new jersey hiv planning group main meeting september 15, …...2016-2017 ryan white part b by county...
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New Jersey HIV Planning Group
Main Meeting
September 15, 2016
Division of HIV, STD and TB Services
Commissioner
RYAN WHITE MOVING FORWARD
Shared Mission
RFA Funding Decisions
Based on meeting the goals for the National HIV/AIDS Strategy:• Increasing Access to Care and Improving Health Outcomes for People Living with HIV.
This includes funding for services that support engagement, retention, adherence, and viral suppression. • Targeted outreach for testing the right people in the right place at the right time.
• Care and support services will address barriers that prevent linkage: issues such as poverty; unemployment; intimate partner violence; unstable housing, including homelessness; hunger; lack of access to transportation. In NJ our goal is to link within the same or next business day, that required coordination and cooperation.
• Engagement in care: For people living with HIV, staying engaged in medical care is an important precursor to becoming virally suppressed. Key social and structural supports are necessary to make this possible.
• Viral suppression: Being virally suppressed—which means that HIV is under control at a level that keeps people healthy and reduces the risk of transmitting the virus to others—not only improves a person with HIV’s health and enhances their lifespan.
Impact of Medicaid Expansion and the Health Insurance Marketplace
RATIONALE FOR FUNDING DECISIONS• A vast majority of HIV positive patients now have health
insurance through Medicaid Expansion or the Marketplace.
• DHSTS estimates that 85 to 90% of clients receiving care in our funded clinics are covered for billable services, confirmed by HRSA..
• Both State and RWB funds have transitioned to services to improve retention, adherence, and viral suppression.
1
2
3
4
5
System 1: Coordination – Testing Site ->Clinical and Support: HIV diagnosis -> Linked to Care same or next business day -> Red Carpet treatment at clinic-> introduction to physician -> baseline labs -> ADAP
System 2 – MCM, ART -Medical/Support, adherence counseling, assessment to include insurance, basic needs; trauma; medical; dental; legal and linkage to other services
System 3 – Coordination of all Systems to support retention and adherence. Health literacy, ongoing trauma-informed counseling, mental health, substance abuse and coordinated support services
System 4 – Coordination all systems to support retention, adherence moving toward independence
System 5 – Coordination all systems to support viral suppression
HIV CARE SERVICE CONTINUUM
State HIV Care and Treatment
Most Significant Changes in State Funding
2015-2016• Ambulatory Care 35%• Medical CM 13%• Psychosocial 9%• Mental Health 1%
2016-12017• Ambulatory Care 0%• MCM 42% • Psychosocial 14%• Mental Health 7%
New services• Emergency Financial Assistance• Non Medical CM• CoPay and Deductible (pilot)• Foodbank
Total $7,907,884
MCM42%
PsySocial14%
Housing14%
Non (CM)9%
MH7%
Outreach5%
Dental5%
EFA2%
Transport1%
CoPay1%
NT0%
Legal0%
2016-2017 State Care Percent by Service
MOA's
Rutgers's - Stigma 264,520 3%
Rutgers's -Education and Training 278,276 4%
$0
$500,000
$1,000,000
$1,500,000
$2,000,000
$2,500,000
$3,000,000
$3,500,000
State Care and Treatment 2016-2017 Funding by Service
$7,907,884
2016-2017 State Care Funding by County
0
500000
1000000
1500000
2000000
2500000
Multiple County Dental - Atlantic, Camden. Essex
Multiple County Legal - Hunterdon, Morris, Middlesex, Sussex, Warren
Ryan White Part B
Most Significant Changes in RWB
Ryan White 2016-2017• Ambulatory Care 22%• MCM 18%
New Services• Non Medical CM• Emergency Financial
Assistance• CoPay and Deductible (pilot)• Foodbank
Ryan White 2015-2016 • Ambulatory Care 63%• MCM 15%
AmbCare22%
MCM18%
Home+YGB12%
NMCM11%
Dental7%
MAI6%
Mental Health4%
Trans4%
Comm.Health3%
Legal3%
CoPay2%
Homecare1.5%
Psychosocial2%
EFA2%
Foodbank1%
Nutrician1%
2017 Ryan White Part B Funding8,106,971
Am
bC
are
, $1
,37
8,9
99
MC
M, $
1,3
18
,77
8
Ho
me
_YG
B, $
87
0,4
23
NM
CM
, $8
50
,21
1
De
nta
l, $
55
4,2
55
Me
nta
l He
alth
, $3
14
,81
8
Tran
s, $
26
8,1
10
Lab
, $2
63
,44
8
Co
mm
.He
alth
, $2
54
,91
4
Lega
l, $
24
2,9
86
Co
Pay
, $1
34
,27
9
Ho
me
care
, $1
24
,00
0
Psy
cho
soci
al, $
12
0,2
68
EFA
, $1
17
,69
7
Foo
db
ank,
$1
01
,51
8
Nu
tric
ian
, $8
7,4
50
Ho
usi
ng,
$6
5,0
00
Sub
spe
cial
ity,
$5
2,5
20
2016-2017 RWB FUNDING -$8,106,971
2016-2017 RYAN WHITE PART B BY COUNTY
0
500000
1000000
1500000
2000000
2500000
3000000
Ocean/Mon Atl, Cape May Cumberland Mercer Mer, Pass, Mon,Berg
Atl, Essex, Middle
Legal and dental Services covers 3 countiesHome care total $124,000 (1.5%)
QM $296,414 4%
HPG $231,155 3%
HOME CARE FUNDING
Hunterdon Medical Center $1,000
Saint Joseph's Hospital $67,000
Visiting Homemaker Services $46,000
Visiting Nurse and Health Svcs. $10,000
Comparison of Service Distribution
2015-2016 Combined Funding 2016-2017 Combined Funding
47%
14%
7%
7%
5%
5%
15%
AmbCare MCM Housing Dental Tx Adh Psychosocial Other
12%
33%
14%
11%
7%
6%
5%
13%
Amb Care MCM Housing Non MCM Dental Mental H CHW Other
Q & A
THANK YOU
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