PATERSON-PASSAIC COUNTY – BERGEN COUNTY
HIV HEALTH SERVICES PLANNING COUNCIL
2012-2015 COMPREHENSIVE HIV HEALTH SERVICES PLAN
2013 PROGRESS REPORT
Approved: Planning & Development Committee December 11, 2013
Approved: Steering Committee December 17, 2013
Approved: Planning Council February 4, 2014
Comprehensive Plan. The 2012-2015 Comprehensive HIV Health Services Plan contains 108 action steps of which 79 are designated for completion in 2012 or 2013.[1] Three objectives are tied to the Quality Management Plan (II.1), the Cultural Competency Task Force Recommendations (III.1) and the EIIA Plan (V.1), each having its own stated objectives and timeframes. See Table 1.
Table 1
2012-2015 Comprehensive Plan
Objectives/Actions and Timeframes
Designated Completion Year / Actions2012 / 33
2013 / 46
2014 / 17
2015 / 7
Total / 108
Because the 2012-2015 Comprehensive Plan is a living document, many actions originally slated for 2012 have been moved to 2013, and some moved to 2014 and 2015. As of November 2013, 33 of 79 (42%) actions designated for 2012-2013 were either completed or ongoing. Twenty-eight (35%) were in progress. Seventeen (22%) were not started. One was removed. See Table 2.
2/11/2014
980-ppc-19/cpu/Progress Report 020414-FINAL - 8 -
Paterson-Passaic County – Bergen County HIV Health Services Planning Council
2012-2015 Comprehensive HIV Health Services Plan
2013 Annual Progress Report to the Planning Council
Table 2
Comprehensive Plan Status Summary
2012-2013 Activities
OBJECTIVES/ACTIONS IDENTIFIED / PERCENT
Completed / 33 / 42%
In Progress / 28 / 35%
No Activity / 17 / 22%
Removed / 1 / 1%
Total / 79 / 100%
Quality Management Plan
The Quality Management (QM) Plan, referenced in Objective II.1 of the Comprehensive Plan, is updated annually. The 2012 QM Plan, completed in September 2013, contained five goals, 26 objectives and 85 specific action steps. As of September 2013, all five goals were acted upon, albeit not all completed. All but two actions in Goal I (Quality Indicators) were completed as were all but one action in Goal II (Outcome Indicators). Goals III (Linkage to Care), IV (Referral Tracking) and V (Program Evaluation) were partially addressed.
Of the 26 objectives contained in the 2012 QM Plan, 19 (73%) were either completed or in progress. Seven (27%) did not have activity. Ten of the 85 action steps (12%) were completed in 2012. Of the remaining action steps, 42 (49%) were in progress or established as ongoing activities. Thirty-three (39%) were not acted upon. See Table 3.
Table 3
Quality Management Plan Summary
OBJECTIVES / PERCENT / ACTIONS / PERCENTCompleted / 19 / 73% / 10 / 12%
In Progress or Ongoing / 42 / 49%
No Activity / 7 / 27% / 33 / 39%
Total / 26 / 100% / 85 / 100%
Cultural Competency Recommendations. The nineteen recommendations of the Cultural Competency Task Force, which are referenced in Objective III.1 of the Comprehensive Plan, are assigned immediate, short term and long term timeframes. Of the nine recommendations identified for immediate action, three are completed. Of the two short-term and eight long-term recommendations, none are completed.
The EIIHA Plan. There are 52 activities identified in the 2013 EIIHA Plan, as referenced in Objective V.1 of the Comprehensive Plan. The EIIHA Plan consists of two parts: Part I targeting four cultural communities and Part II to enhance identification, informing, referring and linking the Unaware into care. Nearly all activities in 2012 and 2013 have centered on Part II. Of the 52 activities in the 2013 EIIHA Plan, 23 (44%) were acted upon. Four were completed and the remainder are now in progress.
A new Linkage to Care Cross Collaborative was convened in 2013 and will continue to meet quarterly in 2014. A second work group of Outreach and EIS providers convened December 12, 2013 and will focus on Part I activities. Two targeted cultural communities identified in 2013 were removed or redefined for 2014. Targeted cultural communities will be (1) Latina PLWHA, (2) Young MSM and (3) African-American female PLWHA.
MAJOR ACHIEVEMENTS IN 2013
The following summarizes the significant achievements of 2013:
· HRSA’s draw-down restriction ended in 2013, and the Grantee’s office met all administrative requirements of the grant.
· The Planning Council completed a two-year Comprehensive Needs Assessment.
· New EIS and revised Outreach standards were completed, bringing clarity to roles and functions of these emerging service categories.
· The Planning Council’s Day of Capacity was considered one of the best ever, with evaluated feedback from attendees.
· Planning Council membership remained stable with increased involvement from alternates.
· The Planning Council completed a code of ethics and evaluation process for Planning Council meetings.
· The Linkage to Care Cross Collaboration, with over 30 members, was the first in this TGA to bring together early intervention, outreach, HIV testing and medical care providers to operationalize the goal of linkage to care within two business days of positive test result. Memoranda of Agreement are being signed by its members.
· The cultural competency initiative includes 18 recommendations formulated by the Cultural Competency Task Force in 2011. The grantee implemented recommendations pertaining to a universal policy statement and was incorporated into standards and contracting requirements.
· The client satisfaction survey was revised. The survey instrument was made easier for consumer comprehension and included questions on outcomes, health status and other important factors in measuring quality.
· The Planning Council received two presentations on the Affordable Care Act to guide them as the TGA prepares for health care reform.
· Access to transportation was expanded with availability of bus passes in the TGA.
· The CDC published its 2012-2013 Provider Directory.
· The Planning Council’s website www.AIDSNJ.org was updated.
· Social media projects by CDC and the Office of the Grantee (billboards and radio announcements) were implemented.
· The Part A consumers and providers participated in various health fairs in both counties including National Night Out in New Milford and Dumont and the AIDS Walk in May as well as World AIDS Day events in both counties. A portion of the Epi-Profile was presented to the Dumont Board of Health by a member of the Planning Council.
· The Quality Management Team continued to improve the quality of primary medical care through structured evaluation and improvement methods. In 2013, the Bergen-Passaic Part A clinics exceeded statewide averages for all six quality indicators under study. One quality indicator (percent of patients receiving two viral load tests in a year) reached 97%, a statewide high. St. Mary’s Hospital and Hackensack University Medical Center, two Part A providers, were recognized in AIDSLine, the New Jersey state newsletter, as a high performing clinic.
· The Part A clinics ranked in the top 75% nationwide for all four indicators of care retention as identified in the National Quality Center’s in+care Campaign.
CHALLENGES FACED IN 2013
Challenges the Part A Program experienced in 2013 are summarized as follows:
· Limited funding slowed the Grantee’s and Council’s ability to expedite projects in timely fashion.
· Progress with implementation of the EIIHA Plan was slower than expected, although this situation is being addressed.
· Targeted outreach as identified in the EIIHA Plan did not occur in 2013. The EIIHA Plan was modified for 2014 with Latino MSM changed to Young MSM and Middle Eastern Communities eliminated. A new EIS/Outreach work group convened in December to begin implementation of the Plan.
· The EIIHA Work Group was suspended in 2012, and its role in the community needs to be re-defined.
· Consumer involvement in quality and case management initiatives had limited success in 2013. The Grantee’s office is working with the National Quality Center to improve consumer participation in quality management.
· Cultural competency recommendations, particularly as they relate to trainings and community outreach, remain open for action.
· Transition to expanded Medicaid coverage and other provisions of the Affordable Care Act received significant attention in 2013. Implementation will begin in 2014 with concerns expressed across all sectors of the Ryan White Program.
· Medical case management standards need to be revised along with updates of all other remaining standards.
· Membership recruitment and participation in community-based activities continued to challenge the Community Development Committee.
· The Planning Council expressed concern about bylaw provisions regarding Council member removal. A task force was appointed to review the paragraph and submit a recommendation in January 2014.
STATUS ON THE OBJECTIVES OF THE COMPREHENSIVE PLAN WITH 2012 and 2013 COMPLETION DATES
I.1 Research, recommend and implement best practice programs designed to engage and retain PLWHA in care, by 2013 and ongoing. Status: Ongoing by QM Team. Part A medical providers rank in top 25% nationally.
I.2 Enhance collaboration between counseling, testing and referral, providing access to HIV medical care within 2 business days for 95% of newly diagnosed PLWHA, by 2013 and ongoing. Status: In progress by Linkage to Care Cross Collaboration.
I.4 Provide for the core services, also recognizing the need for support services that will remove barriers to engagement and retention in care, annually and ongoing.
Status: Completed.
I.6 Maintain access to HIV medications by relieving the costs of co-payments and deductibles, ongoing. Status: Ongoing.
II.1 Implement the annual Quality Management Plan, annually and ongoing. Status: In progress by the Quality Management Team.
II.2 Expand the dialogue between provider, consumer and Planning Council, focusing on quality of care, by 2012 and ongoing. Status: In progress. Consumers have been invited to attend Quality Management Team meetings. Participation has not been achieved.
II.3 Revise the Client Satisfaction Survey to include issues of quality, by 2013. Status: Completed and awaiting review by Part A providers.
II.6 Expand the capacity of Ryan White providers to use data for quality improvement, by 2013. Status: Ongoing. RDE conducts technical assistance trainings for new Part A employees.
III.1 Implement the recommendations of the Cultural Competency Task Force, by 2015. Status: In progress. Contractual requirements have been incorporated into the FY2014 RFP. Other recommendations await action.
III.2 Increase the number of cultural communities involved in the provision of HIV/AIDS services, by one per year. Status: Removed/revised. No activity in 2012.
III.6 Evaluate the need for educational/health literacy materials in additional languages, annually. Status: No activity.
IV.1 Improve communication among Planning Council members as evidenced by ongoing evaluation of meeting effectiveness, by 2012. Status: Completed and Ongoing.
IV.2 Empower consumers to express their values, attitudes and belief systems around health practices as measured by their involvement in the QM Team and participation in educational opportunities, by 2012 and ongoing. Status: In progress. Additional activity required.
IV.3 Use targeted communication strategies to reach specific cultural communities, in accordance with the EIIHA Plan, annually and ongoing. (Consider the following recommendations during implementation: Continue social media programs to reach the younger HIV-infected population; utilize the internet as the preferred means of communication with young MSM; use gender specific prevention messages; utilize traditional communication approaches for the 50+ population.) Status: In progress.
IV.4 Enhance communication between Ryan White and non-Ryan White funded providers, annually and ongoing. Status: Ongoing.
IV.5 Work to reduce HIV stigma by developing and implementing a community social marketing plan targeting different cultural communities at a rate of one or more per year, by 2013 and annually. Status: No activity
V.1 Implement the Early Identification of Individuals with HIV/AIDS Plan (EIIHA), annually. Status: In progress.
V.2 Expand collaboration with community-based organizations by participating in a minimum of two community events per year, by 2012 and ongoing. Status: Ongoing.
V.3 Collaborate with private physician groups by educating them on HIV testing policy, the National AIDS Strategy and the availability of Ryan White programs at a rate of two per year, by 2012 and ongoing. Status: No progress.
V.5 Evaluate the need to expand the peer and patient navigator program by 10% annually, as funding permits, by2012 and ongoing. Status: Ongoing.
V.7 Co-locate Prevention with Positives in the HIV care clinics, by 2013. Status: No activity.
RECOMMENDATIONS OF THE PLANNING & DEVELOPMENT COMMITTEE FOR 2014
1. Communicate the provisions of the Comprehensive Plan to Part A providers, in particular those activities for which they are responsible.
2. Continue expanded communications with the Grantee, the Planning Council and Part A providers related to prospective changes in the care system.
3. Continue to implement the Early Identification of Individuals with HIV/AIDS (EIIHA) Plan. Revitalize the EIIHA Oversight Work Group and involve a broad constituency of community stakeholders.
4. Continue to implement the immediate, short term and long term recommendations of the Cultural Competency Task Force.
5. Update medical case management standards, and update remaining standards of the Part A Program.
6. Implement recommendations of the Quality Management Team regarding case management quality improvement, and revitalize the case management training program.
7. Implement alternate communication methods, such as Facebook and Twitter, for educational purposes. Monitor the success of recent social media projects and consider expansion in 2014.
8. Provide educational presentations to the Planning Council on the work of the Quality Management Team, SPNS and the EIIHA Work Group.
9. Continue to support the work of the Community Development Committee as the outreach arm of the Planning Council.
10. Continue with the comprehensive plan quarterly review process currently in place.
ATTACHMENTS:
1. 2012-2015 Updated Activities Plan (under separate cover)
2. 2012 Quality Management Activities Plan
3. Cultural Competency Task Force Recommendations
4. 2013 EIIHA Activities Plan
ATTACHMENTS
1. 2012-2015 UPDATED ACTIVITIES PLAN
2. 2012 QUALITY MANAGEMENT ACTIVITIES PLAN
3. CULTURAL COMPETENCY TASK FORCE RECOMMENDATIONS
4. 2013 EIIHA ACTIVITIES PLAN
2/11/2014
980-ppc-19/cpu/Progress Report 020414-FINAL - 8 -
Paterson-Passaic County – Bergen County HIV Health Services Planning Council
2012-2015 Comprehensive HIV Health Services Plan