San Francisco Ryan White Part D Women, Infants, Children, and Youth - - PowerPoint PPT Presentation

San Francisco Ryan White Part D

Women, Infants, Children, and Youth with HIV/AIDS ( HIV + WICY)

Bill Blum Chief Operating Officer, Community Oriented Primary Care Director, HIV Health Services

Federal Ryan White Funding Categories

The Ryan White legislation created a number of programs, called Parts, to meet needs for different communities and populations affected by HIV/AIDS. Each is described below:



Part A provides emergency assistance to Eligible Metropolitan Areas and Transitional Grant Areas that are most severely affected by the HIV/AIDS epidemic. Within Part A, Minority AIDS Initiative (MAI) provide core medical and related support services to improve access and reduce disparities in health outcomes in metropolitan areas hardest hit by the epidemic.



Part B provides grants to all 50 States, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, and 5 U.S. Pacific Territories or Associated Jurisdictions. Additional Part B funds are "earmarked" for State AIDS Drug Assistance Programs (ADAP), which primarily provide

• medications. Under Part B, MAI fund outreach and education services designed to increase minority

access to ADAP.



Part C provides comprehensive primary health care in an outpatient setting for people living with HIV disease. Under Part C, MAI funds are used by community health centers and other service providers to improve access to early intervention HIV/AIDS services.



Part D provides family-centered care involving outpatient or ambulatory care for women, infants, children, and youth with HIV/AIDS ( HIV + WICY)



Part F provides funds for a variety of programs:



The Special Projects of National Significance Program grants fund innovative models of care and supports the development of effective delivery systems for HIV care.



The AIDS Education and Training Centers Program supports a network of 11 regional centers and several National centers that conduct targeted, multidisciplinary education and training programs for health care providers treating people living with HIV/AIDS.



The Dental Programs provide additional funding for oral health care for people with HIV.

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Ryan White Part C & D Consolidation Proposal

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 Health Resources & Services Administration (HRSA)

is currently soliciting feedback on the proposed 2015 consolidation of the RW Parts C & D.

 Rationale is to lessen administrative burden. However will

result in less protection for HIV+ WICY specific funding and service levels.

 Proposing an additional $4 Million funding level. May or

may not be off set by expanded eligible applicant pool.

 Final budget appropriation awaiting Congressional

approval.

 Final Funding Announcement not expected before

the fall of 2014, but HRSA/HAB doing concurrent RFP planning.

HIV in SF WICY Population

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Women 25+ Transgender Women Youth 13-24 Children 2-12* ‘08 ‘09 ‘10 ‘08 ‘09 ‘10 ‘08 ‘09 ‘10 ‘08 ‘09 ‘10 Living w/ AIDS 504 539 546 192 195 202 38 34 93** 2 2 2 Living w/ HIV non-AIDS 386 360 365 149 148 151 161 178 n.a. 4 3 Living w/ HIV/AIDS 890 899 911 341 343 353 199 212 202 6 2 5 Newly reported HIV non- AIDS 37 28 29 10 12 10 43 52 53 Newly reported AIDS 40 23 15 9 9 10 13 n.a. n.a.

Sources: SF Department of Public Health HIV/AIDS Epidemiology Annual Reports, 2008-2010

• Because of the zero-prevalence of infant infection in SF over the past three years, infants and

children under the age of 12 were not included in the above table.

• n.a. = statistics for this age range not available

**For this cell, youth aged 13-29 were used, as that was the available number for the time period

Social Context of SF: In HIV+ WICY Compared with Overall HIV+ and General Population

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HIV + WICY HIV+ General Pop. Racial/ethnic minorities 59% 37% 58% Adolescents (ages 13 to 24) 7% 2% 13%* Homeless 35% 8% 2% Uninsured 40% 25% 8% Underinsured 51% 46% 23% Illegal drugs and/or alcohol abuse 73% n.a. 10% Unemployed 78%** n.a. 9% Primary language (non-English) 12% 22% 35% Live below 100% of the FPL 72% 17% 11%

Source: SFDPH - HIV/AIDS Epidemiology Annual Report, 2010, *Approximated based on 2010 census data—broken down 10-14, 15-19, 20-24. **Rates only available for youth.

San Francisco RW Part C Grantee

San Francisco Community Clinic Consortium (SFCCC)

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 HIV/AIDS program is operated in

partnership with SFCCC health clinics and SFDPH clinics.

 A continuum of services is

provided including primary medical care, medication adherence support, dental/oral health care, nutritional assessments and counseling, substance abuse and mental health assessments and referrals.

 Calendar year 2013 served 600

UDC

 Funding level of $820,000/year

 RW Part C Grantee: SFCCC

Subcontractors: (7)

 Tom Waddell Urban Health

Center (SFDPH)

 South of Market Health

Center

 HealthRight 360  Larkin Street

Youth Services

 Lyon-Martin Clinic  Mission Neighborhood Health

Center

 Native American Health

Center

San Francisco RW Part D Grantee Family Service Network (FSN) Members

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

RW Part D Grantee: UCSF Positive Health Program (PHP/Ward 86) @ SFGH

Subcontractors: (7)



Family HIV Clinic (FHC) @ SFGH



South Van Ness Adult Behavioral Health Services (SVNABHS)/SFDPH



Bay Area Perinatal AIDS Center (BAPAC)/UCSF



UCSF Women's HIV Program (WHP)



Larkin Street Youth Services Aftercare Program (LSYS)



Catholic Charities Catholic Youth Organization Rita da Cascia Program (RdC)



Substance Abuse Outpatient Program(STOP)/SFAF

FSN – Service Provision

 PHP/Ward 86: Primary & specialty medical care with onsite case management,

social work, treatment adherence, psychiatry and clinical trials.

 BAPAC: Comprehensive preconception counseling and prenatal care for HIV+

women.

 FHC: Primary & specialty medical care for HIV+ people and their affected family

members with on-site nutritionist, social worker and pharmacist.

 LSYS: Comprehensive on-site medical care, case management, peer advocacy and

housing for HIV+ youth (18-24 years of age).

 RdC: Case management, housing, support groups for families and community

building activities.

 SVNABHS : Individual, group and couples psychotherapy, psychiatric services, and

clinical case management for those living with HIV.

 STOP: Outpatient substance abuse treatment for HIV+ individuals.  WHP: Primary & specialty medical care with onsite case management, social work,

treatment adherence and psychiatry.

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FSN – Target Populations

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 The targeted population is San Francisco HIV-positive

WICY.

 The population includes increasing numbers of women of color,

particularly African-Americans and Latinas.

 Transgender and older women across all racial and ethnic

groups.

 Homeless youth, and gay and bisexual young men.  The vast majority of these individuals live in poverty, are

homeless or in marginal housing, have experienced trauma, and face complex substance use and mental health issues.

 The Network expects to serve 400 WICY utilizing Part D

funds.

FSN – RW Part D Funding Levels

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FY 13-14 FY 14-15* PHP $103,803 $95,498 BAPAC $16,757 $15,416 FHC $50,323 $46,297 LSYS $22,979 $21,141 RdC $110,929 $102,055 SVNABHS $97,531 $89,729 STOP $20,399 $18,767 WHP $72,811 $66,986 Total Grant Amount $495,532 $455,889

*11 month contracts that end June 30, 2015

Next Steps for 2015 Pending Consolidation

• f RW Part D Funding Into RW Part C

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 SFDPH - HHS maintains service continuum for

HIV+ WICY services potentially utilizing RW Part A & B and General Funds to wrap around RW Part C funding shortages.

 SFDPH in conjunction with SFCCC, UCSF and

community partners determine best strategies for SF application for RW Part C funding.