Quarterly Reports

1. Quarterly Reports Brazos Valley Council of Governments August 2011

2. Staffing • When filling out the Staffing section, please remember to only include information for staff that are funded through Ryan White Part B or State Services. • If a position was vacated and filled within the same quarter, you should still report it on the first chart. • Only list a position on the second chart if it was still vacant at the end of the quarter.

3. Funding • Please do not include funding from BVCOG when answering the Funding questions; this is a space to include fundraising conducted by your agency, recent grant awards, donations, etc. • If there clients are requesting services that your agency can not provide due to funding constraints or other barriers, please be as specific as possible in your response. • Why are you unable to provide the service? • How many clients are requesting assistance? • If you are not operating a wait list, but have a long wait period before accessing the service, please report that here with as much information about the situation as possible. • Would additional funding alleviate the wait time? • Should you start a wait list?

4. Quality Management • Quality improvement is a continuous process; your agency should always have things to report in this section. • Your QM Committee should be meeting a minimum of quarterly, in addition to other activities undertaken by your staff. • If your agency is not focusing on improving any specific HAB measures, or is not required to collect that data, provide documentation of QM activities you have undertaken in your response to question one. • Please let us know why you have chosen to focus on a specific measure. This part is often overlooked. • At no point should either of these questions go unanswered.

5. Quality ManagementQuestions 2c and 2d Sample Response What we’re looking for • The data are entered in to ARIES, then reviewed by a supervisor. • The data manager works closely with Clinic Nurse to ensure medical information is entered appropriately into ARIES by both nurse and support staff (i.e., TB test results, vaccines, lab results). The data manager now reviews ARIES lab entries monthly to ensure that all labs ordered and billed are entered.

6. Program Coordination Describe activities that occurred during the quarter designed to bring individuals who are out of care into care. Include results or challenges experienced. Sample Responses What we’re looking for • None • Began outreach to all physicians in local clinic settings. • Staff participated in Homeless Count Day. This included small groups going out to designated areas and assessing people that consider themselves homeless. As part of the count, representatives from various agencies provided information about their programs, so the homeless can access the services they. Staff assessed engaged those individuals that were willing to talk and distributed brochures about our HIV program. 

7. Program Coordination Describe activities that occurred during the quarter to evaluate the effectiveness of the current service system and/or activities designed to improve the current service system. These activities may include removing barriers, increasing service capacity, increasing efficiency of service delivery, or addressing issues related to service access, including creation of new access points or entry systems. Sample Responses What we’re looking for • None • Staff met with the local health department to discuss the effectiveness of immunizations. It was determined that clients need additional time to complete the immunizations. Now, if a client has 30 days to use a voucher for the immunization. If it expires, the client can ask their case manager and get another voucher. This activity helped increase the efficiency of service delivery.   • We were approached to provide educational materials and input for staff training at the local probation department. Though not asked to participate in the training directly, we were able to provide a range of appropriate education materials and agency brochures. Because of the number of individuals seen and the nature of clients served there, it is important for us to build a relationship with the agency for referrals of HIV positives identified within the probation system. • The clinic doctor informed staff that 3 patients could benefit from mental health services. Staff contacted the current counselor about the need for additional clients to be seen, and was informed that her schedule was full, but other counseling staff would be asked to help. Case management staff was able to coordinate an additional counselor for mental health services . As of the end of the quarter, two mental health providers are available to meet clients’ needs.  

8. Program Coordination Describe needs assessment activities that occurred during the quarter. Activities may include the examination of the current care system, assessment of client need for HIV core medical or supportive services, and assessments related to addressing unmet need populations. Sample Responses What we’re looking for • No needs assessment activities occurred during the quarter • Staff conducted a phone survey and spoke with clients who came in to the office to see if they would be interested in receiving their medications from a mail order pharmacy. Several clients expressed an interest in this service, and indicated this service would allow them to receive their medicine in a more timely manner. An MOU was created with the pharmacy.

9. Program Coordination Other than those listed above, describe any new collaborative relationships developed to enhance continuity of HIV medical or support services. Common Responses What we’re looking for • None • Relationship established with a specialist in oral and maxillofacial surgery as a result of a client’s need to be evaluated for possible oral surgery, identified during routine dental treatment. Client was referred to the specialist by their routine dental provider, and our agency established an MOU with him in order to be able to assist client with insurance co-payments, deductibles, etc… This relationship will allow our other clients to benefit as well.

10. Year-End Questions Describe activities conducted during the year aimed at improving the HIV program. How has your agency or services changed because of quality improvement activities? Common Responses What we’re looking for • None • Full implementation of the acuity levels system this year has made it possible for Case Managers who are responsible for large client case loads to better focus their efforts on the clients with the greatest need, while not neglecting others with only a need for occasional support. The system also makes it possible to identify those clients with changing needs and provides the flexibility to change acuity levels whenever warranted. • Our closer involvement with the local hospital, who provides all client medical care should significantly help our agency achieve one of the new national HIV program goals: keeping clients in medical care.

11. Year-End Questions Describe your QM Committee’s recommendations for changes and continued improvements to next year’s QM program. Common Responses What we’re looking for • None • More diversity in representation on the QM Committee should help us become more proactive in our client’s medical care. We want to become increasingly involved in the medical appointment scheduling process, influence the type of medical protocols used with our clients, and help track HIV/AIDS clients moving in and out of the medical system. As a total HIV Prevention and Services program, our long-term goals will be to help individuals learn of their HIV status, get them into services, and help them continue in medical care.