Cr Cross oss-Pa Part t Collaboration n for r Integrated d Plan Plannin ing an g and D Develo elopmen ent o of In Integr egrated ed HIV P HIV Preven entio ion an and C Car are e Plan Plans s Emily Gantz McKay, EGM Consulting, LLC Brandi Bowen, New Orleans Regional AIDS Planning Council Jeremy Turner, HIV/STD Viral Hepatitis Division, Indiana State Department of Health Julie Hook, JSI Research & Training Institute, Inc., Integrated HIV/AIDS Planning Technical Assistance Center Aisha Moore, JSI Research & Training Institute, Inc., Planning CHATT
Ag Agenda • Introduction and Overview of Integrated/Comprehensive Planning and Integrated HIV Prevention and Care Plans • Lessons Learned for Cross Part Collaboration to Improve I ntegrated Planning • Monitoring and Evaluation of Integrated Plan • Voice of Community • Improving C ommunity C onnection to the Plan • Training and TA Resources Available 2
Del Delay y of f In Integr egrated ed Plan n Guidance ce for r 2022-2026 2026 • Guidance for preparation of u pcoming Integrated HIV Prevention and Care Plans for 2022-2026 has been postponed until later in year due to the COVID-19 emergency • Outlined in a June 17, 2020 letter from HRSA and CDC H IV program leaders • Also outlines expectations for continued use o f e xisting integrated plans and encouragement for refinement of o ngoing planning, incorporation of E nding the H IV Epidemic plans, and community engagement 3
In Intr troductio ction n an and d Ov Over ervie view w Legislative Requirements Integrated/Comprehensive P lanning Integrated HIV Prevention and Care Plans - 2017-2021 Emily Gantz McKay, EGM Consulting, LLC 4
Le Legislative R Requireme ments s • RWHAP Part A planning council required to “develop a comprehensive plan for the organization and delivery of health and support services” • Required to be “ compatible w ith any State o r local plan for the p rovision of services to individuals with HIV/AIDS” • RWHAP Part B must: • Provide “ a comprehensive p lan that describes the o rganization and delivery of H IV health care an d support services to be f unded” that is developed through “a public advisory planning process” • “Convene a meeting…for the p urpose o f d eveloping a statewide c oordinated statement of need” (SCSN) …Until 2 016, plan and SCSN were required every th ree years 5
Wh Why y Develop p Plans? ns? • Chance to step back from ongoing work and look at the system of care – see how well it responds to diverse and changing needs of people with HIV • Strategy or roadmap for developing or strengthening service systems • Opportunity for broad community engagement BUT… • A plan is of limited value unless it: • Has strong consumer and community buy-in • Is used, monitored, and updated 6
Wh Why y Integrated a d a nd C d C ross ss-Pa Part t Plan Plans? ? • Looking separately at prevention and care no longer makes sense – “Treatment is Prevention” • Joint planning allows for a broad look at services, not limited by funding streams • Integrated planning can reduce the burdens of multiple plans BUT… • Developing a cross-part plan requires considerable organization and coordination • Consumer and community input often harder to achieve at the state level • Statewide plans may not fully reflect local differences in populations and needs of those with HIV 7
2017 2017-2021 2021 In Integ egrated ed HIV HIV Preven entio tion n and and Car are e Plan lan Subm ubmis issio ions ns • Guidance issued June 2015 called for first Integrated HIV Prevention and Care Plan and SCSN, due September 30, 2016 for 5 years: 2017- 2021 • RWHAP Part A and B programs urged to develop a combined prevention and care plan for CDC and HRSA • Programs could choose to s ubmit a lone or with other programs in their state – many c hose cross-part submissions • 45% of all RWHAP Part A and Part B programs • 56% of R WHAP Part A programs • 77% of R WHAP Part B programs with Part A programs in their states 8
2017 2017-2021 2021 In Integ egrated ed HIV HIV Preven entio ion and and Car are e Plan lan Su Submissi ssions 1
Lo Lookin ing g Back Back/Lo /Lookin ing g Ahead ead What have we learned about cross-part planning from the 2017-2021 Integrated HIV Prevention and Care Plan experience that can help when we begin developing our next plan? 10
Fact ctors s That t Hel Help p Make e Cross- ss- Part t Planning g Su Success ccessful l • Clearly stated, shared expectations • Agreement on resources – how costs/resources will be shared • An agreed-upon, documented structure an d process to guide t he • Open m eetings and t ransparent work decision making – with use of a neutral facilitator where n eeded • A realistic plan to plan, with tasks, responsibilities, and timeline • Clear staff r oles • Processes that ensure a consumer • Timely access to needed expertise voice f rom both Parts in decision • Mutual trust built on met deadlines making and kept promises • Ongoing engagement of planning • An integrated plan that has councils/planning bodies – including “ownership” and can guide action at decision-making roles state and local levels • Shared and well d efined leadership and decision making 11
Si Situations s to o Av Avoid d in n Cross- Pa Part t Planning g • A late start to planning • Sense of an unfair burden on one person or entity • Loosely defined roles and responsibilities • Serious disagreements about goals, objectives, and/or priorities • No clear process for decision making • Attempts by one person or entity to control the process or make the • Lack of consumer and community decisions participation and buy-in • Loose or missed deadlines • Unclear or minimized role for a planning council, for whom this is a • Not enough time for everyone to legislative responsibility review and improve drafts • Limited access to needed data 12
Indian iana’ a’s I s Integr grated d HIV P Preventio tion n and C an Car are P Plan lan Jeremy Turner, Director, HIV/STD Viral Hepatitis Division Indiana State Department of Health
In Indiana’s s In Integr egrated ed HIV HIV Pr Prevention n and d Care e Plan n • A 5 year, 149-page plan drafted by planning bodies comprised of consumers and service providers from across the state • Includes planning for both HIV services and prevention • Incorporates Marion County RWHAP Part A TGA, ISDH RWHAP Part B, CDC and HUD funding • Includes: Goals, Objectives, Strategies, Activities • Precursor to a n elimination strategy 14
Plan D Plan D es esig ign n 15
Go Goals o als o f f th the Plan e Plan • Reduce new infections • Increase access to care and improve health outcomes • Reduce disparities and health issues among PLWH • Expand the coordination of s ervice delivery s ystems • Ensure continued financial support 16
Mon Monitori oring a and E Evaluation on • Original plan called for monitoring a nd evaluation to be completed by a b ody c omprised of C PG, CHSPAC, RWHAP Planning Council and staff from the county and state • Funders meet m onthly to d iscuss progress toward plan objectives • RWHAP Supplemental dollars assisted greatly in progress toward achieving goals outlined in the plan 17
Ch Challenges • Turnover-loss of institutional knowledge from retirees/job changes and transitions in executive leadership • Inability t o provide ongoing mon itoring a nd evaluation of the plan due to changes in advisory and planning bodies • Utility of the plan: t he size of the document i s cumbersome and more effort should have been made to create a “road show” • Rural vs Urban nature of Hoosier communities 18
Ho How w Ser ervic vices E es E xpanded panded • Better c oordination of funding after t he creation of a comprehensive list of all sources available • Strategic collaborations between agencies • Followed a model where all care sites would become one-stop shop medical homes 19
Vi Viral l Suppr uppres ession n 20
Indi Indiana na HIV HIV Ser ervi vice e Sites es 21
Con Continuum m of of Ca Care e Commi Committees s • There is benefit in providers meeting to address barriers and gaps that impact each phase of the CoC • CoC committees should be comprised of not only ASOs and CBOs with HIV related missions, but all of the community partners that contribute to services vital to retaining clients in care • CoC committees should work together to determine the best steps forward to ensure quality service provision, including preventing duplication of services, identifying which partners are best equipped to provide specific programs • Successfully forming comprehensive groups to improve service delivery mechanisms will play a vital role in ending the epidemic 22
Recommend
More recommend
