Showing posts with label PA suburban counties. Show all posts
Showing posts with label PA suburban counties. Show all posts

Friday, September 20, 2013

The (PA) State of HIV Planning: A report back from the September 2013 PA HPG meeting

This week, I had the privilege of attending the PA statewide HIV Planning Group (HPG) meeting.  Pennsylvania has a new integrated planning body that includes both HIV prevention (for all counties except Philadelphia) and HIV care (for the whole state).  This overlaps with our local care planning for the five counties in Southeastern PA.  You can read a little more about this, plus get the meeting schedule, on the PA HPG's website.



PA HPG meetings take place outside of Harrisburg.
Photo Credit: JasonTromm via Compfight cc

Members of the PA state HPG are from all over Pennsylvania, so the group conducts its business over the course of two-day meetings held every other month.  This cuts back on travel time and expenses, and gives the group a lot more time to work together.  These meetings include sessions with the entire body, as well as smaller breakout task groups each day to dive into meatier issues.  I live-tweeted the PA HPG meeting. If you're interested in a play-by-play, you can search hashtag #PAHPG over on Twitter.

The first day started off with reports back from each of the three task groups: one that deals with membership issues, another dealing with priority setting and resource allocations, and a third that plans needs assessments.  Note: This structure will shift in January, but that's what it looks like for now.
 
After updates, we broke into task groups.  I sat in with the priority setting and resource allocation group on the first day.  Their requirements are a little bit different from what I'm usually involved with, because the care funding comes through Ryan White Part B.  For Part A funding (what we get in the Philadelphia Eligible Metropolitan Area, or EMA), the planning body is required to both set service priorities and allocate/budget money for these services.  (You can get a refresher on the Philadelphia EMA Part A process here.)  On the state, Part B level, the planning body does not have to make the budget, so the task group focused largely on the priority setting process.  They had an extensive conversation on the type of data and information the PA HPG would need in order to make its decisions, planning out almost a year's worth of presentations.  They also briefly discussed the process itself, which will have some parallels to the Philadelphia EMA's process.
 
Later on, the whole PA HPG reconvened to talk about their new protocols, which were similar to what we call bylaws for our planning bodies here.  HPG members were asked to review the protocols for changes.  The HPG also got an introduction to the three new HIV data managers at the Department of Health.  These new positions include one data manager each for care, prevention, and the Special Pharmaceutical Benefits Program (SPBP). 
 
Last on the HPG's agenda was concurrence for the statewide HIV prevention 2013 interim progress report and 2014 grant application.  This document gets sent to the CDC, and the CDC then uses the document to decide how much prevention money the state will receive.  It includes changes, successes, and challenges to prevention services and the planning process itself.  It also includes special projects and relatively detailed budgets.  The document is 62 pages long, with around 72 pages of appendices.  I actually read the whole thing - the most notable part for me was about a special demonstration project called Project Silk.  Project Silk is a drop-in program geared toward minority LGBTQ ball youth in Pittsburgh, and has had some pretty remarkable results.  They've managed to reach a challenging population, and they are using a peer navigator program.  I'm looking forward to hearing more about the project at future meetings.  The PA HPG did ultimately concur (or agree with) the application after hearing a very thorough presentation, and that was the last item on the first day's agenda.

Day two was much shorter, and we broke almost immediately into task groups.  On the second day, I decided to move over to the needs assessment group.  If you're not familiar with the term "needs assessments," it just refers to ways that we can figure out what people need, like surveys, focus groups, town hall meetings, and other similar activities.  The task group wants to look particularly at people who are "late-testers," meaning that they aren't diagnosed with HIV until they're already sick, so they're diagnosed with AIDS at the same time.  They also want to find out more about provider capacity - essentially, whether the providers have room for more clients.  Plus they're planning to gather as much data as possible from sources like SPBP and partner services to help them plan their needs assessments.  We're going to be sharing our data with them to help with this process.

Later on, the whole PA HPG got back together for task group reports.  While I was with the needs assessment group, the priority setting and resource allocation task group continued talking about the tool in the context of the whole process.  They also further refined their presentation schedule for 2014, and talked about having a more unified priority setting process that would get input from many local consumer groups.  I offered to speak with our own Positive Committee about the process when they had more information.  Then we heard from the membership task group, which plans to have an ongoing orientation process that includes mentorship.  They requested that the Department of Health have the application materials translated into Spanish.  They're also looking for more HIV-positive consumer members.


The new Kenneth McGarvey fashion line

Last on the agenda was the final approval of the HPG protocols, including any updates.  Once that was taken care of, there was a small surprise.  Ken McGarvey, the director of the HIV/AIDS Division of the PA Department of Health (DOH), created a model of the care continuum that pops its head into many of the DOH's documents.  At the end of the meeting, there were surprise t-shirts immortalizing the famous "McGarvey HIV Service Model."

A steering committee meeting followed the main meeting, but it was time for me to head back to Philadelphia.  I'm looking forward to attending the next PA HPG meeting, and excited for increased collaboration between our planning bodies and the PA statewide group!

Monday, July 29, 2013

Health Reform Resources: Enrollment Support and Marketplaces

As the start of open enrollment (October 1, 2013) draws closer, there has been a flurry of resources concerning how to help consumers screen for eligibility and enroll in Marketplace plans and Medicaid. Below you will find several new resources relevant to the Philadelphia region. Community-based providers and AIDS service organizations are encouraged to explore all the resources and opportunities available to assist with the transition to the era of health reform and new coverage options. You can explore our
other blog posts about health reform here.

Stakeholder Call with HHS and CMS about the Health Insurance Marketplace in PA - July 31, 2013

This second in a series of three calls is intended specifically for stakeholders in Pennsylvania. HHS and CMS regional officials will give brief updates on the operational execution of the Marketplace including systems readiness; consumer support and outreach.   

Certified Application Counselor Organizations

There are going to be opportunities for organizations to be trained and certified to provide counseling to enrollees. As a CAC organization, your staff and volunteers will help people understand, apply, and enroll  for health coverage through the Marketplace. There are three official trainings on how to become a Certified Application Counselor Organization over the next couple of weeks. Register at the links below.

Date
Time
Webinar Link



July 31, 2013
1:30 – 3:00 pm ET
August 6, 2013
1:30 – 3:00 pm ET
August 7, 2013
1:30 – 3:00 pm ET


Kaiser Family Foundation Issue Brief -- Helping people with HIV Navigate the Transition to ACA Coverage.

This issue brief is a summary of a roundtable discussion convened by Kaiser Family Foundation in March 2013 concerning planning for the coverage transition, helping people with HIV choose and enroll in coverage and troubleshooting during coverage transitions.
Key passages:
Pg. 5 - HIV community needs to plan for changes in the role of the Ryan White HIV/AIDS Program 
Pg. 5 - HIV community stakeholders need to be aware of their state's organizational structure and work to inform state policymakers about the needs of people with HIV and standards for HIV care.
Pg. 6 - HIV service providers may need to consider business re-design options to maximize their engagement with the health system.
Pg. 6 - Best practices and lessons learned from states and organizations that have begun navigating through HIV-related policy changes will help inform how to better plan for challenges that may occur
Pg. 8 - It may be important to differentiate between types of HIV enrollees in ACA coverage
Pg. 9 - While HIV providers and clinic staff are poised to play a central role in supporting coverage transitions, they may require specific training and support


Insurance Marketplace Pre-screening Tools and other Resources at HIVhealthreform.org

There are too many great resources on hivhealthreform.org to list here. One of the most interesting is the pre-screening tools (for both Medicaid-expansion states and those not currently expanding Medicaid coverage) from Duke Law Project.

Friday, July 26, 2013

Health Reform To-Do List

This presentation was designed specifically for people living with HIV/AIDS (PLWHA) who are uninsured or in need of affordable insurance options. Most of the information is general to PLWHA in the US, but some Pennsylvania information is included because the state is not expanding Medicaid coverage to low income adults (not at this time anyway). These slides are adapted from content developed by the Target Center. I highly recommend providers and consumers of Ryan White services check out the Target Center for great resources about Health Reform and so much more.

I created this interactive presentation in an effort to help more people understand how the Affordable Care Act, or "Obama Care" may affect them. It's intended to be used as a starting-off point to explore resources to help you make the best decisions for yourself and your family. Anything that is underlined is a link to something to help you understand your options or help plan for your new coverage in 2014. Please take time and explore the links.

If you have questions or comments, please be sure to leave comment here or email me. I will do my best to answer your question or lead you to a good resource.



Thursday, February 28, 2013

The Big Picture - February 2013

This post is part of a new monthly series published on the fourth Thursday of every month. It will provide an overview of themes and topics from the general meetings and committee meetings of the Ryan White Planning Council and Prevention Planning Group each month. To view meeting materials and presentations, please visit www.hivphilly.org.

Ryan White Planning Council (RWPC)

Every summer, the Planning Council (RWPC) makes contingency plans for how it will spend money for fiscal year, which starts the following spring. That way, they have a plan when they find out how much money they’ll be getting from the federal government. Grant awards come out at a different time every year, based on when the federal budget is finalized. As of the writing of this post on February 28, 2013, we have not yet received our full award for the fiscal year starting on March 1, 2013. This year, planning will be unusually challenging.

We are facing an impending sequester and the end of the continuing resolution (a type of continuation budget when Congress fails to make appropriations). Although the Ryan White program will still be fundable, the Ryan White Treatment Modernization Act is set to expire in the fall. While this could complicate our responsiveness to changes caused by the Affordable Care Act, government and community leaders decided not to seek reauthorization due to political and budgetary concerns. We’re also uncertain about the impact of Medicaid expansion – which, at this time, is very likely in New Jersey and unlikely in Pennsylvania. It could be called a perfect storm. (Learn more here.)

To prepare for a rocky year, the RWPC and its committees have pressed forward with their work. The Finance and Comprehensive Planning Committees have already begun to talk about the summer’s allocation process. The Finance Committee has agreed to hold two allocations processes this year: one in the traditional format, and a second that addresses potential changes caused by national-level issues. Since we are not sure how much money we’ll have for the year starting March 1, 2013, the Finance Committee recommended that we act as if we have received a 5% cut (a suggestion then approved by the RWPC).

Meanwhile, the Comprehensive Planning Committee looked at how the Ryan White service categories fit in the continuum of care. (Learn more about the continuum of care here.) The Needs Assessment Committee received a presentation from the AIDS Activities Coordinating Office (AACO) on its Client Services Unit (CSU) and quality management, so they would have a better idea of how to measure the effectiveness of the different services. The Positive Committee talked about disclosure and reviewed their goals and objectives. The Nominations Committee also discussed their policies and next steps in uncertain times. They’re also accepting applications for RWPC membership through the second week in March.

Prevention Planning Group (PPG)

In the second half of 2012, the PPG and RWPC jointly explored the idea of combining care and prevention planning in one body. This idea was tabled due to the uncertainty that surrounds the current planning environment. But, the PPG was still in need of a change. The CDC released new HIV Planning Guidance in July 2012, marking a shift away from the old duties of prevention planning.

In order to decide what the future of prevention planning should look like in Philadelphia, the PPG called two special February meetings: one on structure, and another on membership. A small group of dedicated members began the hard work of ironing out the details. They chose to recommend that the PPG have 12 – 20 voting members (plus non-voting members), who would meet every other month to plan for stakeholder engagement. They also recommended that the PPG build more flexibility into its process. (Read a summary of points from the workgroup meetings.)

When the PPG met in February, consultant Matthew McClain presented draft bylaws based on the recommendations from the two workgroups. He also created an outline of a work plan for the new group. After a thorough review of the bylaws, PPG members identified a few areas for change as well as their next steps. In coming weeks, the PPG will create roles and responsibilities for voting and non-voting members. They will also develop an application and scoring process, beginning with a special membership meeting.

This is an exciting, if tumultuous, time to get involved in community planning for the Philadelphia area. To learn more, follow the links in this post, attend one of the meetings listed on our calendar, or email info@hivphilly.org to find out how to get involved.

Wednesday, October 5, 2011

2012 Ryan White Allocations

Every year, the Philadelphia EMA Ryan White Planning Council (RWPC) hosts three Allocations meetings for each region in the Eligible Metropolitan Area (EMA) to plan its budget for the next year. One meeting is for the New Jersey counties (Salem, Camden, Gloucester, and Burlington), one is for the PA suburban counties (Bucks, Chester, Montgomery, and Delaware), and the third is for Philadelphia County. Each region receives a portion of the total EMA's funding that reflects their share of the HIV/AIDS epidemic, based on the most recent data available.

At the Allocations meetings, each region makes a plan for how they would spend their portion of the funding if the EMA received the same amount of money as last year, if they received a 5% decrease in funding, and if they received a 10% increase in funding. These plans are for the fiscal year that begins on March 1 of the next year. Each region can also make instructions to the grantee (the AIDS Activities Coordinating Office, or AACO) at its meeting.

After these three meetings, the Finance Committee of the Ryan White Planning Council (RWPC) meets to review each region's plan, including any instructions to the grantee. The Finance Committee can choose to recommend, recommend against, or make no recommendation on these plans (although the Finance Committee almost always recommends the regional plans with no changes). The Finance Committee then presents the allocations plans from all three regions to the RWPC, who then votes on the plans and the instructions to the grantee.

The allocations plans for next year were based on the 2009 number of living HIV/AIDS cases in each region. Based on this data, the PA suburban counties represent 14.20% of living HIV/AIDS cases in the EMA, while the New Jersey counties represent 10.55% of cases and Philadelphia represents 75.25%. These shifts provided the starting point for each region's decision-making.

Here's the breakdown for each region.

Philadelphia
Level-funding budget: Philadelphia chose to keep all services funded at the same levels in the case of level funding.

5% decrease budget: Philadelphia chose to spread a 5% decrease proportionally across all service categories (based on their level-funding budget).

10% increase budget: Philadelphia chose to give core service categories a 9% increase (based on their level-funding budget), while giving supportive service categories an additional 1% increase on top of their other 10% increase.

Instructions to the grantee: Philadelphia instructed the grantee to provide utilization data (to the Comprehensive Planning Committee) and expenditure data (to the Finance Committee) for the current and previous fiscal years. Philadelphia also instructed the grantee to clarify whether there were any organizations that provided treatment adherence services, but did not provide medical case management services.

PA Suburban Counties


Level-funding budget: The PA suburban counties chose to keep all services funded at the same levels in the case of level funding.


5% decrease budget: The PA suburban counties chose to spread a 5% decrease proportionally across all service categories (based on their level-funding budget).


10% increase budget: The PA suburban counties chose to spread a proportional increase across all service categories with the exception of transportation and drug reimbursement (based on their level-funding budget), because these categories had been underspent. They instructed the amount of the increase that would otherwise go to transportation and drug reimbursement (approximately $53,746) be placed into other categories as follows:


  • 25% into medical case management

  • 25% into ambulatory care

  • 50% spread across all remaining service categories

Instructions to the grantee: The PA suburban counties instructed the grantee to analyze outreach services in Chester city, with the results reported to the Comprehensive Planning Committee.


New Jersey Counties
Level-funding budget: The New Jersey counties chose to move funding from food bank/home-delivered meals (leaving a $5 placeholder) into state ADAP, as there were no providers currently able to provide food bank/home-delivered meals and the state ADAP program had received cuts.

5% decrease budget: The New Jersey counties chose to spread a 5% decrease proportionally across all service categories (based on their level-funding budget).

10% increase budget: The New Jersey counties chose to spread a 10% increase proportionally across all service categories (based on their level-funding budget).

Instructions to the grantee: The New Jersey counties instructed the grantee to review the efficacy of the medical case management model (to be reported to the Comprehensive Planning Committee), and to possibly expand the model to include triage.