Ryan White Part A Program Las Vegas TGA Introduction Bridget - - PowerPoint PPT Presentation

Comprehensive Needs Assessment 2018 Ryan White Part A Program Las Vegas TGA

Introduction

• Bridget Kelly, Doctoral student, Criminology and Criminal

Justice

• Cannon Survey Center Manager, Part-time Instructor
• Pet, swing dance, and bonsai enthusiast
• Interests arising from Ryan White collaboration:

– HIV in the South/ in prisons; harm reduction

Background

• Work began in May 2018
• Survey instruments were developed collaboratively with the

Recipient Office

• Both surveys were built in Qualtrics
• Consumer Survey was translated into Spanish
• Survey team was trained on confidentiality and referrals
• Provider Survey Data Collection (optional and anonymous)

– June 27 through July 25, 2018

• Consumer Survey Data Collection ($5.00 gift card)

– July 2 through August 14, 2018

Presentation Outline

• Part One: Provider Survey
• Part Two: Consumer Survey

Provider Survey Data Collection

• Providers

–Self-administered online –Recruited by email, group announcements –55 survey respondents; 16 agencies invited

Providers: Respondent Profile

• 38% case managers/social workers
• 20% program managers/supervisors
• 1/3 spend over 50% of time with clients
• 60% have worked with HIV/AIDS population for 5 years or less
• 71% have worked with agency for 5 years or less

Providers: Agency Profile, Type

54.7% 39.6% 22.6% 20.8%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%

AIDS service

• rganization

Medical provider Mental health provider Public health clinic Type of Organization

Providers: Agency Profile, Funding

90.6% 56.6% 37.7% 26.4% 24.5%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0%

Ryan White Part A Funding Ryan White Part B Funding Federal/State Government Contributions/Private Donations Revenue (fees)

Funding Streams

Providers: Agency Profile, Languages

• 85% foreign translation services available (typically Spanish, French, Amharic)

75.5% 64.2% 64.2% 34.0%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0%

Currently have bi- lingual staff on hand Language line Ensuring translators are provided by an

• utside company/
• rganization

Translating patient material into lanugages besides English

Translation Services

Providers: Agency Profile, Access

• 98% near public transportation

100.0% 13.7% 5.9%

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

Weekday hours (8am to 5pm) Weekday evening hours (After 5pm) Weekend hours Agency Hours of Operation

Providers: Capacity

76.5% 66.7% 21.6% 17.6%

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

An increase in demand for services from clients? An increase in the number of clients seeking services? A decrease in the amount of funding your agency receives from any funding stream? A decrease in the amount of funding provided from private donations? Changes in Demand and Funding

Providers: Capacity and Agency Needs

62.0% 58.0% 32.0% 26.0%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%

Funding to expand current capacity Funding to develop new capacity Increased partnerships with HIV/AIDS specialty agencies and

• rganizations

Training Agency Needs to Increase Capacity

Providers: Client Needs

25.0% 15.5% 12.9% 8.6% 7.8%

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0%

Housing/ Assistance to Homeless Mental Health/ Behavioral Health/ Substance Abuse Services Transportation Medical Care Case Management/ Coordination/ Assistance with Eligibility Client Needs Ranked by Number of Mentions (Top 5)

Providers: Ryan White Service Importance

68.0% 62.0% 60.0% 54.0% 52.0%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0%

Early Intervention Services Medical Case Management Mental Health Services Emergency Financial Assistance Medical Transportation Most Important Ryan White Services (Top 5)

Providers: Agency Barriers

60.0% 36.0% 30.0% 30.0% 22.0% 22.0%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%

Clients routinely miss appointments Agency doesn't provide all the services a person needs Not enough resources at my agency Clients may have trouble getting to

• ur offices

Clients don't have payment source Insufficient staff to provide services

Agency Barriers to Service Provision

Providers: Wait Lists for Services

• 26% report a wait list for some services, typically

– Mental health services (2+ weeks) – Housing (months-year) – Specialty referrals (2-6 months) – Nutrition (3-4 weeks) – Vision/dental (1 month or more)

Providers: Suggested Improvements

• Support of eligibility processing
• Transportation
• Agencies/locations that can accommodate the full range of

services that clients need

• Coordination/communication between agencies
• Funding/resources/personnel

Questions

Consumer Survey Data Collection

• Consumers

–Self-administered online/mail + Interviewer-administered by phone –Recruited by phone, flyers, group announcements –199 survey respondents; 3,169 contacts attempted up to 3x, 943 received link –Incentive provided - $5 gift card for Smith’s Food & Drug

• 171 sent, 28 opted out

Consumers: Respondent Profile

• 199 respondents: 76% male, 76% age 45+
• 37.2% White/C, 28.4% Black/AA, 27.3% Hispanic/Latino

0.5% 7.2% 15.9% 35.4% 29.7% 11.3%

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0%

18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 and

• lder

Age

0.5% 1.1% 28.4% 27.3% 0.5% 37.2% 4.9% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0%

American Indian/Alaskan Native Asian Black/African American Hispanic/Latino Native Hawaiian/Pacific Islander White Multiple Races

Race/ethnicity

Consumers: General Service Needs and Challenges in Managing Health

• In your opinion, what is your most important service that helps you

manage your HIV status?

– Medication/medication assistance – Access to doctors, staff, and medical care

• What challenges/concerns did you have in the past 12 months

taking care of yourself?

– Financial constraints – Struggles with poor health – Inconsistency in medical care – Transportation

Consumers: Changes in Administration of Care

59.2% 10.9% 16.3% 13.6%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%

No changes A little change Some changes A lot of changes In the past year have there been any changes in the way HIV/AIDS care is administered?

Consumers: Difficulty Obtaining Treatment

66.1% 10.4% 15.1% 8.3%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%

No difficulty A little difficulty Some difficulty A great deal of difficulty To what extent have you had difficulty obtaining HIV/AIDS care and treatment that you need?

Consumers: Health Information Sources

76.1% 21.8% 15.2% 18.3% 38.6% 12.2%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0%

Clinic visit Service

• rganization

Support group Online (internet, Facebook, etc.) Case manager Other Where do you receive information about your HIV-related health?

Consumers: Travel Time to Health Provider

26.3% 34.8% 16.7% 22.2%

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0%

Less than 15 minutes 16 minutes to 30 minutes 31 minutes to 45 minutes More than 45 minutes On average how long does it take you to get from your home to your HIV doctor's

• ffice?

Consumers: Cultural Competence of Providers

7.3% 3.9% 8.4% 80.4%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%

Not at all A little Some A great deal Are the services you receive at your HIV doctor's

• ffice culturally competent?

Consumers: Experiences with Stigma

• In the past year, have you experienced stigma at your

treatment provider(s)?

– 92% indicated NO – 8% indicated YES

Consumers: Services Received

60.1% 57.2% 47.0% 42.6% 35.2%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%

Health Insurance Assistance Oral Health Care Medical Case Management Food Assistance Mental Health Services Received in the Past Year (Top 5)

Consumers: Services Needed, but Not Receiving

• Barriers include: Lack of awareness/availability of service,

transportation

45.5% 42.2% 29.1% 29.0% 26.4%

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% 50.0%

Oral Health Care Food Assistance Medical Transportation Emergency Financial Assistance Housing Assistance Services Needed Now, but Not Receiving (Top 5)

Consumers: Service Need, Regardless of Current Use

65.9% 54.0% 50.3% 42.9% 37.0%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%

Oral Health Care Health Insurance Assistance Food Assistance Medical Transportation Housing Assistance Services with Great Deal of Need (Top 5)

Consumers: Additional Services Needed, but Not Receiving

• Vision care
• Financial assistance
• Housing
• Specialty care

Conclusions and Recommendations

• High need and use:

– Oral health care – Transportation – Health insurance assistance

• High need (sometimes not receiving):

– Food assistance – Housing

• To address a common barrier (lack of awareness/help with

eligibility):

– Medical case management

Questions

Full Report

• Available from the Part A Recipient Office

Contact Information

• Bridget Kelly, MA – Cannon Survey Center Manager

– Bridget.Kelly@UNLV.Edu – (702) 895-5731

• Jonathan Basilio, MPH – Part A Quality Manager

– Jonathan.Basilio@ClarkCountyNV.Gov – (702) 455-5737