Cr Cross oss-Pa Part t Collaboration n for r Integrated d - - PowerPoint PPT Presentation

Cr Cross

• ss-Pa

Part t Collaboration n for r Integrated d Plan Plannin ing an g and D Develo elopmen ent o

• f 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

• f

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
• mmunity C
• nnection

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

• f 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

• f o

ngoing planning, incorporation

• f 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

• rganization

and delivery

• f

health and support services”

• Required

to be “ compatible w ith any State o r local plan for the p rovision

• f

services to individuals with HIV/AIDS”

• RWHAP

Part B must:

• Provide “

a comprehensive p lan that describes the o rganization and delivery

• f 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

• ordinated

statement

• f

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

• ngoing work

and look at the system

• f

care – see how well it responds to diverse and changing needs of people with HIV

• Strategy
• r

roadmap for developing

• r

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

• r

with

• ther

programs in their state – many c hose cross-part submissions

• 45% of all

RWHAP Part A and Part B programs

• 56%
• f 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

• ur 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

• An

agreed-upon, documented structure an d process to guide t he work

• A

realistic plan to plan, with tasks, responsibilities, and timeline

• Processes

that ensure a consumer voice f rom both Parts in decision making

• Ongoing

engagement

• f

planning councils/planning bodies – including decision-making roles

• Shared

and well d efined leadership and decision making

• Agreement
• n

resources – how costs/resources will be shared

• Open m

eetings and t ransparent decision making – with use

• f

a neutral facilitator where n eeded

• Clear staff r
• les
• Timely

access to needed expertise

• Mutual

trust built

• n

met deadlines and kept promises

• An

integrated plan that has “ownership” and can guide action at state and local levels

11

Si Situations s to

• Av

Avoid d in n Cross- Pa Part t Planning g

• A late start to planning
• Loosely defined roles and

responsibilities

• No clear process for decision

making

• Lack of consumer and community

participation and buy-in

• Unclear or minimized role for a

planning council, for whom this is a legislative responsibility

• Limited access to needed

data

• Sense of an unfair burden on one

person or entity

• Serious disagreements about goals,
• bjectives, and/or priorities
• Attempts by one person or entity

to control the process or make the decisions

• Loose or missed deadlines
• Not enough time for everyone to

review and improve drafts

12

Indian iana’ a’s I s Integr grated d HIV P Preventio tion n an and C 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

• utcomes
• Reduce

disparities and health issues among PLWH

• Expand

the coordination

• f s

ervice delivery s ystems

• Ensure

continued financial support

16

Mon Monitori

• ring a

and E Evaluation

• n
• Original plan

called for monitoring a nd evaluation to be completed by a b

• dy c
• mprised
• f C

PG, CHSPAC, RWHAP Planning Council and staff from the county and state

• Funders

meet m

• nthly

to d iscuss progress toward plan

• bjectives
• RWHAP

Supplemental dollars assisted greatly in progress toward achieving goals

• utlined

in the plan

17

Ch Challenges

• Turnover-loss
• f institutional knowledge

from retirees/job changes and transitions in executive leadership

• Inability t
• provide
• ngoing mon

itoring a nd evaluation

• f

the plan due to changes in advisory and planning bodies

• Utility
• f

the plan: t he size

• f

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
• ordination
• f

funding after t he creation

• f

a comprehensive list

• f all sources

available

• Strategic collaborations

between agencies

• Followed

a model where all care sites would become

• ne-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

• f

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

Wh What t Options s Exi xist t to

• Improve

e Ser Service ce Del eliver ery? y?

• Agencies have examined their potential to expand services independently,

hiring staff and acquiring additional space or revitalizing existing space to accommodate new services

• Strategic collaborations are a very effective way to quickly offer new

programs

• Collaborations can include having outside agencies provide services at your
• rganization, integrating partners with your team to provide a seamless

service experience for clients

• Another collaborative model includes requesting funding for additional

staff to be placed at satellite locations, integrating your staff member into another organizations team to provide services in targeting locations where clients have struggled to remain engaged in care

23

Lou Louisi siana a HIV/AIDS S Str trategy y for

• r

Pr Prevent ntion, , Treat atment nt, , and d Care e Se Service ces 2 2017-2021 2021

Brandi Bowen, Program Director New Orleans Regional AIDS Planning Council

Ov Over ervie view w

• f

f Prio ior r Process cess in in Lo Louis isian iana a

25

Over erview w of f Prior r Process cess in n Lo Louisiana a

Louisiana created

• ne

Integrated HIV Prevention and Care Plan inclusive

• f RWHAP

Part B and both RWHAP Part A jurisdictions

• Stakeholders

Coordination Workgroup, including recipients, planning body l eads, people with HIV

• HIV Planning

Group, including statewide representation from prevention/care providers

• Planning

Council in New Orleans and Advisory Council in Baton Rouge, including people with HIV and diverse stakeholders

26

Over erview w of f Prior r Process cess in Lo Louisiana a

• Stakeholders

Coordination Workgroup formed early to g uide coordination efforts, alignment across jurisdictions, decide process matters, ensure community i nput. Specific sections/writing tasks assigned and tracked; drafts shared and revised

• HIV Planning

Group, as statewide planning body, hosted community presentations sharing epi a nd needs assessment data, sharing drafts in process, seeking feedback

• Planning

Council in New Orleans and Advisory Council in Baton Rouge led planning work for sections

• n

RWHAP Part A programs and collaborated across communities to maximize input, buy-in and support

27

Update e on n Curren ent t Process cess in n Lo Louisiana a

• HIV Planning

Group, statewide planning body, reoriented to be aligned with newer Ending the HIV Epidemic (EHE) initiative. Integrated planning w

• rk is

now

• verlapped

with EHE planning

• Planning

Council in New Orleans and Advisory Council in Baton Rouge similarly adapted integrated planning efforts in alignment with EHE and Fast Track Cities strategizing

28

Collaboration n acr cross ss ser service ce systems ems

Ryan White HIV/AIDS Program Parts A-F & Other Partners

• CDC, Community Based

Organizations, Continuum of Care, Faith based groups, FQHCs, Health Departments, Hospital Associations, HUD/HOPWA, Pharmacies, Justice Systems, Pharmaceutical companies, PEOPLE LIVING WITH HIV, Prevention organizations, SAMHSA, and many more Find Common Ground

• Common Language/Defined Terms
• Shared goals/agreed upon vision
• Accessible concepts/data

visualizations

• Specific concrete actionable items
• Understand and address different

approaches and fundamental principles of each stakeholder set

29

Col Collabor

• ration
• n

More ways to enhance collaboration

• Skillful

and neutral group facilitators

• Concrete

timeline, advance meeting schedules, consistency

• Specific task assignments

and follow up

• Sensitivity

to d iverse perspectives and backgrounds

• Flexible

consensus driven approaches

• Participants’ motivation
• Make/keep it fun

30

Vo Voice e of f Community y

What community said…

• Keep

it short

• Address institutional racism
• Address stigma

What happened was…

• 133 pages later
• Trainings

to ‘undo institutional racism’ and greater focus

• n

social determinants of health

• PLWH

Stigma I ndex Project, more trainings, promotion

• f

U=U

31

Vo Voice e of f Community y

What community said…

• “stop

the violence against transgender women”

• “housing is healthcare”
• address

knowledge gaps (lack

• f

public health info/seeking behavior) What happened was…

• Trainings

to deconstruct transphobia

• Stronger

focus

• n

coordination across service systems, more responsive service models, survival services

• More attention to community
• utreach

32

Vo Voice e of f Community y

• The l

ives

• f

people with HIV are not spliced and diced like service system silos and isolated sections

• f

long drawn

• ut

plans.

• To be most responsive to needs of people

with HIV, planners could think more holistically a bout whole person needs, whole community needs. While striving to end the HIV epidemic, repeating the same steps that led to this point would likely result in the same

• utcomes.
• Think

differently. Think ‘integratedly.’ Supportive services, behavioral health, STD and HCV, prevention and treatment and/or treatment as prevention…. Smooth service access, services delivered with respect and compassion… All must be addressed to achieve RWHAP goals.

33

Vo Voice e of f Community y

• Center

people with HIV (PLWH) with empowerment and support

• PLWH

are prevention warriors!

• Recognize

PLWH for their contributions and abilities to make change

• Be

honest a bout t he ways and pace

• f

changing the service system

34

35

Imp Improving g Commu mmunity y Connect ection n to to Plan n

• Disseminate

final plan to a ll key stakeholders and establish mechanisms for sharing plan updates and progress towards goals

• Distill

the I ntegrated Plan and its activities into a succinct visual or snapshot to promote

• r

communicate progress

• In

Action! Wisconsin developed an abbreviated version

• f their

Integrated Plan to distill the 130-page plan into 10 pages and a

• ne p

age A t-A-Glance document

Imp Improving g Commu mmunity y Connect ectio to to Plan n (co cont). ). n n

• Share

and update plan activity progress to p lanning bodies/planning councils and

• ther

stakeholders.

• Include

successes, challenges, modifications, and lessons learned.

• Create

a progress report

• r

activity dashboard that is updated and shared regularly according to an established schedule

37

In action!

https://targethiv.org/ihap/wisconsin-integrated-hiv-plan-2017-2021-2019-progress-report

HR HRSA HAB A HAB F Funded ed T TA A A Availab ailable le

Com Community H y HIV/AIDS S Technical l Assistance e and and Training aining (Planning lanning CHATT) ) Project t

• Planning

CHATT b uilds the capacity

• f

Ryan White HIV/AIDS Program (RWHAP) Part A planning councils/planning bodies and planning bodies (PC/PB) across the U.S.

• Our

goal i s to help PC/PB to meet legislative requirements, strengthen consumer engagement, and increase the involvement

• f c
• mmunity

providers in HIV service delivery p lanning.

• https://targethiv.org/planning-chatt

Integrated HIV/AIDS Planning Technical Assistance Center

IHAP TAC TA and Training Still Available to Jurisdictions

▪ Integrated Planning ▪ Implementation and Monitoring of Integrated Prevention and Care Plans ▪ Optimizing Resource Allocation Methodologies

Visit us a t https://targethiv.org/ihap

Th Thank k you! !

Que Questions ns/Comme mments ?