Ryan White Part C Early Intervention Services

1. Ryan White Part C Early Intervention Services Greater Baltimore HIV Health Services Planning Council Meeting May 18, 2010 Presented by Franny Lerner, RW Part C Project Director

2. Ryan White Part C:Early Intervention Services (EIS) • Funder: Health Resources Services Administration (HRSA), HIV/AIDS Bureau (HAB) • Purpose: Provides comprehensive primary health care in an outpatient setting for people living with HIV disease. http://hab.hrsa.gov/treatmentmodernization

3. Eligible Organizations • Federally qualified health centers • Family planning agencies • Comprehensive Hemophilia Diagnostic and Treatment Centers; • Rural Health Clinics; • Health facilities operated by or under contract with the Indian Health Service; • Community-based organizations, clinics, hospitals, and other health facilities that provide early intervention services to those persons infected with HIV/AIDS through intravenous drug use; and • Nonprofit private entities that currently provide comprehensive primary care services to populations at risk of HIV/AIDS, including faith-based and community-based organizations.

4. Early Intervention Services Costs • Primary care • Laboratory, x-ray, and other diagnostic tests • Medical and dental equipment and supplies • Medical case management • Electronic medical records • Patient education in conjunction with medical care • Transportation for clinical care providers to provide care • Periodic medical evaluations • Other clinical and diagnostic services regarding HIV/AIDS

5. Core Medical Services Costs • AIDS Drug Assistance Program • Health insurance premium and cost-sharing assistance for low-income individuals • Home health care • Hospice services • Home and community-based health services as defined under Part B.

6. Clinical Quality Management Costs • Continuous Quality Improvement (CQI) activities; • Clinical quality management coordination; • Data collection for clinical quality management purposes; • Consumer involvement to improve services; and Staff training & technical assistance (including travel & registration) to improve services, including the annual clinical update and biennial Ryan White HIV/AIDS Program All-Grantee Meeting & local travel to meetings not directly related to patient care.

7. Patient transportation to medical appointments; Staff travel to provide support services; Outreach to identify people with or at risk for HIV Translation services, Patient education materials Participation in the Statewide Coordinated Statement of Need process; Patient advocates to maintain access to care; and Respite care (with Justification) Support Services Costs

8. Indirect costs, Rent, utilities, and other facility support costs Telecommunications Postage Liability insurance Office supplies Audits Payroll and accounting services Computer hardware and software Program evaluation and data collection related to evaluation Administrative Costs

9. Chase Brexton Health Services’RW Part C EIS Program Project Period Jan. 1 – Dec. 31, 2010 Total Funding amount for 2010: $1,169,001.00 Portion Subcontracted to Johns Hopkins: $345,119.00

10. Primary HIV Care Dental HIV CTR Specialty Care referrals Dermatology Podiatry GI Vision Case Management Nutrition Pharmacy/MST Mental Health Addictions Labs Radiology CQI/PAC Primary Care Services

11. 2010 CBHS Funding Levels by Category: EIS/Core Services = $666,136. CQM = $47,301. Support Services = $12,375.

12. Early Intervention Primary Care/ Core Services Primary HIV Medical Care: $331,421.

13. Early Intervention Primary Care HIV Counseling, Testing & Referral: $0.

14. Early Intervention Primary Care/ Core Services Pharmacy/Medication Support: $48,689.

15. Early Intervention Primary Care/ Core Services Nutrition: $16,302.

16. Primary Care Services Oral Health: $0.

17. Early Intervention Primary Care/ Core Services Mental Health: $50,302.

18. Early Intervention Primary Care/ Core Services Addictions: $15,000.

19. Early Intervention Primary Care/ Core Services Case Management: $25,443.

20. Early Intervention Primary Care/ Core Services Laboratory Testing: $41,750.

21. Early Intervention Primary Care/ Core Services Radiology: $7,000.

22. Early Intervention Primary Care/ Core Services Specialty Consultation referrals: $10,000.

23. Clinical Quality Management Clinical Outcomes Improvement & Staff Education: $47,301.

24. Support Services Translation: $12,375.

25. Sub-populations Targeted: • IVDU & their partners • African Americans • MSMs • LGBT

26. Relationships with RW Part A providers supplement Part C services provided at CBHS through: • Referrals for Housing • Referrals for MADAP

27. Effective Strategies for engaging PWLWHA into care: • Increased HIV testing to all medical patients (CDC Recommendations)

28. Effective Strategies for engaging PWLWHA into care: • Walk-in STD clinic for the community

29. Effective Strategies for engaging PWLWHA into care: • Triage Case Managers available to newly diagnosed patients to assist with accessing entry into care

30. Effective Strategies for engaging PWLWHA into care: • Medication Support Team • 1:1 assessment of treatment readiness • HIV 101 – group visit for patients beginning treatment • Club Med – biweekly & monthly groups (adherence & pill box assistance)

31. Effective Strategies for engaging PWLWHA into care: • Multi-tiered Case Management assesses level of services needed • Homeless needs • Prison outreach & release planning • Off-street new patients • Returning patients

32. CBHS Locations • Baltimore City: Mt. Vernon • Baltimore County: Randallstown • Howard County: Oakland Mills/Columbia • Talbot County: Easton (no Part C funds) www.ChaseBrexton.org