program, Los Angeles, CA Vista Community Clinic, Vista, CA West County Health Centers, Inc., Guerneville, CA Denver Health HIV Primary Care Clinic, Denver, CO Denver Public Health ID Clinic, Denver, CO University of Colorado Hospital, Aurora, CO City of Hartford, Hartford, CT Community Health Center, Middletown, CT Community Health Services, Hartford, CT Fair Haven Community Health Center, New Haven, CT Waterbury Hospital, Waterbury, CT Yale University School of Medicine, New Haven, CT Carl Vogel Center, Washington, DC Howard University Hospital, Washington, DC Medstar Health Research Insititute/Washington Hospital Center, Washington, DC Unity Health Care, Washington, DC Whitman-Walker Health, Washington, DC Borinquen Healthcare Center of Miami Dade, Miami, FL Broward County Human Services Ryan White Part A Program, Fort Lauderdale, FL Children's Diagnostic & Treatment Center, Inc., Fort Lauderdale, FL Florida Department of Health, Tallahassee, FL Hendry County Health Department, LaBelle, FL NOFLAC, Pensacola, FL Ryan White Part A Orlando EMA, Orlando, FL Social Services Navigators, Hollywood, FL The Center for Positive Connections, Miami, FL The McGregor Clinic, Inc., Fort Myers, FL University of South Florida, College of Public Health, Tampa, FL AID Atlanta Joye Bradley Health Services Clinic, Atlanta, GA AID Gwinnett, Duluth, GA Cobb-Douglas Board of Health, Marietta, GA DeKalb County Board of Health Ryan White Early Care Clinic, Decatur, GA Emory University, Atlanta, GA Fulton County Government, Atlanta, GA Fulton County Ryan White Program, Atlanta, GA Georgia Department of Public Health - HIV Unit, Atlanta, GA Georgia Health Sciences University, Augusta, GA Grady Memorial Hospital Corporation, Atlanta, GA Waikiki Health Center, Honolulu, HI Siouxland Community Health Care, Sioux City, IA University of Iowa, Iowa City, IA Alliance of Chicago, Chicago, IL Chicago Department of Public Health, Chicago, IL Howard Brown Health Center, Chicago, IL Indiana University Health-LifeCare, Indianapolis, IN UKSM-W MPA HIV Program, Wichita, KS Matthew 25 AIDS Services, Henderson, KY University of Kentucky, Lexington, KY University of Louisville Research Foundation/Wings Clinic, Louisville, KY Children's Hospital New Orleans, New Orleans, LA FACES, Baton Rouge, LA Family Service of Greater Baton Rouge, Baton Rouge, LA GOCARE, West Monroe, LA Interim Louisiana State Unversity Public Hospital, New Orleans, LA LSU - Earl K Long Medical Center, Baton Rouge, LA LSU - Hospitals/University Medical Center, Lafayette, LA New Orleans Metoropolitian Area, Harvey, LA NO/AIDS Task Force, New Orleans, LA Office of Health Policy and AIDS Funding, New Orleans, LA Primary Health CAre, Marrero, LA Southwest Louisiana AIDS Council, Lake Charles, LA Volunteers of America Greater Baton Rouge, Baton Rouge, LA Jordan Hosiptal ACCESS Program, Plymouth, MA Lynn Community Health Center, Lynn, MA Baltimore/Towson Part A EMA, Baltimore, MD Chase Brexton Health Services, Baltimore, MD Prince George's County Health Department HAB Clinic, Cheverly, MD Ingham County Health Department, Lansing, MI Michigan Department of Community Health, Lansing, MI Minnesota Department of Human Services/Part B, St. Paul, MN City of St. Louis Health Department, Saint Louis, MO Kansas City Free Health Clinic, Kansas City, MO Truman Medical Center, Kansas City, MO Washington University, St. Louis, MO Central MS Circle of Care Program, Jackson, MS Delta Regional Medical Center, Greenville, MS University of Mississippi Medical Center, Jackson, MS AIDS Care & Educational Services, Wilmington, NC Carolina Family Health Centers Inc., Wilson, NC Mecklenburg County Health Department, Charlotte, NC Tri-County Community Health Council, Inc., Newton Grove, NC Wake Forest University Health Sciences, Winston Salem, NC ND Department of Health, Bismarck, ND Dartmouth Hitchcock Medical Center, Lebanon, NH Dartmouth-Hitchcock HIV Program, Bedford, NH State of New Hampshire, Division of Public Health Services, Concord, NH Cooper University Hospital, Camden, NJ Jersey City Medical Center, Jersey City, NJ Jersey Shore University Medical Center, Neptune, NJ Newark Beth Israel Medical Center, Newark, NJ Robert Wood Johnson Medical School, New Brunswick, NJ Saint Michael's Medical Center, Peter Ho Memorial Clinic, Newark, NJ St. Joseph's Hospital & Medical Center, Paterson, NJ The FXB Center, Newark, NJ UMDNJ - RWJMS Eric B. Chandler Health Center, New Brunswick, NJ UMDNJ Newark - ID Clinic, Newark, NJ Visiting Nurse Association, Asbury Park, NJ Health Division - Ryan White Part B, Carson City, NV Northern Nevada HOPES, Reno, NV Ryan White Part A Las Vegas TGA, Las Vegas, NV AIDS Care, Rochester, NY Anthony Jordan Health Center, Rochester, NY Boriken Neighborhood Health Center, New York, NY Community Healthcare Network, New York, NY Harlem Hospital Center, New York, NY Health and Education Alternatives for Teens (HEAT Program), Brooklyn, NY Kings County Hospital Center, Brooklyn, NY Mount Sinai Hospital, New York, NY New York Presbyterian Hospital, New York, NY North Shore University Hospital, Great Neck, NY NYC Health and Hospitals Corporation, New York, NY NYC HHC East New York Diagnostic & Treatment Center, Brooklyn, NY NYU School of Medicine, New York, NY Research Foundation of SUNY Stony Brook, Stony Brook, NY Ryan Chelsea-Clinton CHC, New York, NY St. John's Riverside Hospital, Yonkers, NY St. Luke's-Roosevelt Hospital Center, New York, NY Staten Island University Hospital, Staten Island, NY The Brooklyn Hospital Center, Brooklyn, NY The Family Center, New York, NY United Way of Long Island, Deer Park, NY Weill Cornell Medical College, New York, NY WHMC, Brooklyn, NY Nationwide Children's Hospital FACES Program, Columbus, OH Ohio Department of Health, Columbus, OH University Hospitals of Cleveland, Cleveland, OH Ursuline Center, Canfield, OH HIV Resource Consortium, Tulsa, OK AACO, Philadelphia, PA AIDS Care Group, Chester, PA Albert Einstein Medical Center-Infectious Disease Center (IDC), Philadelphia, PA Drexel Partnership Comprehensive Care Program, Philadelphia, PA Easton Community HIV/AIDS Organization, Easton, PA Hamilton Health Center, Harrisburg, PA Pennsylvania/MidAtlantic AIDS ETC, Pittsburgh, PA Positive Health Clinic, Pittsburgh, PA Scranton Temple Residency Program, Scranton, PA St. Luke's Hospital, Bethlehem, PA The AIDS Project, State College, PA Two Rivers Health & Wellness Foundation, Easton, PA Centro de Salud Familiar Dr. Julio PalmieriFerri, Inc, Arroyo, PR Concilio de Salud Integral de Loiza, Loiza, PR PR CoNCRA, Rio Piedras, PR PR CoNCRA, San Juan, PR San Juan EMA, San Juan, PR Miriam Hospital Immunology Center, Providence, RI Thundermist Health Center, Woonsocket, RI Catawba Care, Rock Hill, SC HIV/AIDS Council, Columbia, SC HopeHealth, Inc, Florence, SC Richland Community Health Care, Columbia, SC Roper St Francis Healthcare, Charleston, SC Sandhills Medical Foundation, Sumter, SC South Carolina HIV/AIDS Council, Columbia, SC The Medical University of South Carolina Lead Agency, Charleston, SC Le Bonheur Health and Well-Being, Memphis,, Tn Memphis TGA Ryan White Part A Program, Memphis, TN Shelby County Health Care Ctr d/b/a Regional Medical Center at Memphis, Memphis, TN Brazos Valley Council of Governments, Bryan, TX City of Austin Health and Human Services HIV Administration, Austin, TX Lubbock MHMR, Lubbock, TX Parkland Health & Hospital System, Dallas, TX AIDS Response Effort, Winchester, VA City of Norfolk/Norfolk TGA, Norfolk, VA Mary Washington Healthcare, Fredericksburg, VA University of Virginia School of Medicine, Charlottesville, VA VDH and/or DC Dept. Health, Fredericksburg, VA Virginia Commonwealth University, Richmond, VA Virginia Department of Health, Richmond, VA Pierce County AIDS Foundation, Tacoma, WA Yakima Valley Farm Workers Clinic/ New Hope Program, Yakima, WA Medical College of Wisconsin, Milwaukee, WI Univeristy of Wisconsin Hospital and Clinics HIV Care Program, Madison, WI University of Wisconsin, Madison, WI Wisconsin Division of Public Health, AIDS/HIV Program, Madison, WI Shenandoah Valley Medical Systems, Martinsburg, WV 247 HIV providers representing 220 HIV programs in 133 cities and across 41 States/Territories have joined the Campaign so far

10. caring for 294,298 people living with HIV

11. % of Grantees by Part Ryan White Funding (n=182)

12. # of Programs by Caseload of Unduplicated Patients per Year (n=222)

13. How Do You Rate the Agency’s Level of QI Experience? (n=215)

14. To What Extent Has Your Agency Recently Engaged in Retention Activities? (n=215)

15. Introduction to in+care Campaign Measures Bruce Agins, MD, MPH

16. Technical Working Group Chaired by Drs. Bruce Agins and Laura Cheever Comprised of distinguished experts in the field of retention, including clinical experts, researchers, national stakeholders and other strategic thinkers from the Ryan White and other health care communities Committee was charged to prioritize and suggest 4 retention measures to be used for this Campaign

17. 1) Gaps in Care Definitions of terms as used in the numerators and denominators of this document: Patient – a patient of any age diagnosed with HIV/AIDS Provider – a health care professional who is licensed in their jurisdiction to prescribe ARV therapy, i.e., MD, PA, or NP Visit – an outpatient/ambulatory medical visit with a health care professional who is licensed in their jurisdiction to prescribe ARV therapy Exclusion criteria: Patients who are documented to be deceased, incarcerated, moved away, or transferred care during the 12-month measurement period are to be excluded from measurement

18. 2) Visit Frequency Definitions of terms as used in the numerators and denominators of this document: Patient – a patient of any age diagnosed with HIV/AIDS Provider – a health care professional who is licensed in their jurisdiction to prescribe ARV therapy, i.e., MD, PA, or NP Visit – an outpatient/ambulatory medical visit with a health care professional who is licensed in their jurisdiction to prescribe ARV therapy Exclusion criteria: Patients who are documented to be deceased, incarcerated, moved away, or transferred care during the 12-month measurement period are to be excluded from measurement

19. 3) Patients New to Care Definitions of terms as used in the numerators and denominators of this document: Patient – a patient of any age diagnosed with HIV/AIDS Provider – a health care professional who is licensed in their jurisdiction to prescribe ARV therapy, i.e., MD, PA, or NP Visit – an outpatient/ambulatory medical visit with a health care professional who is licensed in their jurisdiction to prescribe ARV therapy Exclusion criteria: Patients who are documented to be deceased, incarcerated, moved away, or transferred care during the 12-month measurement period are to be excluded from measurement

20. 4) Viral Suppression Definitions of terms as used in the numerators and denominators of this document: Patient – a patient of any age diagnosed with HIV/AIDS Provider – a health care professional who is licensed in their jurisdiction to prescribe ARV therapy, i.e., MD, PA, or NP Visit – an outpatient/ambulatory medical visit with a health care professional who is licensed in their jurisdiction to prescribe ARV therapy Exclusion criteria: Patients who are documented to be deceased, incarcerated, moved away, or transferred care during the 12-month measurement period are to be excluded from measurement

21. Campaign Measures Frequency of Visits (every 6 months) Gaps in Care (no visit in the last 6 months) Patients New to Medical Provider (every 4 months) Viral Suppression (last VL, <200 copies/ml, all pts in care)

22. in+care Campaign Data Reporting Jane Caruso

23. Campaign Database Allows participating agencies to self-report their performance data on this online application Individual agencies need to register to access the database Form a group of grantees, which would allow them to generate group reports, such as HIVQUAL regional groups, collaboratives, networks Immediate access to individual scores trended over time to regional/national benchmarking reports to reports based on common search criteria to group scores of established groupings Coaches have access to individual/groups scores to better assist participating agencies

24. Registration

25. Data Entry

26. Data Entry

27. Data Reporting

28. Data Collection Details • First Data Collection Submission Deadline: December 1, 2011 • Measurement Period: • 10/01/2010 – 09/30/2011 • Access to in+care Campaign Database: incareCampaign.org (‘+submit data’) • Testing of in+care Database: • till November 4, 2011 - data are deleted on 11/14 • Database Instructions: • incareCampaign.org

29. Progress Report Form A) What recent interventions have you tried to improve retention rates? What measurable results, if any, did you have? Focus on identifying those out of care; re-engaging individuals back into care; preventing those in care from falling out of care B) What are the major recent barriers/challenges you are facing in achieving higher retention rates? Focus on barriers your consumers have identified, challenges that your providers have identified; underlying system issues in your organization C) What lessons did you learn that would be helpful to others? Focus on recent discoveries that made a vast difference to your retention efforts; tools, forms (please attach); observations from provider and consumers D) What technical assistance needs to you have for NQC, HAB and our Campaign coaches?

30. Local Quality Champions Michael Hager

31. Local Quality Champions Create peer learning opportunities for HIV providers • Meet locally face-to-face/virtual to discuss retention issues Takes advantage of existing meeting structures and communities of learning, including HIVQUAL Regional Groups, cross-Part meetings, network meetings • Build regional peer exchanges with minimal input by Campaign coaches • Extend the reach and impact of the Campaign

32. Quality Champions Wanted! Responsibilities of Quality Champions: • Conduct at least 2 face-to-face meetings/calls • Reach out to local HIV providers; NQC will assist • Provide logistical support for these meetings • Facilitate the discussions and chair the meetings • Report activities back to Campaign staff Sign-up to become a Quality Champions – incare@NationalQualityCenter.org

33. Consumer Engagement in the in+care Campaign Bob Tracy

34. Partners in+care Promote awareness among consumers about the Campaign and how to improve health by being in care Encourage self-care among consumers Reaching out to consumers and step up as partners in quality improvement activities

35. Consumer Engagement Web Site. Resources. Announcements. Consumer Corner. Sign-up to be in+care partners. Tools. in+care poster and brochure. Training. Consumer webinar series for individuals and groups. Quality Academy. Stories and Tips. People living with HIV sharing in+care stories and tips.

36. Time for Questions and Answers

37. Next Steps • Campaign Webinar: November 9, 2011 at 12pm ET • Meet the Author – Dr. Edward Gardner: November 16, 2011 at 12pm ET • First Data Collection Submission Deadline: December 1, 2011

38. Campaign Headquarters:National Quality Center (NQC)90 Church Street, 13th floor New York, NY 10007Phone 212-417-4730 incare@NationalQualityCenter.orgincarecampaign.org youtube.com/incarecampaign