State Fiscal Year 2019 HIV Funding Peter DeMartino Prevention and - - PowerPoint PPT Presentation

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State Fiscal Year 2019 HIV Funding Peter DeMartino Prevention and - - PowerPoint PPT Presentation

Oct 27, 2023 225 likes •526 views

State Fiscal Year 2019 HIV Funding Peter DeMartino Prevention and Health Promotion Administration Center for HIV Prevention and Health Services June 19, 2018 PHPA MISSION AND VISION MISSION The mission of the Prevention and Health

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Peter DeMartino Prevention and Health Promotion Administration Center for HIV Prevention and Health Services June 19, 2018

State Fiscal Year 2019 HIV Funding

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PHPA MISSION AND VISION

MISSION

  • The mission of the Prevention and Health Promotion Administration is to protect,

promote and improve the health and well-being of all Marylanders and their families through provision of public health leadership and through community- based public health efforts in partnership with local health departments, providers, community based organizations, and public and private sector agencies, giving special attention to at-risk and vulnerable populations. VISION

  • The Prevention and Health Promotion Administration envisions a future in which

all Marylanders and their families enjoy optimal health and well-being.

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Resource Inventory

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Baltimore City Baltimore MSA MADAP $ 13,270,490 $ 23,937,037 Care Services $ 46,378,796 $ 50,346,252 HIV Prevention $ 15,044,412 $ 16,552,044 Total $ 61,909,251 $ 78,050,886 PLWH 12,384 17,307 $ per PLWH $ 4,999 $ 4,510

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Core Services - $8,383,806 (2018) - $20,973,331 (2019)

Service Category Number of Providers 2018 Number of Providers 2019 SFY 2018 Award SFY 2019 Award Percent Change Outpatient/Ambulatory Health Services 8 10 1,737,751 2,654,853 153% Oral Health 8 8 1,597,777 1,294,890 81% Early Intervention Services 5 15 468,799 12,467,612 2659% Medical Nutrition Therapy 3 3 183,074 195,524 107% Home and Community-Based Services 1 1 60,135 83,797 139% MCM 14 13 2,962,851 2,897,097 98% Mental Health 6 6 1,210,450 1,186,829 98% Substance Abuse Outpatient Care 2 3 162,969 192,729 118%

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Support Services - $7,262,480 (2018) - 7,457,402 (2019)

Service Category Number of Providers 2018 Number of Providers 2019 SFY 2018 Award SFY 2019 Award Percent Change Non-Medical Case Management 12 8 1,702,146 1,186,612 70% Emergency Financial Assistance 1 1 1,722 1,723 100% Food Bank/Home Delivered Meals 7 8 92,966 89,063 96% HE/RR 13 9 1,621,317 1,556,034 96% Housing 11 11 1,531,090 3,174,797 207% Linguistic Services 1 2 50,000 10,833 22% Medical Transportation 12 14 263,135 274,554 104% Outreach 13 5 1,388,697 484,325 35% Psychosocial Support 10 9 611,407 679,461 111%

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Minority AIDS Initiative

  • Ryan White Part

B is limited in use of MAI funds

  • Outreach Only
  • $386,638
  • Three Providers
  • Decrease from

2018

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Housing

  • Ryan Part B is one of many housing models
  • What models are we using in Maryland?
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Housing First

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Upstream

Outreach Early Intervention Services Health Education/Risk Reduction

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Funding Streams

  • Upstream directs RWHAP Part B grant dollars under:

» Outreach » Early Intervention Services (EIS) » Health Education/Risk Reduction (HERR)

  • Ideally, funded entities will implement a full Upstream program

including all three categories of activities.

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  • Um. Yeah, so we don’t do that…
  • HRSA/HAB PCN 16-02 and Treatment Adherence

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Program Guidance: Treatment Adherence services provided during an Outpatient/Ambulatory Health Service visit should be reported under the Outpatient/Ambulatory Health Services category whereas Treatment Adherence services provided during a Medical Case Management visit should be reported in the Medical Case Management service category.

MAI Outreach and Traditional Outreach

Not Everything is Upstream HERR

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Funding Streams

  • Upstream directs RWHAP Part B grant dollars under:

» Outreach » Early Intervention Services (EIS) » Health Education/Risk Reduction (HERR)

  • Ideally, funded entities will implement a full Upstream program

including all three categories of activities.

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Making Strategic Investments: EIS

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Surveillance Case Finding HCV Housing DIS

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+

Magnetic

  • Continuum

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Maryland Five-Year Integrated Plan

General Population

Community Mobilization Marketing to a general audience

Vulnerable Population

PrEP and nPEP Syringe Services Behavioral Risk Reduction HIV-informed Systems Integration Condom Distribution and Promotion

Full Diagnosis

Routine Testing Partner Services Targeted Testing

Care Engagement

Linkage to Care/Data to Care Expanded HIV Provider Network Care Coordination Peer Support Networks Culturally Responsive and Flexible Workforce Health Literacy

Viral Load Suppression

Medication Adherence Access to Medications

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fix systems not people

  • “Your answer is not my solution”

– A huge dose of humility

  • We all do incredible work; even when we’re

wrong

  • And doing the wrong thing better and better

doesn’t make it right

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contracting as intervention:

  • Address network impoverishment
  • Move the burden from the consumer and

acknowledge the privileged system

  • Develop infrastructure for key activities as

markers of system production rather than intervention specific outcomes

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WE HAVE A GOAL: 5,692

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37,200 X .153 5,692

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Core Elements:

RWHAP funding dictates the core elements of Upstream.

  • MANDATORY ELEMENTS:

– Upstream must target a vulnerable population as identified in the National HIV/AIDS Strategy (NHAS); NHAS 2020; or the State Integrated HIV Plan – Upstream must be a significant enhancement to existing HIV or Health Services within a funding program. RWHAP Upstream must not supplant existing funding.

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  • defined as any population where the prevalence of HIV is much higher

than the general population -

  • Gay, bisexual, and other men who have sex with men of all races and

ethnicities (noting the particularly high burden of HIV among Black gay and bisexual men)

  • Black women and men
  • Latino men and women
  • People who inject drugs
  • Youth aged 13 to 24 years (noting the particularly high burden of HIV

among young Black gay and bisexual men)

  • People in the Southern United States
  • Transgender women (noting the particularly high burden of HIV among

Black transgender women)

Vulnerable Populations – NHAS 2020

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EIS TESTING

Upstream

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Priority Population Outreach HERR LINKAGE

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Testing

Upstream: PrEP

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Priority Population Outreach HERR

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Testing

Upstream: STI

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Priority Population Outreach HERR

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Testing

Upstream: HCV

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Priority Population Outreach HERR

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Testing

Upstream: SSP

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Priority Population Outreach HERR

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Maryland Department of Health

Prevention and Health Promotion Administration

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