Virginia HIV Community Planning Committee

1. Virginia HIV Community Planning Committee New Member Orientation

2. Community Planning is … • A collaborative effort between the health department and community planning groups (CPGs) to design local prevention plans that best represent the prevention needs of communities at risk for or already infected with HIV. • A process in which people with different life experiences, interests, backgrounds, and expertise come together to plan how to prevent HIV infections where they live.

3. Prior to Community Planning • Funding (~$140 million) was distributed based on Congressional mandates • Majority of funding went to CTRPN • As well as HERR, Minority, PIC, Outreach • Responsibility was not shared • CDC distributed funding based on available data • Programs monitored by CDC

4. HIV Prevention Community Planning • Development began in 1993 • U.S. Department of Health and Human Services; legislature; community; & national organizations • Implementation began in 1994 • Priority setting and selection of populations & interventions moved to the local community rather than the Federal government

5. Community Planning Strategy • Planning focuses on the epidemic in your local jurisdiction • Brings all parties to the table • Brings all relevant data to the table • Parity, Inclusion, Representation (PIR)

6. P.I.R. • Parity • All members have the ability to participate, make decisions, & carry out planning tasks • Inclusion • Members have a meaningful involvement in the community planning process with an active voice in decision-making. Assures that the views, perspectives, & needs of all affected communities are included. • Representation • Members should represent the perspective of the affected communities’ values, beliefs, & behaviors

7. CPG includes representatives from… • Local / State Health Departments • Other State / local agencies • Non-governmental organizations (CBOs) • Representatives of communities & groups at risk for HIV infection or already infected • Experts in epidemiology, behavioral & social sciences, & evaluation

9. Goals Objectives Implement an open recruitment for membership Broad-based community participation Ensure that membership is representative of at-risk populations Encourage inclusion & parity Identification of HIV prevention needs for each priority population Carry out an evidence-based process to determine prevention needs Prioritize populations based on data Select interventions for each population based on established criteria Targeted resources for priority populations & interventions Demonstrate a direct relationship between the plan & the application for funding Demonstrate a direct relationship between the plan & funded interventions

10. Role of CPG Members • Make a commitment to participate in decision-making • Serve on committees to gather data and information • Review epidemiologic and scientific data • Set priorities among needs & interventions • Contribute to the development of the plan • Evaluate the planning process • Assess the health department’s responsiveness • Determine technical assistance needs

11. Role of CPG Co-chairs • Develop an agenda based on input from CPG members • Facilitate participation and proper orientation of all members • Determine shared responsibilities • Review minutes • Manage conflicts • Represent the sentiments of the CPG members regarding concurrence

12. Leadership: Promoting community participation Ensuring clear understanding of roles Providing support to all CPG members Technical: Furnishing epidemiologic data Profiling community resources Assisting with needs assessment Allocating funds based on priorities Logistical: Drafting a comprehensive work plan Managing meeting logistics Disseminating materials to members Role of Health Department Staff

13. How to increase your CPGs Success • Be committed & collaborate • Understand the community you represent • Become a part of one or more of your CPGs committees / work groups • Take information back to the community you represent or serve

14. Questions???

15. Quiz time……….. When was community planning first implemented?  1994 What is P.I.R?  Parity, Inclusion, & Representation What does that mean?  Parity - All members have the ability to participate, make decisions, & carry out planning tasks  Inclusion - Members have a meaningful involvement in the community planning process with an active voice in decision-making. Assures that the views, perspectives, & needs of all affected communities are included.  Representation - Members of the CPG should represent the perspective of the affected communities’ values, beliefs, & behaviors

17. The Guidance… • A blue-print for HIV prevention planning • Provides flexible direction to CDC grantees to design & implement a participatory HIV prevention community planning process • Defines the CDC’s expectation of health departments & CPGs in implementing HIV prevention community planning

18. Importance of Community Planning • CDC expects HIV prevention community planning to improve HIV prevention programs by strengthening the: • Scientific basis • Community Relevance • Population- or risk-based focus of HIV prevention interventions

19. Reduce the number of new HIV infections in the U.S. from an estimated 40,000 to 20,000 per year by 2005, focusing particularly on eliminating racial & ethnic disparities in new HIV infections. 2 components to consider by CPG: Targeting populations for which HIV prevention will have the greatest impact Reducing HIV transmission in populations with highest incidence CDC Strategic Plan

20. Advancing HIV Prevention Initiative Putting more emphasis on counseling, testing, & referral, including PCRS & prevention services for persons living with HIV to help prevent further transmission once they are diagnosed with HIV • Making HIV screening a routine part of medical care • Creating new models for diagnosing HIV infection, including the use of rapid testing • Improving & expanding prevention services for PLWHA • Further decreasing perinatal HIV transmission

21. What do CPGs do? Primary task is to work with the health department to develop a Comprehensive HIV Prevention Plan that is based on both scientific evidence & community needs. • Plan should include prioritized target populations & a set of prevention activities/interventions for each target population Comprehensive HIV Prevention Plan

22. CPG tasks to complete the Plan • Develop an Epidemiology Profile • Conduct Needs Assessment • Assemble a Resource Inventory • Conduct a Gap Analysis • Prioritize Populations • Identify Potential Strategies & Interventions • Develop a Plan • Evaluate the Planning Process • Update the Plan Community Services Assessment

23. Key components of the Plan • Epidemiology Profile • Community Services Assessment • Needs Assessment, Resource Inventory, Gap Analysis • Prioritized Target Populations • Appropriate Science-based Prevention Activities/Interventions

24. The Plan… • CPG is required to develop at least 1 Comprehensive HIV Prevention Plan every 5 years. • Virginia is on a 5-year planning cycle • Plan completed in December 07 • CPG should be aware of contracting & funding cycles • The Comprehensive HIV Prevention Plan should describe the entire HIV prevention program

25. Accountability • Health departments will support a collaborative community planning process • Priority target populations & interventions are based on: • Having the greatest impact on reducing HIV transmission • Reducing HIV transmission in populations with highest incidence • CPGs will review health department’s application for federal HIV prevention funds • Allocation of CDC resources should be consistent with the prioritized populations & interventions

26. Letters of Concurrence, Concurrence with Reservations, or Non-concurrence • Health departments must include a letter of concurrence or non-concurrence from the CPG with their annual grant application. • Should indicate that: • CPG was provided a copy of the grant, including the budget • Degree of collaboration in developing, reviewing, or revising the grant • Degree to which the health department responded to priorities • Process used to obtain concurrence • Letter(s) should be signed by both CPG co-chairs

27. Questions???

28. Yep…time for another quiz… What is the primary task of the CPG?  To develop the comprehensive HIV prevention plan What are the 5 key elements of the comprehensive HIV prevention plan?  Epi Profile Community Services Assessment Prioritized Target Populations Appropriate Science-based Prevention Activities/Interventions Letter of Concurrence / Concurrence with Reservations / Non-Concurrence

29. Virginia HIV Community Planning Committee (HCPC)

30. Virginia HCPC • Mission is to identify the most effective HIV prevention strategies for Virginia • Includes the development of a comprehensive HIV prevention plan & setting priorities for HIV/STD primary & secondary prevention services in collaboration with consumers & providers

31. Virginia HCPC - Bylaws • Mission • Roles & Responsibilities of • The Health Department • The HCPC • Shared Responsibilities • Membership • Governance of Meetings Bylaws

32. Virginia HCPC - Membership • Open nomination process • Between 20 & 30 members • Members must commit to serving 2 years on the HCPC • Members are allowed 2-3 absences in a 12-month period • Executive Directors of organizations that may compete for VDH funding not allowed to serve on HCPC • Only allow 1 individual per agency to serve on HCPC

33. Virginia HCPC • Elaine Martin --- Health Department Co-chair Rosalyn Cousar --- Community Co-chair • Includes representatives from State Agencies: • Education • Juvenile Justice • Social Services • Mental Health, Mental Retardation, & Substance Abuse Services • Includes HIV+ individuals, community representatives & those who work for various CBOs/ASOs • Keep a balance of age, race, gender, sexual orientation, HIV status, geographic region, education, and life experiences

34. Virginia HCPC • Meet 6 times per year in Richmond • HCPC meetings are open to the public

35. Our Meetings • CPG Consensus on Effective Meetings and Respectful Discussions • You don’t have to bring your big notebook! • Review of the notebook

36. Virginia HCPC Subcommittees • Ryan White • STD • Research • Standards & Practices

37. Past Accomplishments • Research for IDU, faith community, MSM, Latinos in rural areas, African American women, Transgender • Recommendations for new grant programs: MSM, Faith Initiative, Prevention for Positives

38. Time Line for the Virginia HCPC 2008 Comprehensive Plan • 2004 Development of Epi Profile • Receipt of Technical Assistance for the CSA • Began Target Population Discussion Groups • 2005 Completed Target Population Discussion Groups • Development of Community Services Assessment • 2006 Prioritization of Target Populations • 2007 Selection of Interventions • Update and Completion of Plan • Update: Plan Completed in December 2007

39. Epidemiology Profile • Completed in December 2007 • Prepared by the Epidemiology Profile Coordinator in conjunction with the HCPC • Includes information on a variety of populations • Trends & rates by race/ethnicity, risk, age, region, & gender

40. Epidemiology Profile (Con’t) • Used to complete the Community Services Assessment (CSA) • To identify target populations • To identify evidence of risk • To identify needs of those target populations

41. Community Services Assessment • Needs Assessment • Resource Inventory • Gap Analysis

42. CSA – Needs Assessment • Needs Identified through: • Expertise of Committee Members • Information from the Resource Inventory • Research Highlights • Epidemiology Profile • Prevention Provider Survey • Informal key informant interviews with target populations

43. Agencies with known funding; receiving funds from federal sources; or receiving funds from major HIV/AIDS foundations. Searched national organizations & other state agencies to identify HIV prevention funding being distributed. Organized by target population Resource Inventory Includes: Agencies providing HIV prevention services Localities being served by the agency; Populations being targeted; Interventions being provided; Funding amount; Source of funding; End date of the funding. CSA – Resource Inventory

44. CSA – Gap Analysis • Used version of Resource Inventory omitting programs with eliminated funding for following year • Reviewed all identified needs to determine whether they are: • Emerging/Existing Needs • Continuing Needs • Prioritized all Emerging/Existing Needs

45. Using Community Services Assessment & Population Data People Living with HIV/AIDS Blacks Men who have sex with men High-risk heterosexuals Transgender Injection drug users Homeless Incarcerated 8. Youth Latinos Populations of Special Interest Mentally Challenged Sex Workers Seniors Asian/Pacific Islanders Prioritization of Target Populations

46. Selection of Interventions • Interventions based on scientific evidence: • Diffusion of Effective Behavioral Interventions (DEBIs) • www.effectiveintervetnions.org • Compendium of HIV Prevention Interventions with Evidence of Effectiveness • www.cdc.gov/hiv/pubs/HIVcompendium/HIVcompendium.htm • Best-evidence interventions • www.cdc.gov/hiv/topics/research/prs/best-evidence-intervention.htm • Any additional HIV prevention interventions

47. Selection of Interventions • Criteria Used • Targets a specific behavior/population • Evidence of effectiveness/based in theory • Acceptable and accessible to the target population • Cost-effective • Sufficient resources available to implement • Adaptable to other populations or settings

48. Where Are We Now? • Awaiting new guidance from CDC • Cooperative Agreement Extended • Working with HIV Care Services on merging the Planning Process

49. Challenges • Seven years of declining funds • Increase in cases among MSM • National incidence higher than previously estimated

50. What to Expect from your First Few Meetings • Confusion • Lots of Acronyms • Feeling Overwhelmed • Welcome