1、Integrated HIV Prevention and Care Planning Groups and Activities July 30, 2013,Andrea Jackson, MPH U.S. Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) Division of Metropolitan HIV/AIDS Programs (DMHAP),What Is Integrated Plann
2、ing?,Integrated planning is the sharing, merging or integration of a States HIV/AIDS Prevention (CDC-sponsored) and Care (Ryan Whitesponsored) planning groupsThis may be accomplished through collaboration on joint projects, sharing planning products, sharing members, or totally integrating into one
3、planning body,Why Integrated Planning?,To develop a coordinated Statewide response to HIV/AIDS To avoid duplication of processes Many points of intersection and shared knowledge, data and processes (ex. epidemiological profile, by-laws, nominations, community involvement) More economical (sharing re
4、sources) May have some of the same people on both groups already Increased collaboration and communication,Why Integrated Planning?,HIV testing and referral to care is often funded by both prevention and care dollars Fosters integration of prevention into care services Community viral load as a reco
5、gnized form of prevention, requires good care coordination Partner services is also important to both prevention and care,Why Integrated Planning?,Key National Policy Shifts: The White Houses National HIV/AIDS Strategy (2010) CDCs High-Impact HIV Prevention (HIHP) (2011) CDCs Advancing HIV Preventio
6、n (AHP) Initiative (2003) CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment (2002) OMBs increasing emphasis on streamlining CDC and HRSA requests for information from programs Improve efficiency and effectiveness of federal programs,Why Should Care And Treatment Pl
7、anners Pay Attention To Prevention?,New strategies for HIV prevention impact care settings PrEP Treatment = Prevention Strategies to encourage knowledge of sero-statusTo facilitate linkagesMaximize service provider capacity,Why Should Prevention Planners Pay Attention To Care And Treatment?,CDCs AHP
8、 and HIHP expand counseling, testing and referral (CTR) and partner counseling and referral services (PCRS) Strategies to provide prevention for HIV positive individuals Provide behavioral interventions in clinical care To facilitate linkages Maximize service provider capacity,Common Goals of Preven
9、tion and Care,To ensure that individuals learn their HIV statusTo ensure that HIV positive individuals are linked to medical care, supportive services, and prevention services that meet their unique needsTo ensure that HIV negative individuals are linked to prevention and other services,Common Goals
10、 of Prevention and Care,Plans are comprehensive and promote coordination and linkages of services Ensure planning reflects the diversity local epidemic Assure meaningful involvement of PLWH in planning processes Assess effectiveness of plans and processes,Partnerships and Collaboration,HRSA expects
11、collaboration, partnering, and coordination in planning and implementation of services between multiple sources of treatment, care and prevention service providersHIV testing sites Non-Ryan White Program providers All Ryan White Program Parts (A, B, C, D, and F) Medicaid and Medicare VA,Possible Bar
12、riers To Integration,Competing agendas (turf issues, mistrust) Over-dominance by either care or prevention More meetings for members who had only been on one group prior Categorical funding/requirements from CDC and HRSA Transition phase requires initial influx of resources to increase knowledge abo
13、ut care and prevention,Benefits of Integrated Planning,Allows development of common mission/vision Encourages sharing of knowledge and data Combines/maximizes limited resources Reduces planning costs in the long term Creates comprehensive services/encourages linkage of services Fosters integration o
14、f prevention into care services and vice versa,Operationalizing Collaboration,Develop operating principles (vision, mission) and by-laws Specify member recruitment and orientation Examine required products of planning Consider multiple opportunities/strategies for community/consumer input into plann
15、ing Obtain training, skills-building and TA (ex: cross-training prevention/care staff),Operationalizing Collaboration (cont.),Address fears and provide information Set clear goals and objectives for collaborative planning Develop an implementation plan Give the process time Leadership selection that
16、 is representative and neutral,Models for Collaborative Planning,Information Sharing Cross Representation on Prevention and Care Planning Bodies Coordinated/ Combined Projects or Meetings Merged Bodies Needs Assessment Activities,HIV/AIDS Planning Models As known to NASTAD as of December 2012,“Cross
17、walk” of CDC & HRSA Planning Requirements & Expectations (snapshot),Created by EGMC for the TAC,Los Angeles, CA Integrated Planning,Commission (serves as the RWPA Planning Council) and Prevention Planning Committee (PPC) had several shared members and a joint committeeCommission had far more funding
18、, a larger staff, and responsibility for determining the use of millions of federal, state, and county fundsPPC members were concerned that if the two groups merged, the Prevention planning function could receive less focus than the HIV care-focused work of the Commission,Los Angeles Integrated Plan
19、ning,Integration Task Force was established in 2012. It included representatives of both planning bodies and had two Co-Chairs from each group. TF jointly developed RWPA Comprehensive PlanThe joint body voted unanimously (in March) to create a new, unified planning body and approved its functions, s
20、tructure, and membership compositionFirst, there had to be agreement on the roles and functions of the new planning body, then a determination of membership and structure,Los Angeles - Lessons Learned,Preparing a joint comprehensive plan provides a good foundation for eventual integration into a sin
21、gle body Taking time to develop shared knowledge and trust is extremely important Establishing and maintaining a sense of parity enables both bodies to accept compromises Merging the two bodies seems highly desirable once everyone recognizes the increasing overlap in the roles of prevention and care
22、,References,CDC/HRSA Letter Supporting Integrated Planning Models, In progress Dear Colleague Letter, Mermin and Cheever, May 22, 2013 NASTAD HIV/AIDS Planning Models (as of 12/2012), B. Pund, April 19, 2013 Toolkit: Integrated, Collaborative or Merged Prevention and Care Planning Processes, NASTAD,
23、 May 2007 Trends in Collaborative Care and Prevention Planning PowerPoint Presentation, NASTAD, C. Jorstad, June 5, 2006 “Crosswalk of CDC & HRSA Planning Requirements and Expectations” EGMC for the TAC “Developing a Unified HIV Prevention and Care Planning Body: Lessons from the Los Angeles EMA” Prepared for: Division of Metropolitan HIV/AIDS Programs HIV/AIDS Bureau Prepared by: Emily Gantz McKay EGM Consulting, LLC,Questions?,Andrea Jackson, MPH Public Health Analyst (301) 443-8364 AJacksonHRSA.govhab.hrsa.gov,
