Attachment 8 : Service Category Plan Table

Two separate tables: 1. Part A and 2. MAI

1. Part A

Service Category Plan Table should include every service category funded by Part A and MAI in the jurisdiction.

Use the sample below as a basis for designing the table. The table should describe the following:

  • Actual amount of Unduplicated Clients (UDC) Served and the funding expended per service category in FY14.
  • Allocated amount of funding and the anticipated number of Unduplicated Clients (UDC) to be served per service category in FY15.
  • Anticipated (Planned) amount of funding and the anticipated number of Unduplicated Clients (UDC) to be served per service category in FY16.

Service Category Plan TablePart A
Service Category / Priority Number / 2014 Actual / 2015 Allocated / 2016 Anticipated
Funding Amount / UDC
Served / Service Unit Definition / Service
Units / Funding Amount / UDC
Served / Service Unit Definition / Service
Units / Funding Amount / UDC
Served / Service Unit Definition / Service
Units
Example: Outpatient Ambulatory Medical Care / 2014: 1
2015: 1
2016: 2 / $2,400,000
(%) / 2400 / 1 unit =
1 visit / 5000 / $2,000,000
(%) / 2000 / 1 unit =
1 visit / 4500 / $1,200,000
(%) / 1200 / 1 unit =
1 visit / 3800
Example: Medical Case Management / 2014: 2
2015: 2
2016: 1 / $1,200,000
(%) / 2400 / 1 unit =
1 visit / 20,000 / $1,500,000
(%) / 2500 / 1 unit =
1 visit / 25,000 / $2,000,000
(%) / 2600 / 1 unit =
1 visit / 30,000
Service Category Plan TableMAI
Service Category / Priority Number / 2014 Actual / 2015 Allocated / 2016 Anticipated / MAI Only
Funding Amount / UDC
Served / Service Unit Definition / Service
Units / Funding Amount / UDC
Served / Service Unit Definition / Service
Units / Funding Amount / UDC
Served / Service Unit Definition / Service
Units / Target populations
Example: Outpatient Ambulatory Medical Care / 2014: 1
2015: 1
2016: 2 / $500,000
(%) / 150 / 1 unit =
1 visit / 600 / $400,000
(%) / 175 / 1 unit =
1 visit / 500 / $350,000
(%) / 200 / 1 unit =
1 visit / 400 / Hispanic Women
Child-bearing
Age
Example: Medical Case Management / 2014: 2
2015: 2
2016: 1 / $200,000
(%) / 150 / 1 unit =
1 visit / 1200 / $250000
(%) / 150 / 1 unit =
1 visit / 1500 / $300000
(%) / 150 / 1 unit =
1 visit / 2000 / Hispanic Women
Child-bearing
Age

Attachment 8 : Service Category Plan Table

2. Minority AIDS Initiative (MAI Table has Target Populations)

Service Category Plan Table should include every service category funded by Part A and MAI in the jurisdiction.

Use the sample below as a basis for designing the table. The table should describe the following:

  • Actual amount of Unduplicated Clients (UDC) Served and the funding expended per service category in FY14.
  • Allocated amount of funding and the anticipated number of Unduplicated Clients (UDC) to be served per service category in FY15.
  • Anticipated (Planned) amount of funding and the anticipated number of Unduplicated Clients (UDC) to be served per service category in FY16.
  • Target Populations for MAI are is defined as an HIV positive individual who self-identifies as a member of one of the racial/ethnic communities, including African Americans, Alaska Natives, Latinos, American Indians, Asian Americans, Native Hawaiians, and Pacific Islanders, or as ‘more-than-one-race’.