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DCHAP Stakeholders
Conference Call September 13, 2013
Polly E. Ross, MD
Division Director
Department of Health and Human Services
Health Resources and Services Administration
HIV/AIDS Bureau
Division of Community HIV/AIDS Programs
TODAY’S TOPICS
Notice of Grant Awards
IAHCT
MAI
HHS Indicators
Affordable Care Act
HIV/AIDS Bureau
Laura W. Cheever, MD, ScM
Associate Administrator
Sylvia Trent–Adams, PhD, MS, RN
Deputy Associate Administrator
Division of Community
HIV/AIDS Programs
Polly E.
Ross, MD
Director
Lynn R.
Wegman,
Deputy
Director
HIV/AIDS Bureau, Division of Community HIV/AIDS Programs
Polly E. Ross, MD, Division Director
Lynn R. Wegman, Deputy Director
Anna Huang, MD, Chief Medical Officer
John Fanning, Senior Policy Advisor
NORTHEASTERN BRANCH
Carrie Jeffries
Branch Chief
PUBLIC HEALTH ANALYSTS
Daniel Baker
Stephanie Bogan
Alex Calvo
Kimberly Hudgens
Elijah Martin
Renata Thompson
Cecilia Yin
CENTRAL BRANCH
Hanna Endale
Branch Chief
PUBLIC HEALTH ANALYSTS
Ralph S. Brisueño
Emily Chew
Wendy Cousino
Mindy Golatt
Karen Gooden
Elizabeth Goodger
Deborah Willis-Fillinger
SOUTHERN BRANCH
Mahyar Mofidi, DMD
Branch Chief
PUBLIC HEALTH ANALYSTS
Gettie Audain
Tessa Brown
Wanda Chestnut
Tracey Gantt
Viven Walker-Marable
Kendra Williams
Gail Williams Glasser
WESTERN BRANCH
Stephanie Yun
Branch Chief
PUBLIC HEALTH ANALYSTS
Kevin Bates
Carmen Brown
Monica Farmer
Monique Hitch
Ron Howard
Sandra Lloyd
Nicole Newburg-Rinn
Reginald Smith
Lillian Sowah
Menina Reyes
Administrative Associate David Pitman
Staff Assistant
9/23/2013
5600 Fishers Lane
Room 9-74
Rockville, MD 20857
301-443-0493
FAX 443-1839,1884
Notice of Grant Award
CMDR Mahyar Mofidi
Chief, Southern Branch
Division of Community HIV/AID Programs
HIV/AIDS Bureau/HRSA
FY 2013 Notice of Awards
Key areas: Part C • Part C January: received three NOAs
• Part C April: received two NOAs
• Part C July: received one NOA
Part C July: 10 month budget period July 1/2013-
April 30,2014
• Make sure FY 2013 1) project and budget dates
and 2) total funding amount are correct
• Conditions of award: Read carefully for requests
and due dates
FY 2013 Notice of Awards
Key areas: Part C Awards Reporting requirements: Read all of the NOAs
carefully, must know what is due and due dates
• Allocation Report
• Expenditure Report
• Ryan White Services Report (RSR)
• Federal Financial Report (FFR)
FY 14 NCC CHANGES
Budget for NCC- FY 14
The Budget submitted should reflect the FY
2013 final award amount.
The Final Award amount is listed on Line 12.a.
of the Notice of Award.
If there are any questions, consult with your
Project Officers.
FY 14 NCC CHANGES
Changes in the Workplan for FY 14 A. Access to Care Objective for entire HIV program
(2 objectives )
B. Counseling and Testing Funded By Part C only
(4 objectives)
C. Clinical Quality Management
• DHHS CORE Indicators (include two in CQM)
Capacity Development – 2013
In FY 2013 –One time funds for two
types of activities :
ACA Outreach and Enrollment
Infrastructure Development.
Over 70 applications were
submitted.
Increasing Access to HIV Care &
Treatment Initiative (IAHCT)
Supplemental Funding
Stephanie Yun
Chief, Western Branch
Division of Community HIV/AID Programs
HIV/AIDS Bureau/HRSA
Increasing Access to HIV Care &
Treatment Initiative (IAHCT)
• In FY 2012, HRSA awarded 275 grantees the
Increasing Access to HIV Care and Treatment
(IAHCT) supplemental funds.
• Funding for FY 2012
• Up to $38,000
• 141 awards for Part C only grantees
• 134 awards for Bureau of Primary Health
Care (BPHC)/Part C dually funded grantees
Increasing Access to HIV Care &
Treatment Initiative (IAHCT)
• What data are we capturing?
• Newly diagnosed within the past 90 days PLWH & new to
medical care
• Previously diagnosed PLWH never been in medical care
• PLWH returning to care after more than 12 months not in
medical care
• Newly enrolled PLWH transferring from another site
Increasing Access to HIV Care &
Treatment Initiative (IAHCT)
• Reporting requirements for IAHCT activities
will be reduced from quarterly to semi-
annually.
• IAHCT reports will be due in EHB:
• January 31, 2014
• July 31, 2014
Increasing Access to HIV Care &
Treatment Initiative (IAHCT)
• Dually Funded BPHC/Part C programs
received IAHCT funds in the August NOA
from the BPHC;
• Funding is for 15 months
• IAHCT reporting for BPHC/Part C
Programs
January 31, 2014
August 31, 2014
Increasing Access to HIV Care &
Treatment Initiative (IAHCT)
• IAHCT Reporting Requirement :
• Please contact your PO if you have an
IAHCT placeholder in EHB but did not
receive funding.
• If you did receive IAHCT funding but do not
see a template, one will be added the
month before the due date.
Increasing Access to HIV Care &
Treatment Initiative (IAHCT)
IAHCT Preliminary Data:
• Goal: President Obama – 7,500 enrolled into care
• IAHCT Awardee Goal: 14,335 enrolled into care
Actual Reported Numbers in 2012:
Over 20,000!
Minority AIDS Initiative (MAI)
Funding
Hanna Endale
Chief, Central Branch
Division of Community HIV/AID Programs
HIV/AIDS Bureau/HRSA
Background:
In 1999, Congress with the support of
the Congressional Black Caucus
authorized that a portion of the Ryan
White Program funding be designated
for Minority AIDS Initiatives.
Minority AIDS Initiative (MAI) Funding
Minority AIDS Initiative (MAI)
Funding
How MAI funds were distributed for FY13.
• Part C MAI funds are currently used as part of the
base award to provide comprehensive primary care
services to people living with HIV/AIDS.
• The most currently available RSR data was used to
determine the percent of minorities served by each
program.
• For FY 2013, Part C Grantees who reported 70% or
greater minority populations will have 56% of their
base award allocated as MAI funds.
Minority AIDS Initiative (MAI)
Funding
• Grantees that have MAI designated
funds must report a description of the
MAI population(s) served by the
program.
• Grantees will continue to submit this
information as part of the Competing
Continuation Application or as part of
the Non Competing Continuation
progress report.
Common Indicators for HHS-funded HIV
Programs
Carrie Jeffries, CRNP, MS, MPH, AACRN
Chief, Northeast Branch
Division of Community HIV/AID Programs
HIV/AIDS Bureau/HRSA
Common Indicators for HHS-funded
HIV Programs and Services • Seven common core indicators approved by
Secretary Sebelius on June 28, 2013
• DCHAP grantees are strongly encouraged to report
on two: • HIV Positivity
• Late HIV Diagnosis
• Linkage to HIV Medical Care
• Retention in HIV Medical Care
• Antiretroviral Therapy (ART) in Persons in HIV Medical Care
• Viral Load Suppression Among Persons in HIV Medical Care
• Housing Status
• Grantees can find more information at:
http://www.aids.gov/pdf/hhs-common-hiv-indicators.pdf
Retention in HIV Medical Care Numerator: Number of persons with an HIV
diagnosis who had at least one HIV medical
care visit in each 6 month period of the 24
month measurement period, with a minimum of
60 days between the first medical visit in the
prior 6 month period and the last medical visit
in the subsequent 6 month period
Denominator: Number of persons with an HIV
diagnosis with at least one HIV medical care
visit in the first 6 months of the 24 month
measurement period
Ryan White Retention in Medical Care
Retained in
medical care:
At least 2
medical visits
that were at
least 90 days
apart
Doshi RK et al. CROI 2013, abstract 1031a.
76%
Viral Load Suppression Among
Persons in HIV Medical Care
Numerator: Number of persons with an
HIV diagnosis with a viral load <200
copies/mL at last test in the 12–month
measurement period
Denominator: Number of persons with
an HIV diagnosis and who had at least
one HIV medical care visit in the 12
month measurement period
Viral Load Suppression
Viral load
suppressed:
HIV-1 RNA <200
copies/ml at the
most recent check
70%
Doshi RK et al. CROI 2013, abstract 1031a.
Viral load suppression,
Retained vs. not retained
Retention status Viral load suppressed (<200
copies/ml at most recent test)
Retained in medical care 75%
Not retained in medical care* 50%
*Received at least 1 RW-funded medical visit but not retained in medical care
Doshi RK et al. CROI 2013, abstract 1031a.
HHS Common Indicator
Implementation and Reporting
• Project Officers will be discussing the
Retention and Viral Load indicators
on the monthly monitoring calls
• Implementation
• Outcomes
• Technical assistance needs
Additional Areas of Interest
1. Does your HIV Clinic have Patient
Centered Medical Home recognition or
certification?
If no, are you intending to apply for PCMH in
the next 12 months?
2. Does your clinic currently utilize an
Electronic Health Record/Medical Record
for patient care?
Two Questions:
Patient Protection and the
Affordable Care Act
Enrollment Begins in Eighteen Days!
Outreach, Enrollment and Education are critical!
All grantees must have a process in place to screen and
enroll clients in health insurance plans for which they are
eligible.
Grantees must vigorously pursue enrollment for all
clients eligible for new coverage (HAB Policy
Clarification Notices # 13-01 through 13-06)
Patient Protection and the Affordable
Care Act - Important Dates • October 1, 2013 – March 31, 2014: Initial open enrollment season for Health
Insurance Marketplaces.
• October 15, 2014 – December 7, 2014 - Annual open enrollment season for coverage beginning on January 1, 2015.
• Enrollment for Medicaid is open all year.
Enrollment Date Effective Date of Coverage
Oct. 1, 2013 - Dec. 15, 2013 January 1, 2014
Dec. 16, 2013 - Jan.15, 2014 February 1, 2014
Jan. 16, 2014 - Feb. 15, 2014 March 1, 2014
Feb.16, 2014 - March 15, 2014 April 1, 2014
Mar.16, 2014 - March 31, 2014 May 1, 2014
Patient Protection and the Affordable
Care Act – Enrollment Training
What Kinds of Enrollment Trainings are Available? • Every state is different – To learn what your state is doing go to:
http://www.statereforum.org/consumer-assistance-training
Training is required for all enrollment staff 1) Navigators have a vital role in helping consumers prepare applications to
establish eligibility and enroll in coverage through the Marketplace. Navigators
play a role in all types of Marketplaces (in all states).
2) In-Person Assisters – will assist in either a State-based Marketplace or a State
Partnership Marketplace and will serve to provide similar support as Navigators.
3) Certified Application Counselors (CAC) – will perform many of the same functions
as Navigators. CACs will be available in all States.
Patient Protection and the Affordable Care
Act – Enrollment Training
• Your organization can still apply to be a
CAC organization • What does a CAC organization do?
• As a CAC organization, your staff and volunteers will help
people understand, apply, and enroll for health coverage
through the Marketplace
• Your organization must agree to ensure that your designated
individuals complete required training, comply with privacy
and security laws, and meet other program standards.
• Apply to be a CAC organization at
http://marketplace.cms.gov/help-us/cac-apply.html
Patient Protection and the Affordable Care Act –
Training Events
Upcoming Webinars All events can be found on HAB’s TARGET Center website at
http://careacttarget org
September 17th – (HAB) Review of HAB’s Policy Clarification Notices (Numbers 13-03 through 13-06) (3:00- 4:30 pm ET)
September 18th – (HRSA) Enrollment - Impact of the ACA on Safety Net Providers and their Patients: Opportunities for Outreach and Education (Noon-1 pm ET)
September 20th - HIV Health Reform Webinar Series: "We Can Do
It!" The New Basics of Health Reform for Frontline HIV Workers -
(2:00-3:30 pm ET - pre-registration required)
September 23rd – The AIDS Education and Training Center, National
Resource Center - ACA and Retaining/Gaining Insured PLWH in Your Practice (2:00 - 4:00 pm ET - pre-registration required)
Affordable Care Act – Key Resources
Consumer Websites: HealthCare.gov / CuidadoDeSalud.gov
Consumer Call Center: 1-800-318-2596 – Available 24/7 in 150 languages
Partner/Stakeholder Website: Marketplace.cms.gov (brochures, fact sheets, Q&As,
presentations and other materials available for download)
HRSA’s Provider Marketplace Toolkit - http://www.hrsa.gov/affordablecareact/toolkit.html
http://www.cms.gov/cciio/programs-and-initiatives/health-insurance-
marketplaces/assistance.html – In person assister training information
http://www.statereforum.org/consumer-assistance-training - state plans for training
navigators and assisters
http://hab.hrsa.gov/affordablecareact/ Ryan White and ACA resources
http://www.careacttarget.org/aca - HAB TARGET Center - RWHAP and ACA resources
Social Media: “LikeHealthCare.gov / CuidadoDeSalud.gov on Facebook
“Follow” HealthCare.gov / CuidadoDeSalud.gov on Twitter
The HAB/ DCHAP Staff
Thanks All of YOU!
QUESTIONS?