The Big Picture - June 2013

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

Ryan White Planning Council (RWPC)


Due to a crazy weather situation that never actually happened, the RWPC and RWPC Nominations Committee meetings were both canceled this month.  Three of the RWPC's committees did still meet, though.

RWPC members Lupe, Gary, and Gerry setting priorities

The Comprehensive Planning Committee met to begin its process for setting service priorities for the 2014 fiscal year.  Each service category was scored using five factors: payer of last resort, consumer survey data, impact on the care continuum, unmet need data, and designation as an Essential Health Benefit (EHB) under the Affordable Care Act (ACA).  The group was able to score all of the services in just one meeting.  They'll talk about the draft list at their next meeting at 10 a.m. on Wednesday, July 10 and then present the list to the RWPC for a vote at their July meeting.

Meanwhile, the Finance Committee met to continue discussions on its FY2014 allocations process.  We were joined by AIDS Activities Coordinating Office (AACO) staff, and the group had a lengthy talk about the type of data they would like to consider.  It will be a challenging year for planning allocations, since the fiscal year will coincide with the beginning of most parts of the Affordable Care Act.  They ultimately created a list of data that they planned to look at in order to evaluate the cost-effectiveness of different services.

The Positive Committee had a special presentation from Philadelphia FIGHT in honor of AIDS Education Month.  They discussed HIV myths and facts, and received information on various services.  They also reviewed their new committee brochure.

Prevention Planning Group (PPG)

June marked the last official meeting of the PPG.  They'll be officially replaced by the HIV Prevention Planning Group (HPG) starting on July 1.  This month, a small review panel met to discuss applications for HPG membership.  They recommended a pool of applicants for the new HPG.  After this, the PPG met for the last time.  We were joined by our CDC project officer, Angie Alvarado.  Community co-chair Jen Chapman gave a fantastic overview of HIV prevention planning, including updates from the Urban Coalition for HIV/AIDS Prevention Services (UCHAPS) and a recent HPG Bootcamp.  We thank the PPG members for their service, and look forward to working with the new HPG starting on Wednesday, July 24.

Points of Integration Workgroup

Members from both the care and prevention planning bodies come together for the Points of Integration Workgroup.  Like each of the committees, they've been giving a lot of thought to the treatment cascade and its implications for Philadelphia.  A few months ago, they chose to focus on the "linkage to care" aspect - getting people that test positive for HIV into medical care right away.  They think that having the HIV tester ask questions about "treatment readiness" at the time of the test might help us to get new positives into care.  At their last meeting, the group started to look at different models for these types of assessments, including the Anti-Retroviral Treatment and Access to Services (ARTAS) model.


This is an exciting 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. If you have questions, you can also call us at 215-574-6760.

What on earth is HIV planning, anyway?

We do it, the health department does it, the community does it, and providers do it.  HIV planning is pretty much our bread and butter around here - we are, after all, the Office of HIV Planning.  But what does that mean?  (Hint: no, we don't plan HIV.)

Ok, give me the details.

Every year, our area gets money directly from the federal government to help with the cost of HIV care and prevention in the Philadelphia area.  (For care, this money covers Philly and eight surrounding counties.  Prevention money is just for Philly.)  The feds know that each city has different needs, so they ask every city to come up with its own plan for how they'll spend the money.  That's where community planning comes in.  We have one group that works on the care side (the Ryan White Planning Council, or RWPC), and one group that deals with prevention (soon to be the HIV Prevention Planning Group, or HPG).  Both groups meet here at the Office of HIV Planning.

Great, but what do they do?

For starters, they have a lot of meetings in our office.  Each planning body has its own monthly meetings, plus committees to deal with specific issues or processes.  Who comes to these meetings, you ask? At least two of our own staff, plus planning body members, HIV service providers, health department staff, and community members (including people living with HIV/AIDS).  What's the point of all these meetings? To plan HIV services in our area.

The topics covered in each meeting vary, but they all have the ultimate goal of making HIV services better and more effective.  We talk about the needs of the community, and sometimes we do surveys or focus groups to get more information.  Other times we talk about the services and how they work.  We also try to stay up to date on the latest news on funding, federal and local policy, and more.  Our office takes the discussion from the meetings and works along with the health department to work some magic.  We document the meetings, do research, and otherwise get a lot of the legwork done so the planning bodies can focus on making educated decisions.  Then we bring our work back to whichever group requested it, so they can use that information as they plan the services.

Sounds like you've got this under control.  Why do you need me?

Ah, thank you.  Here's the thing:  we can do research until the end of time, but it's not the same as getting real input from people that live and work in our community.  There aren't too many opportunities for you to have an impact on the way an entire system works, but this is one of them.  You get to work with other dedicated individuals to make HIV care and prevention work better. 

You sold me.  How do I get involved?

That depends on how much time you have to give.  The HIV Prevention Planning Group (HPG) is taking applications for new members through Tuesday, June 18 at 5 p.m.  You can apply here, and then send your resume and personal statement to HPG@hivphilly.org.  You can also learn more about the Ryan White Planning Council (RWPC) on our website.  (They accept applications on a rolling basis - their next round will be in the fall.) Can't make a commitment right now?  Register as a community expert and we'll call on you when we need your expertise.  You can also attend a meeting, call us at 215.574.6760, or email me at briana@hivphilly.org.

The Team: Noel Ramirez

This post is part of a series that features a member of the community planning team - one of the devoted members of the Ryan White Planning Council or the Prevention Planning Group that volunteers his or her time to improve HIV services in our area.

This month, we feature Noel Ramirez.  Noel is now a Planning Council member, but until recently he served on the Prevention Planning Group. I asked him the following questions.



What made you decide to get involved in community planning?

I wanted to bring a youth/young person perspective to the table to shake things up a bit.  I was also tired of hearing people say that young people are apathetic.  We’re not.

 

You previously served on the Prevention Planning Group, and now you're on the Ryan White Planning Council, which is a pretty unique situation.  How do you think your time on the PPG will help you as an RWPC member?

I got to sample the great snacks and fruit flavored teas!

 

On the real, my time with the PPG was helpful in initially understanding the planning process.  I also got to meet people in the planning council through a variety of ad-hoc meetings.

 What is your favorite part about community planning?

My favorite part of community planning is learning the mechanics of policy and practice.  As a direct service provider, I never quite understood how and why things are. Community Planning really gives me an opportunity to really see what goes on behind the scenes.

What is the biggest challenge facing community planning today?

I’m working with getting some young people into it.  Outreach to youth and creating opportunities for young people seems to be the most obvious challenge. 

What do you wish more people knew about community planning?

The office staff and the community are awesome and fabulous.  (Ed. note: No, I didn't coerce Noel into saying that.)  The refreshments are great. And your voice is actually pretty important.

 

Noel: One of the many faces of community planning

What do you do?  What programs are you involved with?

I am a program manager at St. Christopher’s Hospital for Children and manage a program called The Sexuality With Education And Truth (SWEAT) Project.  The SWEAT project is a community-wide program for HIV+ young gay/bisexual men in Philadelphia. I work with different HIV care provider sites and develop/facilitate programming that provides young dudes an opportunity to find their voice, find a friend and find a community that support, loves and honors who they are.

 

I also do consulting work with YHEP’s Prep Program “I AM Men’s Health” and have developed curriculum and programming for HIV- men who are taking Prep.

What do you want Philadelphians to know about PrEP?

It’s an option and new technology for you when deciding how you’re going to engage in sex.  Check it out and talk to a medical provider for more information! 

What is your favorite thing about the Philly area?

I love riding my bike through different neighborhoods in the summer. I have also am currently having a love affair with Fuel…perhaps my favorite food joint so far. Next to Smokeless BBQ in South Philly.

 

Anything you like to do while you're in the neighborhood for meetings?  (No is fine!)

My programming work is usually in the evenings, so I’m usually off to that.

Anything else you'd like to add?

I love, honor and respect the people involved in the fight of HIV.  Planners, affected, infected, medical providers, administrators, government folks, medical case managers and allies, you have all stolen my heart :)

To meet our featured community planners or get involved in the process yourself, we invite you to participate in one of our meetings. You can always view a meeting calendar at http://www.hivphilly.org/calendar.html, or email info@hivphilly.org to learn more.

The Big Picture - May 2013

This post is part of a monthly series published on the fourth Thursday of every month. It provides 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)


This May, the Ryan White Planning Council (RWPC) received two separate presentations on the latest trends in HIV.  First up, Dr. Helena Kwakwa told RWPC members about the new health system navigators in the City's Health Centers.  This program helps people that just found out that they're HIV-positive into medical care.  It also helps people get back into care if they stopped going to the doctor.  Next, we had Evelyn Torres and Sebastian Branca from AACO give us an update on the Client Services Unit (CSU), the Housing Services Program (HSP), and Quality Management (QM).  You can get the full scoop here.

Treatment Cascade

Meanwhile, the Comprehensive Planning and Finance Committees held another joint meeting.  They talked about the priority setting process that the RWPC has to have at least every three years.  They use this process to organize service categories from highest priority to lowest priority.  There are going to be some major changes this year, so they updated their priority setting tool.  The new tool focuses more on the treatment cascade.  They also started to tackle the idea of cost-effectiveness for services.  The Comprehensive Planning Committee will move forward with priority setting, while the Finance Committee keeps working on allocations-related issues.

Both the Needs Assessment Committee and Points of Integration Workgroup (a joint venture of the RWPC and PPG) are plugging along with their work on linkage to care.  Linkage to care (making sure newly diagnosed HIV-positive people get into medical care) is one of the most challenging parts of the cascade for the Philadelphia area.  The Needs Assessment Committee kept working on specific questions they had for HIV testers about how currently they get their clients to the doctor.  The Points of Integration Workgroup agreed to create a new model for linkage to care for the Philadelphia area.  They're starting off by looking at research on current models.  Both groups talked about navigators, too.

The Positive Committee has also been discussing coming changes from the Affordable Care Act (ACA).  (Nicole is doing a great series on health reform and the average consumer.)  The Philadelphia Eligible Metropolitan Area (EMA) covers nine counties in two states.  Since New Jersey is expanding its Medicaid program but Pennsylvania isn't, we'll have some unique challenges in 2014.  Nicole also talked about Essential Health Benefits and other topics from the ACA. 

Prevention Planning Group (PPG)

Last year, the CDC came out with a new HIV Planning Guidance.  This changed the work required in prevention planning, shifting its focus to broad community engagement.  The PPG has been working to re-imagine itself for several months, in order to stay consistent with this changing landscape.  The PPG as we know it will cease to exist when all of its members' terms expire on June 30.  Its new incarnation, the Philadelphia HIV Prevention Planning Group (HPG), will kick off in July.  Their specific tasks are changing, but their work is just as important.  Apply for HPG membership by June 18, and help shape the future of HIV prevention in Philadelphia.



This is an exciting 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. If you have questions, you can also call us at 215-574-6760.

The Big Picture - April 2013

This post is part of a monthly series published around the fourth Thursday of every month. It provides 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)





Do 1 Thing

This month, the Ryan White Planning Council (RWPC) had a bit of a break in its agenda after a very busy and stressful March.  (Read about the funding decisions that the RWPC made in emergency meetings in March here.)  RWPC members received a presentation on the Do 1 Thing project from Dr. Stacey Trooskin.  Dr. Trooskin talked about racial and geographic disparities in both HIV and Hepatitis C (HCV), and how this program was designed to address these disparities.  Do 1 Thing is a comprehensive campaign that includes testing, linkage to care, and treatment for both HIV and HCV.  There is a heavy community outreach component, and a clinical side as well.  View the whole presentation to learn more.  The RWPC also welcomed seven new members.

Meanwhile, the Comprehensive Planning and Finance Committees held their first joint meeting to prepare for this year's allocations meetings.  Each year, the RWPC plans how it will allocate (or spend) its money for the next fiscal year, even though they don't know how much money the Philly area will have.  This way, they'll have a plan in place so they can move quickly once they actually receive an amount.  They always break this planning out into separate meetings around the region, so that the Southeastern PA Counties, the South Jersey counties, and Philadelphia each have their own plans.  (Become an allocations pro here.)  This year will be a little different, since the Affordable Care Act kicks into full gear in January.  The Comprehensive Planning and Finance Committees are trying to decide how to best tackle these issues, since there are still a lot of answers we don't have.  They agreed on what data they want to look at first, and that they should include the treatment cascade in their decision-making.

The Needs Assessment Committee has also been talking about the importance of the cascade, and linkage to HIV care in particular.  They want to find out more about the process that different HIV testers use to get new positives into medical care.  This month, they talked about that process in two different systems.  They also began to work out the questions that they still had, in order to decide what type of needs assessment would be most appropriate.



Project PrEPare

The Positive Committee talked about something a little different - pre-exposure prophylaxis, or PrEP.  PrEP involves HIV-negative people taking antiretroviral medications in order to prevent HIV infection.  Dr. Sarah Wood and Kimberley Desir came to the committee to talk about the Children's Hospital of Philadelphia's PrEP trial, called "Project PrEPare."  They're recruiting young men and transwomen who have sex with men, between the ages of 18 - 22, for this study.  Learn more about Project PrEPare in their presentation.
 

Prevention Planning Group (PPG)

In April, the Prevention Planning Group moved forward in its plans for change for the summer.  The current membership will end on June 30, so the PPG is using this time to draft new bylaws, membership applications, and other documents.  At their April meeting, they agreed upon a name for the new group (the Philadelphia HIV Prevention Planning Group, or HPG), and reached consensus to adopt their new bylaws.  They also approved a membership application, and will be recruiting new members soon.  Keep an eye out!



This is an exciting 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. If you have questions, you can also call us at 215-574-6760.

The Big Picture - March 2013

This post is part of a monthly series (that's usually) published on the fourth Thursday of every month. It provides 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)

Last month, the Planning Council (RWPC) did some contingency planning for what we'll do once we receive our full award from the federal government.  (Read what happened last month here.)  We don't know how much funding we have for the fiscal year that started on March 1, but we received some new information midway through the month.  We got this information after the RWPC already met, so the Finance Committee and RWPC held emergency meetings. 

In February, we already knew that we should expect a 5.1% cut to Ryan White funds due to the sequester, so the RWPC planned accordingly.  However, in March, HRSA told our area that we should expect an additional 5.2% cut, because our area's portion of HIV/AIDS cases had risen slower than cases in other areas.  All in all, the grantee (otherwise known as AACO, or the AIDS Activities Coordinating Office) suggested that the RWPC plan for an 11% cut.  This would be about a $2.1 million cut to funding for services.  The grantee also developed a suggestion that they believed would minimize the impact of the cuts on consumers.  This suggestion was reviewed at length by the Finance Committee and the larger RWPC, and ultimately approved by both.  The final plan ends funding for early intervention services and care outreach after the first quarter, and spreads the remaining cuts proportionally across the other services.

Earlier in the month, the RWPC received a treatment update from Dr. Chris Vinnard.  They also learned about Early Identification of Individuals with HIV/AIDS from consultant Matthew McClain.  The Comprehensive Planning Committee continued and honed its conversation on Ryan White service categories and their relationship to the continuum of care.  They also talked about reimbursement for Ryan White services and the need for a peer navigator program.  Meanwhile, the Needs Assessment Committee discussed how and where people enter into HIV care. The Positive Committee listened to a podcast on the Origin of HIV and received a policy update.  The Finance Committee (in their first meeting of the month) also got a policy update, before discussing the care continuum chart developed by the Comprehensive Planning Committee last month.  Last but not least, the Nominations Committee met to review applications for RWPC membership.  Seven out of eleven applications were approved, and the new members will take their seats on the Planning Council in April.
 

Prevention Planning Group (PPG)

The PPG met this month to receive a special presentation from AACO epidemiologist Dr. Kathleen Brady.  She gave an overview of the latest data on the HIV/AIDS epidemic in the Philadelphia area in order to help the PPG complete its work.  The PPG also continued its process of reinventing itself.  This month, consultant Matthew McClain presented an updated version of the group's draft bylaws based on the recommendations from the last meeting.  He also developed a draft version of a new membership application.  PPG members were asked to review the draft documents so they could provide suggestions and changes at the next meeting.

The Points of Integration Workgroup, a joint venture of the PPG and RWPC, met at the beginning of the month to develop their work plan for the rest of the year.  They continue to examine the process of linking newly diagnosed HIV cases into the care system.


This is an exciting 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.  If you have questions, you can also call us at 215-574-6760.

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.