Maxwell Ohikhuare, MD Lloyd White County Health Officer Co ... · D. Huntsman reported that the...

Planning Council Thursday June 29, 2017

12:30PM-3:30PM

Teleconference Meeting Location California Department of Public Health

Office of AIDS 1616 Capitol Avenue, Suite 616, MS 7700

Sacramento, CA 95814

Meeting Location First Congregational United Church of Christ

3041 N Sierra Way San Bernardino, CA 92405

(909)519-3927

These facilities are in compliance with the Americans with Disabilities Act of 1992.

Agenda 12:30pm 1. Call to Order

• Roll Call* - PC Staff • Introductions – L White • Pledge of Allegiance – L White

L. White

2. Approval of the Agenda2 2.1 Planning Council Agenda for June 29, 2017

PC Members

3. Approval of Minutes2 3.1 Planning Council Minutes of April 27, 2017

PC Members

4. New Business2 California Planning Group Update (C. Smith)

4.1 Discussion and vote regarding the Planning Committee’s Proposed

Dates/Location for PSRA (A-1) a. Option 1:

i. Date: Tuesday & Wednesday –July 25/26, 2017 ii. Location: Crestmore Manor 4600 Crestmore Road

Jurupa Valley, CA 92509 b. Option 2:

i. Date: Wednesday & Thursday- July 26/27, 2017 ii. Location: First Congregational United Church of

Christ 3041 N Sierra Way San Bernardino, CA 92405 4.2 Discussion and vote regarding the Planning Committee’s Proposed

Agenda for 2017 PSRA (A-2) 4.3 Discussion and vote regarding the Planning Committee’s Proposed

Consumer Caucus Agenda (A-3) 4.4 Discussion and vote regarding the Planning Committee’s Proposed

Consumer Caucus Flyer (A-4) 4.5 Discussion and vote regarding the Planning Committee’s Proposed

PSRA Training Agenda (A-5)

L. White

Riverside/San Bernardino California Transitional Grant Area

First Congregational United Church of Christ – Haskell Hall 3041 N Sierra Way

San Bernardino, CA 92405 (909)519-3927

Website: www.iehpc.org

Maxwell Ohikhuare, MD Lloyd White County Health Officer Co-Chair Interim Community Co-Chair

4.6 Discussion and vote regarding the CCC’s recommendation to submit a letter to the SB County Board of Supervisors requesting rationale for (1) rationale for not approving the appointment of Terry Evans to the Inland Empire HIV Planning Council and (2) the criteria that would disqualify prospective Planning Council members for Board of Supervisor approval. (A-6)

4.7 Discussion and Vote to Recommend Reallocations for FY 17/18 4.8 Discussion and vote regarding the Standard Committee’s

Recommendation to add the following to the Financial Eligibility Criteria for Medical Nutrition Therapy - Total Income < 400% of Federal Poverty Level. (A-7)

4.9 Discussion and vote regarding the Standard Committee’s Recommendation to strike the following service component to the Early Intervention Service Standard – Service Component #8: “Utilize the standardized Enrollment Form and Progress Form to document entry into the EIS program and track and report progress.” (A-8)

4.10 Discussion and vote regarding the Standard Committee’s Recommendation to Discussion and vote regarding the Standard Committee’s Recommendation to strike the following service components to the Psychosocal Support Service Standard – Service Component #1 & #2: “(1) Develop initial individual assessment. (2) When appropriate, this initial assessment must be made available for development of the client’s Care Plan.” (A-9)

5. Reports (limited to 5 min) 5.1 Committee Reports (See also Planning Council Staff Report)

• Empowerment • Finance • CCC • CDC/EAM • Bylaws • Planning • Standards

5.2 Ryan White Program Report (A-10) 5.3 State Representatives 5.4 California Planning Group Update (C. Smith) 5.5 Planning Council Staff Report (A-11)

L. White

6. Public Comments1 Public

7. Members Privilege PC Members

8. Review of Action Items Staff will:

PC Staff

9. Agenda Setting for Next Meeting

July 13, 2017 – PSRA Training First Congregational United Church of Christ

3041 N Sierra Way

Lloyd White

San Bernardino, CA 92405

10. Roll Call* PC Staff

3:30pm 11. Adjournment Lloyd White

1Public Comments: Any member of the public may address this meeting on items of interest that relate to the Ryan White CARE Act by completing a speaker slip to indicate their interest in addressing the Planning Council. A three-minute limitation will normally apply to each member of the public who wishes to comment, unless waived by the Chair. 2Any member of the public who fails to follow these guidelines or repeatedly engages in disrespectful or disruptive behavior, will be warned, and then if the behavior persists, will be asked by the chair to leave the meeting. Prior to removing the individual, the chair of the meeting shall state on the record the reason for removal. 3The agenda item may consist of a discussion and a vote. Public comments can be made prior to each Planning Council vote. * Members must be present at both roll calls to receive credit for meeting attendance. ** Copies can be obtained at the I.E.H.P.C. office and will be available at the meeting. Requests for special accommodations (e.g., language translation) must be received 72 hours prior to the date of the meeting. Contact PC Support at (909) 693-0750. All meetings of the Planning Council and its committees are open to interested parties from the general public. Notices are posted in compliance with the California Brown Act. Information regarding Planning Council meetings, and/or minutes of meetings are public records and are available upon request from the Planning Council Support Staff by calling (909) 693-0750 or by visiting the website

Planning Council Thursday April 27, 2017

12:30 pm-3:30 pm Meeting Location

California Department of Public Health Office of AIDS

1616 Capitol Avenue, Suite 616, MS 7700 Sacramento, CA 95814

Meeting Location County of San Bernardino

Registrar of Voters 777 E. Rialto Ave, San Bernardino, CA

These facilities are in full compliance with the Americans with Disabilities Act of 1992. Minutes

Members: A. Jacobson, C. Smith, D. Huntsman, M. Ohikhuare, J. Taylor, J. Chan, L. White, M. Katz, C. Bridges-Cobb, Z. Welden Staff: A. Fox, D. Wheeler, D. Perez County Counsel: M. Markel RWP: J. Jones, B. Flippin Public: J. Ruiz, A. Brazier, Y. Saenz, B. Ramsey, J. Piedra, A. Lopez, D. Derriott, L. Kiley

12:45 pm Planning Council Duties & Responsibilities Workshop 1. Call to Order

• Roll Call* Reading of the Council’s meeting “Code of Conduct”

• Introductions • Pledge of Allegiance

L. White

2. Approval of the Agenda2 2.1 Planning Council Agenda for April 27, 2017

There was a motion to approve of the Council agenda for April 27, 2017. M/S/C: D. Huntsman, A. Jacobson – No Abstentions

PC

Members

3. Approval of Minutes2 3.1 Planning Council Minutes of January 26, 2017

There was motion to approve the January 26, 2017 minutes. M/S/C: C. Smith, A. Jacobson - No Abstentions

PC Members

4. New Business2 • Office of AIDS and ADAP Update

CDPH has established a new ADAP call center that began operations on March 6, 2017. The Call center is part of the roll out of the new ADAP enrollment system. M. Katz updated the Council on the AIDS Medi-Cal Waiver program. An extension of the 2012-2016 waiver has been granted by the Centers for Medicare and Medicaid Services. CDPH is currently responding to questions regarding the 2017-2021 AIDS Waiver renewal application.

L. White


County of San Bernardino, Department of Public Health 351 Mt. View • San Bernardino, CA 92415-0100

(909) 693-0750 Website: www.iehpc.org

Maxwell Ohikhuare, MD Lloyd White County Health Officer Co-Chair Community Co-Chair

The Office of AIDS posted on its website the results of a data report on the Syringe Exchange Program. Kings County Public Health Department has applied to CDPH/OA to authorize a new syringe exchange program. A brief overview of the CPG meeting was provided. Ten Subject Matter Experts (SME) from OA will be attending CPG meetings as necessary.

• California Planning Group Update C. Smith the Council’s CPG representative gave an update on the April meeting. Two new Co-Chairs were elected Tony Viramontes from Orange County and Robin LaMert from Sacramento. The agenda included an orientation for new members; presentations from the OA from Dr. Juliana Grant, Chief, OA Surveillance Research and Evaluation Branch on State Surveillance. State updates on Prevention and on Part B. There was also an in-depth presentation on “Getting to Zero/Integrated Plan/Needs Assessment”. The CPG was provided updated on several legislative initiatives impacting PLWH/A. Mr. Smith also shared with the Council an acronym that the CPG adopted during its meetings. ELMO = Enough Let’s Move On.

4.1 Discussion and vote regarding the Bylaws committee’s (A-1) D. Huntsman reported that the committee met on 2.9.17 (County Counsel attended meeting) and on 3.2.17. The Bylaws were reviewed by County Counsel and the Grantee on 3.6.17 and 3.9.17. The draft Bylaws were mailed, emailed and posted on the Council Website to Council members, Council Partners and for public view on April 13, 2017. Allowing at least 10 days for review. There was a motion to approve the Council Bylaws. M/S/C: D. Huntsman, J. Taylor – No Abstention

4.2 Discussion and vote regarding the CDC’s recommendation to submit to J.

Goodro to the Chief Elected Official for approval and appointment to the Planning Council.

J. Taylor reported that the committee is recommending Justin Goodro for Council membership. Mr. Goodro brings following resources to the Council: He is a Certified Peer Support Specialist in Riverside County; Mental Health Resources/Knowledge and Substance Abuse Resources /Knowledge. He has also completed the Board of Supervisor Application There was motion to approve CDC recommendation to submit to the Chief elected official J. Goodro for Council membership. M/S/C: J. Taylor, C. Bridges-Cobb – No Abstentions

4.3 Discussion and vote regarding the CDC’s recommendation to submit S. Cromwell-Nieve to the Chief Elected Official for approval and appointment to the Planning Council.

J. Taylor reported that the committee is recommending Shelia Cromwell-Nieve for Council membership representing Riverside County. Ms Cromwell vacated her seat in San Bernardino County, when she moved to Riverside County. There was a motion to approve the CDC recommendation to submit Sheila Cromwell-Nieve to the Chief Elected official for approval for Council membership. M/S/C: J. Taylor, A. Jacobson – No Abstentions

4.4 Discussion and vote regarding the Finance committee’s recommendation to approve the 2017/2018 Planning Council Budget. (A-2)

A. Jacobson reported that the committee met and reviewed the Council’s Fiscal Year 2016/2017 expenses and finalized the fiscal year 2017/2018 budget. The budget includes the staff changes for the new Council staff contract and Council outreach and advocacy activities. There was a motion to approve on contingency of review 60-90 day the 2017/2018 Planning Council Budget. M/S/C: A. Jacobson, J. Taylor – No Abstentions

4.5 Discussion and vote regarding the Standards committee’s recommendation to approve the revised Housing Standard. (A-3)

J. Chan reported that the committee met on 3.16.17 and discussed the new HRSA definition on Housing Services. The committee did not see a need to revise any existing services but wanted to revise the Housing Standard to include the revised HRSA definition. There was one public comment from A. Brazier, Housing Coordinator from FAP suggesting that the Standards committee re-visit the Housing Standards in future meetings. There was a motion to approve the Standards Committee’s recommendation for the revised Housing Standard. M/S/C: J. Chan, J. Taylor – No abstentions

4.6 Discussion and vote regarding the Standards committee’s recommendation to approve the Medical Nutritional Therapy Standard. (A-4)

J. Chan reported that the committee met on 3.16.17 and 3.30.17 to discuss the newly funding Medical Nutrition Therapy (MNT) Standard. The committee received input from local nutritionist and from other planning councils that fund the (MNT) standard. The standard complies with both Federal and State guidelines. Since this is a new standard the committee will review status in 3-6 months. B. Flippin with RWP gave an update of their monitoring of RW providers and suggested that some of the language be changed and deleted in order to make clear the roles of staff and services. There was a motion to approve the Standard Committee’s recommendation to approve the Medical Nutritional Therapy Standard as revised. M/S/C: J. Chan, A. Jacobson. Z. Weldon, D. Huntsman abstained.

4.7 Discussion and vote to approve the request for the following data report from Ryan White for the 2017 Priority Setting and Resource Allocations Summit. (Client Profile, Dashboards, Resource Gaps, Epidemiology)

There was a motion to approve the data report request from Ryan White for the 2017 Priority Setting and Resource Allocation Summit. (Client Profile, Dashboards, Resource Gaps, Epidemiology. M/S/C: J. Chan, C. Bridges-Cobb – No abstentions

5. Reports (limited to 5 min.) 5.1 Committee Reports

• Empowerment C. Smith reported that the committee met on 3.2.17 and 3.16.17. The committee was updated on the Provider Town Hall that was held November 30th.

22 people attended Speaker: Dr. Farabi – Infectious Disease Specialist and HIV Hospitalist, Discussion topic: Social Determinants of Care Important to understand Provider Limitations when receiving care

L. White

• Specialty services can’t provide all care. i.e.- housing services staff are not qualified to provide medical care. They are also very limited in their ability to provide ancillary services; acknowledge the need for HIV patient peer support

o Need to examine impact on Long term survivors: impact of years on meds & the feeling of isolation and loss

The committee reviewed and revised its 2017 workplan Next Town Hall will be on May 24th in the City of Perris (see flyer) Time 5:30pm to 7:30pm Topics

• Women of Color and HIV • Transgender Individuals • Serodiscordant Relationships • Disclosure and Safe Places

The committee is working on a directive to provide information to Ryan White Providers about the Planning Council goals and objectives.

• Finance – No Report • CCC – No Report • CDC/EAM – No Report • Bylaws – No Report • Planning – No Report • Standards – No Report

5.2 Ryan White Program (A-5) B. Flippin announced that the RW program has a new Statistical Analyst, Laura Moore. Her first day was March 18th, 2017. L Moore is the ARIES go-to person and she will provide leadership around all projects related to data analysis. Per IEHPC request, the program is in the process of submitting approval for a core service waiver for FY 17/18 to allow expenditures for Support Services over and above the 25% legislative limit. The competitive RFP process for the next 3-year RWP contract period has been completed and all contracts are in place (Part A and B). One new/returning contract (Inland AIDS Project) had to be terminated within the first month due to agency closure (no funds had yet been spent). Therefore, Part A contracts consist of all returning agencies and Part B contracts consist of two returning and one new agency.

5.3 State Representatives (A-6) No Report 5.4 Planning Council Staff Report (A-7)

A. Fox referred Council members to review her report that was in the agenda packet.

RFP for Support Staff update – Daniel Perez, MSW, MPA Division Chief of Disease Control, San Bernardino County Public Health.

Dr. Ohikhuare provided an update on the HIV Planning Council Support Staff Transition The Council Support Staff RFP closed on February 24, 2017. There were no submissions for the RFP. The Department staff then moved forward with a No-Bid contract with Unity Social Justice Center, Directed by Reverend Benita Ramsey. Reverend Ramsey met with members of the Executive committee on March 21, 2017 to share her background and experience with the HIV community. The contract is currently being processed by Human Services in order to be Agendized at a upcoming Board of Supervisors meeting. Tentative start date June 1, 2017.

Dr. Ohikhuare asked Reverend Ramsey to introduce herself.

6. Public Comments1 Y. Saenz express his concern that there is no needle exchange program in the Inland Empire. He expressed the need for an increase of the amount allocated for grocery vouchers and other food options for low income individuals, especially in the rural areas. A. Lopez was concerned about the Conduct of some Council members who are very abusive to staff outside the Council meetings.

Public

7. Members Privilege Dr. Ohikhuare updated the Council that due to the lack of eligible Council members no election would be held at this meeting. C. Smith shared that at the CPG meeting he was informed by M. Katz that the Council’s interpretation of “affiliated consumer” differs from HRSA’s. M. Katz added that HRSA does not restrict consumer’s being on Boards of Part B or C providers but restrictions do apply to Part A providers.

PC Members

8. Review of Action Items Staff will:

• Mail Council membership application to Denise with OS • Process Bylaws in order to be Agendize on Board of Supervisor

meeting. • Process J. Goodro and S. Cromwell-Nieve paperwork and submit to

CEO office via the Clerk of the Board • Send copy of FY budget to RWP • Send Copy of revised Housing and MNT standard to RWP and post on

Council website • Send Data report request to RWP • Agendize Housing on next Standard committee agenda • Agendize letter requesting reason for membership denial to BOS on

CDC agenda

PC Staff

9. Agenda Setting for Next Meeting June 29, 2017

County of San Bernardino Department of Public Health

Lloyd White


2:59 pm 11. Adjournment Lloyd White

1 Public Comments: Any member of the public may address this meeting on items of interest that relate to the Ryan White CARE Act by completing a speaker slip to indicate their interest in addressing the Planning Council. A three-minute limitation will normally apply to each member of the public who wishes to comment, unless waived by the Chair. 2 The agenda item may consist of a discussion and a vote. Public comments can be made prior to each Planning Council vote. * Members must be present at both roll calls to receive credit for meeting attendance. ** Copies can be obtained at the I.E.H.P.C. office and will be available at the meeting. Requests for special accommodations (e.g., language translation) must be received 72 hours prior to the date of the meeting. Contact PC Support at (909) 693-0750. All meetings of the Planning Council and its committees are open to interested parties from the general public. Notices are posted in compliance with the California Brown Act. Information regarding Planning Council meetings, and/or minutes of meetings are public records and are available upon request from the Planning Council Support Staff by calling (909) 693-0750 or by visiting the website

2017 Priority Setting & Resource Allocations Data Summit Tuesday and Wednesday July 25- July 26, 2017

Crestmore Manor 4600 Crestmore Road Jurupa Valley, CA 92509 (Or First Congregational Church 3041 N Sierra Way SB, CA 92405)

(This facility is in full compliance with the Americans with Disabilities Act of 1992)

AGENDA Day 1 – Tuesday, July 25th (Or Wed. 26th) (9:00 am – 5:00 pm)

Please bring your PS&RA Summit binder each day. Please take rolling breaks as needed.

9:00am Call to Order Welcome, Introductions, Announcements and Roll Call Vice Chair Mission, Vision, Guiding Principles & Shared Values PC Support Staff Code of Conduct PC Support Staff

Members Privilege Vice Chair Instruction for Public Comments Vice Chair

Public Comments Members of the Public

Ryan White Program Overview (RWP) Ryan White Staff Eligibility & Allowable Use of Funds History of Reallocations & Expenditures Future of Healthcare - Changes to Consider

PLWH/A in Riv/SB TGA Ryan White Staff

Epidemiology RWP Client Profile

GAP Analysis Dashboards

Instructions for Development of Directives PC Support Staff

12:00-1:30pm Lunch - Consumer Caucus of Ideas and Gaps (Lunch provided to registered attendees only - Event Brite)

Instruction for Public Comment PC Support Staff Additional Priority Setting Considerations PC Support Staff

Review of the Continuum of Care C. Smith Integrated Plan and Needs Assessment Review J. Chan Consumer Caucus Report PC Support Staff

PS&RA Process & Instructions PC Support Staff

Priority Setting Decision-Making Tools 2017-18 Prioritized Svc Categories ,(refer to binder appendix)

Review of 2017-18 Funded Service Priorities Prioritize/Approve Service Categories for FY 18-19 Note: Public comments will be interspersed within the Prioritizing Service Category discussion

5:00pm Recess

Attachment A-2

2017 Priority Setting & Resource Allocations Data Summit

AGENDA Day 2 – Wednesday, July 26th (Or Thurs 27th) (9:00 am – 5:00 pm)

Please take rolling breaks as needed.

9:00 Call to Order Welcome, Introductions, and Roll Call PC Support Staff Reconvene / Housekeeping Instruction for Public Comment Code of Conduct

Resource Allocations Process and Instructions

Conflict of Interest PC Support Staff Funding Percentages RWP Staff

Develop and Approve Final Allocations Planning Council

Note: Public comments will be interspersed within the Resource allocation discussion

12:00-1:00pm Lunch

(Lunch provided to registered attendees only - Event Brite)

Instruction for Public Comment PC Support Staff Develop and Approve Final Allocations Cont’d. Next Steps Planning Council

Post Award Instructions – Direct RWP to apply proportions to the final grant award

Instruct Planning Committee to Refine Directives Members Privilege Vice Chair

Public Comments Vice Chair Reminder – Evaluation of PSRA 5:00 Adjourn

Priority Setting and Resource Allocation Consumer Caucus

July 26, 2017

Caucus Agenda

What is the Council and the PSRA?

Why are you here?

Why is it important to you?

What are the 4 most important issues for you?

Attachment A-3

The Ryan White Program Invites all Clients/Consumers to the:

2017

Priority Setting & Resource Allocation Summit

Consumer Caucus

July 26, 2017 12:00pm-1:30pm

Crestmore Manor

4600 Crestmore Road Jurupa Valley, CA 92509

Let your Voice Be Heard!

Please RSVP at: [email protected] or Eventbrite: Https://www.eventbrite.com/edit?eid=35586232379 Lunch will be served. Please RSVP.



First Congregational United Church of Christ 3041 N Sierra Way



Attachment A-4

mailto:[email protected]

http://www.iehpc.org/


PS&RA Training

Thursday, July 13, 2017 9am-12pm

Meeting Location



This facility is in full compliance with the American with Disabilities Act of 1992.

Agenda 9:00am 1. Call to Order

Roll Call* Introductions

L. White

2. Approval of Agenda2

3. New Business2

3.1 Training Components I. Conflict of Interest,

II. Directives, III. PS&RA Process IV. Ryan White Client Profile Reports V. How to Read Data Reports

VI. Question and Answer

PC Staff

4. Public Comments1

L. White

5. Members Privilege PC Members

6. Review of Action Items PC Staff

Riverside/San Bernardino California Transitional Grant A

First Congregational United Church of Christ – Haskell Hall 3041 N Sierra Way


Website: www.iehpc.org Attachment A-5


12:00pm 8. Adjournment L. White

1 Public Comments: Any member of the public may address this meeting on items of interest that relate to the Ryan White CARE Act by completing a speaker slip to indicate their interest in addressing the Planning Council. A three-minute limitation will normally apply to each member of the public who wishes to comment, unless waived by the Chair. 2 The agenda item may consist of a discussion and a vote. Public comments can be made prior to each Planning Council vote. * Members must be present at both roll calls to receive credit for meeting attendance. ** Attachment was not available at time of printing, but will be available at the meeting. Requests for special accommodations (e.g., language translation) must be received 72 hours prior to the date of the meeting. Contact PC Support at (909) 388-0426. All meetings of the Planning Council and its committees are open to interested parties from the general public. Notices are posted in compliance with the California Brown Act. Information regarding Planning Council meetings, and/or minutes of meetings are public records and are available upon request from the Planning Council Support Staff by calling (909) 388-0426 or by visiting the website http://www.iehpc.org. Servicios en Español: Notificación para servicios de intérprete deben de someterse setenta y dos horas de anticipo. Por favor llame (909) 388-0426.

San Bernardino County June 29, 2017 Board of Supervisors Dear Sirs and Madams: Recently, the Inland Empire HIV Planning Council forwarded to the Board of Supervisors (BOS) its recommendation for Terry Evans to rejoin the Planning Council as a consumer member. Mr. Evans had already served on the Planning Council for 8 years, distinguishing himself with his dedication, extensive knowledge of the Ryan White funding process, Planning Council history, and serving several years as its Community Co-Chair. The Board of Supervisors denied Mr. Evans’ appointment without providing the Planning Council any rationale for its decision. Planning Council consumer members are volunteers who must submit to a lengthy process which requires that they attend numerous meetings, be interviewed by the Planning Council’s Council Development Committee, receive its approval, and be forwarded for a vote and approval of their membership from the full Council before that recommendation is then sent to the BOS for your final approval. The Planning Council needs to know what the BOS considers disqualifying criteria for candidates, so that the Council and the HIV consumers do not waste months of time and effort if the BOS deems them unsuitable for Council membership. Therefore, we ask the following:

1. The Board of Supervisors provide its rationale for not approving the appointment of Terry Evans to the Inland Empire HIV Planning Council.

2. The Board of Supervisors provide the criteria that would disqualify prospective Planning Council members for Board of Supervisor approval, so that the Council and the HIV consumers themselves do not waste months of time and effort if the BOS deems them unsuitable for Council membership.

We thank you for your consideration. Sincerely, Lloyd White Interim Community Co-Chair




Riverside/San Bernardino California Transitional Grant Area Maxwell Ohikhuare, MD Lloyd White County Health Officer Co-Chair Interim Community Co-Chair

Attachment A-6

Financial Eligibility Criteria. RWP rev’d 6.9.16; IEHPC approved 6.23.16. Page 1 of 1

Effective: March 1, 2016

Ryan White Program (Part A and Part A MAI) Financial Eligibility Criteria

***NOTE: Please refer to the entire set of Standards of Care for complete eligibility criteria.

CORE SERVICE CATEGORY FINANCIAL ELIGIBILITY CRITERIA1

Outpatient/Ambulatory Medical Care Total income < 400% of Federal Poverty Level

AIDS Pharmaceutical Assistance (local) Total income < 400% of Federal Poverty Level

Oral Health Total income < 400% of Federal Poverty Level

Home and Community Based Health Services Total income < 400% of Federal Poverty Level

Mental Health Total income < 400% of Federal Poverty Level

Medical Case Mgmt. (Including tx adherence) Total income < 400% of Federal Poverty Level

Substance Abuse Outpatient Total Income < 400% of Federal Poverty Level

Early Intervention Services Total Income < 400% of Federal Poverty Level

Medical Nutrition Therapy Total Income < 400% of Federal Poverty Level

SUPPORT SERVICE CATEGORY

Case Management (Non Medical) Total income < 300% of Federal Poverty Level

Food Total income < 150% of Federal Poverty Level

Housing Services Total Income < 300% of Federal Poverty Level

Medical Transportation Total income < 200% of Federal Poverty Level

Psychosocial Support Total income < 200% of Federal Poverty Level

1 Federal Poverty Guidelines: • Refer to the most current poverty guidelines at http://aspe.hhs.gov/poverty. • In the Riv/SB TGA, the Federal Poverty Guidelines should be applied to a “family”. • “Family” is defined by the Department of Health and Human Services as “a group of two or more

persons related by birth, marriage, or adoption who live together; all such related persons are considered as members of one family. For instance, if an older married couple, their daughter and her husband and two children, and the older couple's nephew all lived in the same house or apartment; they would all be considered members of a single family.”

• If an individual does not fit this definition, and is not in a legal, domestic partnership, their income may be considered a separate “family” income.

Attachment A-7

http://aspe.hhs.gov/poverty

Early Intervention Services. IEHPC Approved 02.24.2011 Page 1 of 4


EARLY INTERVENTION SERVICES

INLAND EMPIRE HIV PLANNING COUNCIL STANDARDS OF CARE RIVERSIDE / SAN BERNARDINO TRANSITIONAL GRANT AREA

RYAN WHITE HIV/AIDS PROGRAM This document offers a limited set of focused standards addressing key aspects specific to this service category. Other relevant standards, including the Common Standards, as well as other policies, recommendations and guidelines should be referenced in conjunction with this standard. Purpose of Standards These service and care standards are prescribed by the Inland Empire HIV Planning Council (IEHPC). The purpose of these standards is to establish a minimum set of quality expectations to ensure uniformity of service funded by the Health Resources and Services Administration (HRSA) under the Ryan White HIV/AIDS Program legislation across the Riverside/San Bernardino Transitional Grant Area (R/SB TGA). These standards are to be monitored and enforced by means of incorporation into service provision contracts managed by the Ryan White Program (RWP) Office on behalf of the IEHPC, as provided by the Ryan White HIV/AIDS Program legislation and HRSA policies, guidance, and other requirements. Definition of Service (HRSA)

Early intervention services (EIS) include counseling individuals with respect to HIV/AIDS; testing (including tests to confirm the presence of the disease, tests to diagnose to extent of immune deficiency, tests to provide information on appropriate therapeutic measures); referrals; other clinical and diagnostic services regarding HIV/AIDS; periodic medical evaluations for individuals with HIV/AIDS; and providing therapeutic measures.

I. Care and Treatment Goal(s) The goal of EIS is to decrease the time between the acquisition of HIV and entry into the medical care system, thereby ensuring early access to HAART, decreasing transmission rates, and improving health outcomes. II. Service Goal Quickly link HIV infected individuals to testing services, core medical services, and support services necessary to support treatment adherence and maintenance in medical care.

Attachment A-8



A. Service Objectives 1. Identify those that are unaware of their HIV infected status, placing

emphasis on those known to be at disproportionate risk for HIV infection and those considered to be at high-risk, and informing them of their status

2. Identify those that are HIV infected that have fallen out of care (“unmet need”)

3. Inform unaware and “unmet need” HIV infected individuals of service options

4. Refer unaware and “unmet need” HIV infected individuals to medical services

5. Link unaware and “unmet need” HIV infected individuals to medical services

B. Description of Services Service Components

1. Conduct in depth, one-on-one encounters that are planned and delivered in coordination with local HIV prevention outreach programs to avoid duplication of effort.

2. Connect/reconnect HIV infected individuals into care utilizing the “Bridge” program as the model.

3. Establish and maintain formal linkages with entities that perform effective outreach with persons found to be disproportionately impacted by HIV or with persons who, by virtue of geographic location or circumstance, have disproportionately less access to care (e.g. prisons, homeless shelters, substance abuse treatment centers, counseling and testing sites, and areas of high-risk sexual activity)

4. Establish and maintain formal linkages with entities that do not traditionally target high risk populations (e.g. community centers, faith based locations/organizations, hospitals, clinics, other nontraditional outlets).

5. Link unaware HIV infected individuals to HIV counseling and testing and, if found to be HIV infected, to other services necessary to maintain/improve health outcomes, including Medical/Non Medical Case Management

6. Identify barriers and refer “unmet need” HIV infected individuals to services necessary to maintain/improve health outcomes, including Medical/Non Medical Case Management.

7. Provide education and informative materials regarding the availability of testing and HIV/AIDS care services to individuals in need of HIV/AIDS information such as those at-risk, those who are HIV positive, those affected by HIV, and caregivers.

8. Utilize the standardized Enrollment Form and Progress Form to document entry into the EIS program and track and report progress. Standard Committee Recommendation: Strike the prior statement as this is creating a barrier to care for clients.

9. Maintain up-to-date, quantifiable data that will accommodate local



effectiveness evaluation and reporting. Evaluation, documentation, and reporting will demonstrate a continuum of client health outcomes improvement from initial encounter and identification to testing and counseling to entry and maintenance in care. Data will include number of encounters by demographics including race/ethnicity, gender, age, risk category, insurance type(s)(when possible), service area(s), and linkages to care including linkages to programs that provide continued monitoring of client in care.

10. For MAI-funded EIS, develop and implement specific, evidence based outreach strategies proven effective in the identification and linkage to and maintenance in care of individuals from Minority populations who may or may not be aware of their HIV status including individuals who may not perceive themselves to be at risk of HIV.

11. If referred to EIS due to missed appointments, discharge from EIS must be agreed upon by all parties involved. A minimum of two disciplines must “sign off” on the discharge (e.g. EIS worker and Medical/Non Medical Case Manager). Ideally would also include Physician and/or Medical/Non Medical Case Manager in case conference.

C. Limitations 1. MAI EIS funds may only be utilized to serve HIV infected individuals

that are Black/African American and/or Hispanic/Latino. See Common Standards for additional MAI requirements.

2. Cash payments or the use of cash incentives for clients is prohibited. 3. Activities that exclusively promote HIV prevention education are

prohibited. 4. Broad scope awareness activities that address the general public (e.g.

poster campaigns for display on public transit, billboards, TV or radio announcements, social marketing electronic media.) may be funded provided that they are targeted and contain HIV information with explicit and clear links to testing and HIV health care services.

III. Service-Specific Staff Qualifications 1. EIS staff must be trained and knowledgeable about HIV/AIDS, current

resources, and eligibility requirements. 2. EIS staff may be peer educators. See Common Standards for training

requirements. 3. EIS staff must have significant experience in at least three of the

following six: street based outreach; HIV counseling and testing; prevention case management; psychotherapy or counseling; health education; HIV based case management. General qualifications include the ability to understand HIV transmission and prevention. HIV disease progressions, the basis of HIV medication and treatments (including issues of adherence), sexual behaviors, the dynamics of substance abuse and addiction, and behavior change therapy and interventions. Equally important is the ability to communicate and to educate clients with regards to managing these issues. EIS Staff must be reflective of the community served (i.e. African American and/or Hispanic/Latino for MAI EIS)



4. EIS staff must be reflective of the community served (i.e. Black/African American and/or Hispanic/Latino for MAI EIS)

5. Please refer to the Common Standards of Care for general staff qualification requirements.

IV. Exceptions and Urgent Need Please refer to the Common Standards of Care for guidance concerning exceptions and urgent need.

V. Reportable Units of Service and Financial Eligibility Please refer to the current service contract for a description of the unit of service and financial eligibility thresholds for each service category.

Psychosocial Support Services –RWP Rev’d 2-2-2012; IEHPC approved 02-23-12 Page 1 of 2


PSYCHOSOCIAL SUPPORT SERVICES

INLAND EMPIRE HIV PLANNING COUNCIL STANDARDS OF CARE RIVERSIDE / SAN BERNARDINO TRANSITIONAL GRANT AREA

RYAN WHITE HIV/AIDS PROGRAM This document offers a limited set of focused standards addressing key aspects specific to this service category. Other relevant standards, including the Common Standards, as well as other policies, recommendations and guidelines should be referenced in conjunction with this standard. Purpose of Standards These service and care standards are prescribed by the Inland Empire HIV Planning Council (IEHPC). The purpose of these standards is to establish a minimum set of quality expectations to ensure uniformity of service funded by the Health Resources and Services Administration (HRSA) under the Ryan White HIV/AIDS Program legislation across the Riverside/San Bernardino Transitional Grant Area (R/SB TGA). These standards are to be monitored and enforced by means of incorporation into service provision contracts managed by the Ryan White Program (RWP) Office on behalf of the IEHPC, as provided by the Ryan White HIV/AIDS Program legislation and HRSA policies, guidance, and other requirements.

Definition of Service (HRSA)

Psychosocial support services are the provision of support and counseling activities, child abuse and neglect counseling, HIV support groups, pastoral care, caregiver support, and bereavement counseling. Includes nutrition counseling provided by a non-registered dietitian but excludes the provision of nutritional supplements.

I. Care and Treatment Goal(s) To provide support and counseling regarding the emotional and psychological issues related to living with HIV to those affected directly and indirectly by HIV and to promote problem solving, service access and steps towards diseases self-management. II. Service Goal: To provide psychosocial support services through the delivery of individual and group counseling to persons living with HIV/AIDS and those otherwise affected by HIV/AIDS in the TGA in order to maintain them in the HIV system of care. A. Service Objectives:

Attachment A-9

Psychosocial Support Services –RWP Rev’d 2-2-2012; IEHPC approved 02-23-12 Page 2 of 2


1. To provide a central and dedicated support contact in order to address and minimize crisis situations and stabilize clients’ psychological health status so as to maintain their participation in the care system.

B. Description of Services

Service Components 1. Develop initial individual assessment. 2. When appropriate, this initial assessment must be made available for

development of the client’s Care Plan. Standards Committee Recommendation: Remove these 2 components to maintain the informal nature of the counseling relationship to help differentiate it from mental health treatment and counseling. This will also reduce barriers to the service. HRSA does not include this in their definition.

3. If a Care Plan is in place, the Care Plan should be reviewed and

incorporated into the delivery of Psychosocial Support. If a client receiving Psychosocial Support presents with additional service needs, these needs should be incorporated into the clients Care Plan, if they are ever in need of Medical Case Management.

4. Provide individual counseling session(s). Document service provision, goals, and progress.

5. Provide group counseling sessions(s). Document group service provision such as: topics/focus, participant names and HIV status, group duration, group type (open/closed), general group goals.

6. Provide allowable, needed services to family members and significant others in the client’s support system, with the goal of developing and strengthening the client’s support system to help maintain their connection to medical care.

7. Facilitate successful case conferencing sessions through direct participation and the provision of appropriate information.

8. Coordinate with and make referrals to both interagency and outside mental health professionals, as appropriate.

9. Coordinate with and make referrals to both interagency and outside nutritional support services, as appropriate.

C. Limitations

1. Excludes the provision of nutritional supplements. III. Service-Specific Staff Qualifications There are no prescribed staff qualifications specific to Psychosocial Support Services. Please refer to the Common Standards of Care for general staff qualification requirements. IV. Exceptions and Urgent Need Please refer to the Common Standards of Care for guidance concerning exceptions and Urgent Need. V. Reportable Units of Service and Financial Eligibility Please refer to the current service contract for a description of the unit of service and financial eligibility thresholds for each service category.

County of San Bernardino Department of Public Health Ryan White Program

Ryan White Program Report – June 2017

Each item will be discussed during the RW Program Report or where placed on the Council agenda.

1. Part A Expenditure Report Attachment A

Expenditure Report as of February 28, 2017

2. Part A Utilization Report Attachment B

Utilization Report as of February 28, 2017

3. Clinical Quality Management (CQM) Update

Unavailable for this month’s packet. Please contactRyan White Program office if you would like an updateon a particular CQM item.

4. Program/Report Highlights

We have received our full award for Program Year 17-18 ($7.71M).

Attachment A-10

p2172

Highlight

Ryan White Program Expenditure *Report June 2017

ATTACHMENT ACOLUMN A COLUMN B COLUMN C COLUMN D COLUMN E COLUMN F COLUMN G COLUMN H

Average Exp Per Expended Remaining % Expended Target %Month (12/12) YTD YTD YTD as of Feb, 17

Out/Amb Medical 446,658.00 37,221.50 351,768.00 94,890.00 78.76% 100.00% -21.24%

Mental Health 446,613.00 37,217.75 420,761.05 25,851.95 94.21% 100.00% -5.79%

Med Case Mgmt 856,233.00 71,352.75 826,101.90 30,131.10 96.48% 100.00% -3.52%

Substance Abuse 327,641.00 27,303.42 299,068.67 28,572.33 91.28% 100.00% -8.72%

Dental 1,278,625.00 106,552.08 1,114,545.83 164,079.17 87.17% 100.00% -12.83%

Home/Comm Based 170,613.00 14,217.75 110,676.53 59,936.47 64.87% 100.00% -35.13%

EIS - Part A 491,440.00 40,953.33 477,171.26 14,268.74 97.10% 100.00% -2.90%

Case Mgmt (non-Med) 769,559.00 64,129.92 744,530.97 25,028.03 96.75% 100.00% -3.25%

Food 419,333.00 34,944.42 351,425.00 67,908.00 83.81% 100.00% -16.19%

Housing 457,883.00 38,156.92 197,772.32 260,110.68 43.19% 100.00% -56.81%

Transportation 303,921.00 25,326.75 219,858.97 84,062.03 72.34% 100.00% -27.66%

Psychosocial 168,658.00 14,054.83 150,728.92 17,929.08 89.37% 100.00% -10.63%

EIS MAI 398,626.00 33,218.83 326,048.67 72,577.33 81.79% 100.00% -18.21%TOTALS 6,535,803.00 544,650.25 5,590,458.09 945,344.91 85.54% 100.00% -14.46%

Column AColumn BColumn CColumn DColumn EColumn FColumn G

Column H Variance between Optimal Percent and Acutal Percent of funds expended. Formula = Column G - Column F

Actual year-to-date expenditures of RWP Part A services as reported by RWP Part A providersActual year-to-date of amounts remaining. Formula = Column B - Column D

Allocations

Percentage of year-to-date of funds expended. Formula = Column D / Column BTarget Percent that should be expended (ex: July is the 5th month of program yr, 5/12=41.67%)

VarianceService Category

Current funded RWP services established by IEHPC at PSRACurrent RWP service allocations established by IEHPC at PSRA Estimated monthly expenditure amounts based on entire allocations. Formula = Column B / 12

LEGEND

*Created by RWP Staff 6/19/17 includes invoices rec'd as of 02/28/17 mls

Ryan White Program Expenditure *Report June 2017

ATTACHMENT A

0.00%

20.00%

40.00%

60.00%

80.00%

100.00%

120.00%Target 100.00%

*Created by RWP Staff 6/19/17 includes invoices rec'd as of 02/28/17 mls

Service CategoryPlanned

UnitsActual Units

Delv'd*% of Total Units

Delv'd vs. PlannedTarget % For This

Time of Year Variance From

TargetOut/Amb Medical 2,535 3,023 119% 100% 19.3%Mental Health 12,508 22,061 176% 100% 76.4%Med Case Mgmt 12,479 17,705 142% 100% 41.9%Substance Abuse 25,933 21,549 83% 100% -16.9%Dental 22,925 17,001 74% 100% -25.8%Home/Comm Based 9,285 10,952 118% 100% 18.0%Case Mgmt (non-Med) 29,624 40,603 137% 100% 37.1%Food 37,843 33,473 88% 100% -11.5%Housing 4,762 7,213 151% 100% 51.5%Transportation 10,747 13,452 125% 100% 25.2%Psychosocial 14,476 13,283 92% 100% -8.2%EIS Part A 18,745 14,887 79% 100% -20.6%EIS MAI 24,247 17,265 71% 100% -28.8%

Service CategoryPlanned Clients

Actual Clients Served*

% of Total Clients Served vs. Planned

Target % For This Time of Year

Variance From Target

Out/Amb Medical 218 185 85% 100% -15%Mental Health 265 307 116% 100% 16%Med Case Mgmt 1,114 1,250 112% 100% 12%Substance Abuse 283 320 113% 100% 13%Dental 1,188 1,041 88% 100% -12%Home/Comm Based 12 14 117% 100% -17%Case Mgmt (non-Med) 2,409 2,235 93% 100% -7%Food 811 852 105% 100% 5%Housing 346 555 160% 100% 60%Transportation 1,003 1,155 115% 100% 15%Psychosocial 256 239 93% 100% -7%EIS Part A 3,868 3,700 96% 100% -4%EIS MAI 4,205 4,067 97% 100% -3%

SERVICE UNIT DELIVERY

CLIENT DELIVERY

ATTACHMENT BRyan White Program Utilization Report June 2017

185 307

1,250

3201,041 14

2,235

852 5551,155

239

3,7004,067

0500

1,0001,5002,0002,5003,0003,5004,0004,500

Actual Clients Served* Planned Clients

0%

20%

40%

60%

80%

100%

Green Bar = % of Total Clients Served vs. Planned

Black Bar = Target %

Maxwell Ohikhuare, MD Lloyd White County Health Officer Co ... · D. Huntsman reported that the...

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