Health Reform and You Part 1

Before we get into the specifics about how health reform and the Affordable Care Act (ACA) affect the lives and health insurance status of people living with HIV/AIDS, we should make sure everyone understands the basics of the law. If you already have the basics of Medicaid expansion, insurance reforms, state health insurance exchanges/marketplaces, federal subsidies for premiums and cost-sharing, and the individual mandate under control, then you can skip this post and wait for Part 2. Part 2 will focus on how the ACA impacts people living with HIV/AIDS. Part 3 will focus on how people receiving Ryan White services might be impacted by the ACA.

But wait! Take this quiz before you do anything. That way you can see what you actually know and what you might want to learn more about.

Leave your comments and questions in the Comments of this post, and I'll do my best to answer them and follow up.

The Basics

Kaiser Family Foundation is a great source for reliable, people-friendly information on health reform and the Affordable Care Act (ACA). I recommend checking them out from time to time or signing up for email updates. Here are some of the useful resources you can find there.

Health Reform Hits Main Street

An oldies but goodie - this animation was created in 2010, right after the health reform law (ACA) was passed by Congress and signed into law by President Obama. It goes over the big changes in the law. It's kind of cute and offers some good information, well worth 10 minutes of your time.

Interactive Health Reform Timeline

You can see what parts of the law have already taken affect and what will come in the months and years ahead. You can select what is featured in your timeline by topic or year.

FAQ - Frequently Asked Questions on Health Reform

Questions and facts about insurance, Medicaid, eligibility, federal subsidies for health insurance and more.

ACA 101 Briefing

On April 26, 2013 Kaiser Family Foundation hosted a briefing outlining the basics of the ACA, to help all of us understand it better and now what it will mean for our lives and our communities.

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Visualizing Health Insurance Coverage Under the ACA

This flowchart is probably the simplest explanation for how coverage and support for health insurance will change in 2014. Just answer the questions in the boxes with a 'yes' or 'no' and you will k now what your options are for health coverage next year.

Stay Tuned for Part 2

Next time we'll talk about how health reform affects people living with HIV/AIDS. Don't forget to leave your comments, questions and concerns about health reform in the comments here. That way I can answer your questions in future blog posts and see what other resources might be available for you and others that address your concerns. 

Policy Update for Providers

There has been so much going on in health policy over the last several weeks, especially concerning how Ryan White service providers are going to be doing business in the era of health reform. I pulled together several (but certainly not all) of the  developments and resources in order to help providers know where to start in preparing to meet the challenges that are sure to come, as well as to take advantage of all the opportunities for growth and sustainability. Last time, I wrote about what community planners need to know. Next up, I'll focus on what all of these changes mean to individuals.

But First

Before you do anything go here and sign up to receive bulletins from HRSA about Ryan White and Affordable Care Act (ACA) news. This is also the place to read all the latest developments and get copies of documents related to Ryan White and ACA.

Also HRSA will host a webcast on Tuesday, May 7th at 1pm EST on the Potential Impacts of the Affordable Care Act on Safety Net Providers in 2014

Eligibility for Ryan White services

In the era of health reform and the ACA, there are so many questions about the role of Ryan White funds and what impact health reform will have on consumers' eligibility for Ryan White services. HRSA released a policy clarification last month that lays out expectations and requirements for client re-certification and eligibility for Ryan White services:

Clarifications on Ryan White Program Client Eligibility Determinations and Recertifications Requirements

Re-certification is still required and important to determine eligibility of individuals. Providers and grantees are responsible to make sure that only eligible individuals receive Ryan White services, meaning all Ryan White clients must be HIV-positive and have low income, in order to be re-certified every six months. The policy statement includes the types of documentation needed and where individual declaration or self-reported status will be accepted for re-certification purposes.

HRSA also held a webinar on April 5th called Eligibility 101: The Affordable Care Act and Ryan White Program - New Opportunities for People Living with HIV/AIDS. You can watch the webinar at the link and download slides.

Essential Community Providers

Starting in 2014, the Affordable Care Act (ACA) will result in over 20 million people enrolling in private insurance coverage through health insurance marketplaces (or exchanges). These private plans, called “Qualified Health Plans” (QHP) must meet standards for inclusion of “Essential Community Providers” (ECPs) in their provider networks. ECPs serve predominantly low-income, medically underserved populations and include, but are not limited to, safety net providers who are eligible to participate in the 340B drug purchase program in these six categories: Federally Qualified Health Centers (FQHCs), Ryan White providers, family planning providers, Indian providers, specified hospitals*, and others. But inclusion in Qualified Health Plans’ provider networks is not automatic. Safety net providers must identify insurers offering plans on their state’s ACA marketplace and negotiate to be included. Keep in mind that ACA implementation is just beginning, and relationships that begin now can be built on in future years--  Essential Community Providers:Tips to Connect with Marketplace Plans from National Academy for State Health Policy

Official deadline for health plans on the federal-facilitated exchanges is Friday, May 3rd, but plans can add providers after that as well.  You can check out the list of Essential Community Providers and determine if your organization is included. Follow the steps in the fact sheet quoted above to work with marketplace plans.

Enrollment Assistance

Ryan White providers are expected to make every effort to assist clients in enrolling in appropriate health insurance, whether Medicaid, a health plan through the state marketplace, or through other public or private programs. 

A joint letter from Center for Medicaid and Medicare Services (CMS) and the Health Services and Resources Administration (HRSA) was released on May 1,2013 clarifying the importance of coordination between Medicaid and Ryan White programs.

HRSA also has a chart detailing how Ryan White providers and grantees can provide benefit enrollment and counseling to clients through  Outreach Services, Early Intervention Services, Medical Case Management, Non-medical Case Management, Health Education and Risk Reduction, and Referral for Health Care or Supportive Services under Parts A, B, and the Minority AIDS Initiative. 

On April 18th, there was an informative panel discussion with national experts on enrollment assistance, thanks to the Kaiser Family Foundation for the video.

You can also use a subsidy calculator to figure out what (if any) amount of federal subsidy you (or a client) might be eligible for in order to make purchasing health insurance on the exchange affordable for you.  

As you probably remember, most individuals will be required to purchase health insurance provided they meet these requirements:

Exchange Applications

Enrollment for the state insurance marketplaces (sometimes called exchanges) will be open on October 1, 2013 and coverage will begin on January 1, 2014 for those plans. The federal government just released the applications that individuals and families will use to apply for coverage on those exchanges. They have been simplified to 3 pages for individuals not offered affordable coverage by employers and 12 pages for families and individuals with employer coverage.  

The individual and small group insurance marketplaces for New Jersey and Pennsylvania will be federally-run, because New Jersey and Pennsylvania did not choose to run their own marketplaces. You can read more about the development of these exchanges at the links for each state.

Huh?!

So are you still unsure about who is going to be eligible for what come 2014? Well, here's a handy flowchart to get you on your way to understanding. Thanks to the folks at the Journal of the American Medical Association and Kaiser Family Foundation for the charts above and below. 

More general information about eligibility and enrollment can be found at Enroll America.

New Jersey and Pennsylvania also have websites to help consumers nad providers navigate insurance options:
New Jersey Department of Banking and Insurance
PA Health Options

Policy Update for Community Planners

There has been a lot of activity in the HIV policy world over the last several weeks. There has been so much going on that I decided to break up all the news and highlights into three blog posts. This post is for community planners, the other two will be for providers and individuals. I hope that you find one or more helpful and continue to educate yourself about health reform and the future of the Ryan White program. 

Ryan White Reauthorization

Ryan White Program Reauthorization Webinar from HIVHealthReform.org on Vimeo.

HIVhealthreform.org had a well-attended and informative webinar a few weeks ago on the reauthorization of the Ryan White Act (see above). You can read up a little bit on the issues on my past blog post. You can check out the slides from the webinar here. 

In short, the Ryan White Act will not be reauthorized this year, at least not in time for the "expiration" in the fall. No worries, the Ryan White program can and will still be funded and carry on. Budgets for 2014 from President Obama and Congress include funding for Ryan White.

Interesting fact: The law creating HOPWA (Housing Opportunities for People With AIDS) has never been reauthorized and the program carries on. 

New Kaiser Reports

Updating the Ryan White HIV/AIDS Program for a New Era: Key Issues and Questions for the Future - Kaiser Family Foundation

image courtesy of AIDSmap.org

This policy brief was released in April 2013 and highlights key issues and questions facing the Ryan White program, in light of recent scientific and policy developments.  The brief is divided into four main themes:

1. Supporting people with HIV at each stage of the Treatment Cascade, from diagnosis to viral suppression.
2. Building HIV care networks in underserved communities.
3. Integrating HIV care expertise into the mainstream health care system.
4. Effectively and fairly allocating Ryan White resources. 

Key issues from the brief for community planners: supporting the maximum number of people along the treatment cascade, integrating HIV care and prevention planning, updating the requirement that at least 75% of Part A funds go to "core services", payer of last resort concerns in the era of health reform, reconsideration of funding formulas to direct resources to communities of greatest need, and greater collaboration between HIV medical care and supportive services. 

Medicaid: A Primer - Kaiser Commission on Medicaid and the Uninsured

Kaiser also issued a comprehensive primer on Medicaid back in March. I recommend taking the time to read it, even if you think you know about Medicaid.  Topics include: Who is covered, what is covered, Medicaid's impact on access to care, costs of Medicaid, and who pays for Medicaid. 

Considering over half of the EMA's Ryan White clients are Medicaid-covered, an understanding of Medicaid's role in our health system is essential to good community planning, especially in the time of even more limited funding and health reform.

Kaiser has a great slide show about the role of Medicaid.

Payer of Last Resort

HRSA has released a few documents and resources concerning "payer of last resort" issues. It is important that Planning Council members have a clear understanding of what payer of last resort really means.

 ....“payer of last resort,” meaning that the Ryan White funds may not be used for any item or service for which payment has been made, or “can reasonably be expected to be made,” by any other payer. -- Joint CMS/HRSA informational bulletin (May 1, 2013)

There was another recent clarification released by HRSA concerning payer of last resort and eligibility of PLWHA for Ryan White services:


Clarifications Regarding Medicaid-Eligible Clients and Coverage of Services by Ryan 
White HIV/AIDS Program

....once an individual is enrolled in Medicaid, RWHAP funds may be used to pay for any medically necessary services which Medicaid does not cover or where Medicaid coverage is limited in scope, as well as premiums, co-pays and deductibles if required. RWHAP funds will continue to cover other core medical services such as adult dental, vision, or enhanced adherence and prevention counseling services as a part of primary care if those services are not covered or are limited under Medicaid, even when those services are provided at the same visit as Medicaid-covered services.  Policy Clarification Notice (PCN) #13-01

These statements are clear. Ryan White program funds CANNOT be used when ANY other payer (private insurance, Medicaid, Medicare, etc.) could cover the service for a RW-eligible client. This does not mean that Ryan White funds can "fill in gaps" in reimbursement for particular services; i.e. bridging the difference between the cost of providing the service and the third-party reimbursement. Ryan White funds can cover services that CANNOT be billed to another third-party, even if these services happen within the same visit or interaction as the Medicaid (or otherwise) reimbursed visit. 

Payer of last resort is such an important issue, because the Affordable Care Act (health reform) will enable more people living with HIV/AIDS to gain access to health insurance and more Ryan White services will be eligible for other third-party reimbursement. The Planning Council is responsible for developing priorities for the allocation of Ryan White funds, and must do so in a manner that takes into account ALL available resources within our EMA's HIV care system. At this point in time, we do not understand the full impact of health reform on the Ryan White system or the clients. The issue of payer of last resort will continue to be important throughout the planning and allocations process for 2014.

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 Science: An HIV Cure

This post is part of a monthly series published on the third Thursday of every month.  In this series, our staff tackle the latest topics and studies related to HIV.   



HIV-infected T cell (image from NIAID_Flickr)

Earlier this month, I attended a webinar on the state of HIV cure research.  Dr. Steven Deeks did a great job presenting in this AIDS Vaccine Advocacy Coalition (AVAC) webinar.  (If you'd like to download his slides or listen to the audio, you can do that here.)  Here's a brief overview of the latest in HIV cure research.

Why do we want a cure?
Antiretroviral therapy (ART) doesn't restore health.  There are lots of side effects to ART.  There are also medication access issues, and adherence can be difficult. 

Why doesn't ART cure HIV?
HIV is great at hiding in the body.  Even when ART is attacking HIV, there are so-called "viral reservoirs" lying in wait.  When treatment is stopped, the hidden HIV springs into action.  It's almost like a game of cat and mouse.  The trick is finding a way to get rid of the hidden virus.

Functional Cure vs. Sterilizing Cure
When we talk about an "HIV cure," it can be one of two kinds:  a functional cure, or a sterilizing cure.  A functional cure can be defined as "long-term health in absence of therapy."  There might be some virus left in the body, but it's not causing any damage.  On the other hand, a sterilizing cure refers to the total eradication of any virus capable of replicating.  This refers to complete annhiliation of any HIV in the body.

Timothy Ray Brown in POZ

The Berlin Patient
Timothy Ray Brown, otherwise known as the "Berlin patient," is the first case of a person cured of HIV.  Doctors are currently trying to prove that he experienced a sterilizing cure after chemotherapy and a dangerous experimental blood stem cell transplant.  The stem cell donor had a CCR5 mutation, which meant that the donor's cells did not have a special receptor that HIV-1 needs in order to take hold.  Brown has been off ART for about five years, and there is no evidence of the virus rebounding.  In fact, his antibody levels have been declining.  Read more about his story here, or get the original study published in the New England Journal of Medicine here.


Baby Cured of HIV in Mississippi
Last month, a new possible cure was announced.  In this case, an HIV-positive mother who was not in care gave birth to a baby girl.  A pediatrician realized that there would be a high risk of transmission, so they started ART in the baby about 30 hours after delivery.  Two blood tests in the baby showed HIV RNA and DNA, so doctors are generally confident that the baby was actually HIV-positive.  The child is now 2 1/2 years old and has been off ART for a year.  Her immune system is healthy and tests are not easily detecting HIV RNA and DNA.  There is debate about what happened - some believe that the virus was only in the mother's cells, others think that only short-lived T cells were infected, and others think that there was something about the baby's immune system that helped eliminate the virus.  There's no published study, but you can read an article about the case here.

14 Adults Able to Control HIV Infection in France
Right on the heels of the news of the toddler in Mississippi, French researchers announced that another 14 adults may have been functionally cured of HIV.  These individuals were all treated shortly after infection, and were on ART for some time.  They then stopped ART, but are able to control the virus without medication.  There do not seem to be any characteristics in these adults that could contribute to their ability to control the HIV, aside from their early treatment.  Read a New York Times article about the study here, or view the full text of the study from PLOS Pathogens here.

2 More Possibly Cured in Boston
Two more adults may be functionally cured of HIV following bone marrow transplants, much like Timothy Ray Brown was.  However, in this case, the donor cells did not have the same CCR5 mutation - so, they were not naturally resistant to HIV-1 like Brown's donor cells.  These patients are still on ART, but doctors are unable to find evidence of HIV in their bodies, and their antibody levels are dropping.  They're not off ART yet, but their cases look promising.  Read an article on the Boston patients here. 

Further reading:
Towards an HIV Cure: People Focused, Science Driven
These are the full recommendations from the International AIDS Society Scientific Working Group on HIV Care, presented in July 2012.

For the Win: Find a Cure Faster
Read the AIDS Policy Project's recommendations for improving the overall research system to encourage scientific advancements in finding a cure.


Is there another topic you'd like to see discussed here?  Please send any suggestions to info@hivphilly.org, or leave a comment below.

Towards more cost-effective HIV prevention planning

Some background: The Philadelphia Prevention Planning Group (PPG) and the City of Philadelphia's AIDS Activity Coordinating Office (AACO) work together to decide which communities have the greatest need for HIV prevention activities, and which interventions work best for those communities.  This is part of what we call "community planning."  AACO decides how the money gets spent and which organizations do the work, keeping in mind the community's needs and what is proven to work best. The PPG provides the community's voice to the process.

In 2011, the Centers for Disease Control and Prevention (CDC) approached the Philadelphia Department of Public Health (PDPH) to participate in the design and testing of a model for how to best spend HIV prevention funds to prevent the spread of HIV. The model was supposed to help health departments make cost-effective decisions to meet the goals of the National HIV/AIDS Strategy.  You can read more about the data used in the model and how the model influenced HIV prevention planning in the 2012 Philadelphia Jurisdictional Plan  (pages 93-95). 

AIDS.Gov recently released a podcast explaining this resource allocation model.  It also talks about the pilot project in Chicago, Nebraska, and Alabama, which is supposed to determine if the model works for those communities and to see if their experiences are similar to Philadelphia's.

The AIDS.Gov blog post explains more about the pilot project, HIV RAMP:

"That model was developed to help Philadelphia’s health department leadership identify the optimal allocation of HIV prevention funds across populations and prevention interventions that would prevent the most new HIV infections. Using local demographic and HIV epidemiological data inputs, and based on calculations of the cost per new infection averted, the model recommended the optimal allocation of the jurisdiction’s HIV prevention budget among several evidence-based interventions for the populations most impacted. Feedback from Philadelphia indicated that the model’s outputs served as a very useful “roadmap” to inform decision making for HIV prevention resource allocation within the jurisdiction, informing both applications for federal funds as well as efforts to strengthen local HIV prevention activities.

The current project, HIV RAMP, involves refining and piloting the original Philadelphia model in three additional jurisdictions that have different local profiles and HIV prevalence rates (Chicago, Nebraska, and Alabama), testing a technical assistance (TA) protocol to support jurisdictions in using the model, and assessing the feasibility of a software or online version of the model that could be more broadly used by other health departments.

“Because making decisions about how to spend HIV prevention funding is never ‘black and white,’ health departments need tools to help them decide how to support the best combinations of effective, evidence-based prevention strategies in their communities,” said Dr. Ronald Valdiserri, Deputy Assistant Secretary for Health and Director of OHAIDP. “Through this pilot project, we hope to develop a practical tool that can help communities apply the principles of the NHAS on the ground.”

Here are some highlights from the Philadelphia jurisdictional plan's discussion of the model development, focusing on the results:

"Cost per new infection averted is an integral part of this resource allocation model. For HIV testing in a clinical setting, the cost per infection averted is $51,293, making it the second most cost-effective intervention for Philadelphia. Testing in non clinical settings for IDU (3) and MSM (1) rounded out the top three most cost-effective interventions for averting HIV transmission at $53,935 and $17,965, respectively. The least cost-effective interventions used in the model were behavioral interventions for HIV- high risk heterosexuals ($15,642,127) and IDU ($2,931,406). Behavioral interventions were not found to be as cost-effective as HIV testing, even for HIV+ individuals. Adherence to ART (4), retention in care (5), partner services, and linkage to care (8) were ranked in the middle of the list of interventions. 

The optimal resource allocations according to those calculations would avert 72 infections in the first year and 245 infections within five years. Testing in clinical settings would receive 39% of the resources and avert 20 infections in one year, 93 infections in five years. Retention in care would receive 29% of the resources and avert 27 infections in year one and 52 infections within five years....Two-thirds of the resources would be allocated to HIV testing in this optimal model, because of the cost-effectiveness of HIV testing (non-targeted), particularly for MSM and IDU communities.  These allocations would serve 1,930 HIV+ individuals and result in 792 new diagnoses. Return on investment ranges (prevention dollars only) from 1.21 in year one to 4.42 in year five....

Recommendations from the model include allocations decisions should be made by both cost and effectiveness. Testing should be prioritized in clinical and non-clinical settings. More resources should be allocated to interventions located in care-settings. Behavioral interventions for HIV- individuals are not allocated resources. Behavioral interventions for MSM can be allocated resources under certain conditions. "

If you want to learn more about the community planning of HIV prevention in Philadelphia, check out the Prevention Planning Group or come to a meeting.

The Team: Michael Dorsey

This post is part of a monthly series published on the second Thursday of every month. It 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 Michael Dorsey.  Michael is a Planning Council member and current co-chair of the Positive Committee.  I asked him the following questions.



Michael in the classroom

What made you decide to get involved with the Ryan White Planning Council?
I got involved with the Ryan White Planning Council because I like to give back to my community and I wanted to be a positive voice to improve care for people living with HIV/AIDS.

What is your favorite part of being a RWPC member?
My favorite part of being a RWPC member is serving on the Positive Committee. It helps me educate PLWHA to take care of themselves, stay linked into care, encourage them to take advantage of support groups, access Ryan White Care Act services, and to always be informed about the HIV/AIDS agenda. I also like the idea that the RWPC performs a great deal of work throughout the year to assess needs, evaluate financial and program activities, and participate in planning that is coordinated with other local and state entities.

What is the biggest challenge you’ve had as an RWPC member?
One of the biggest challenges I have been faced with is getting members to serve on various committees, be a voice and participate, and pass information on to educate their communities. If there is ever going to be an AIDS-free generation, those affected/infected must advocate for the cause.

What do you wish more people knew about community planning?
I wish more people knew that community planning supports and enhances the role of PLWHA. They help one to make effective decisions in their community, and that it is made up of people who represent different communities, cultures and experiences.

How has your background as an educator helped you as a member?
My background as an educator has helped me to be a motivated spokesperson to mentor and coach those individuals who need help in any given area. We all come from different background with different skills. With that being said, we all have something to give back. We must continue to “ACT UP, FIGHT BACK, and FIGHT HIV/AIDS!”

What is your favorite thing about the Philly area?
My favorite thing about the Philly area is that we have so much history, geography, cityscape, culture, economy, demographics, law & government, education, as well as the transportation system. Also the diversity and love here. I appreciate that the Philadelphia is the largest city in the commonwealth of Pennsylvania, and the second largest city on the East Coast of the United States. It also played an instrumental role as a meeting place for the Founding Fathers of United states, who signed the Declaration of Independence in 1776.

Anything you like to do while in the neighborhood for meetings?
I would like to just pass on information that is learned through attending professional development workshop or what is learned in support groups in Philadelphia.

Anything else you’d like to add?
One thing that I would like to add would be commending the staff at Office of HIV Planning for the work that they do. The staff has a great vision, passion, outstanding decision makers, builders for the community at large, and have good character. Kudos for being quick, committed, analytical and thoughtful.

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.