Planning Council Meeting

May 15 th, 2018

Ryan White Office

BALTIMORE CIT Y HEALTH DEPARTMENT

RYAN WHITE PART A/MAI PROGRAM

CLIENT-LEVEL DATA PRESENTATION

FISCAL YEAR 2017 MARCH 1ST 2017 THROUGH FEBRUARY 28 TH 2018

BALTIMORE ELIGIBLE METROPOLITAN

AREA (EMA)

7/19/2018 1

Improve the quality of l ife for people living with HIV/AIDS and

their families in Baltimore City and surrounding counties

Provide comprehensive guidance to Ryan White providers and

the Baltimore Planning Council to ensure compliance with

Ryan White legislations and standards of care

Objective

Demonstrate FY 2017 client level data for priority setting and

resource allocation

MISSION

BCHD RYAN WHITE PROGRAM

7/19/2018 2

Total Consumers Served by Ryan White N = 12,486

Received any Ryan White defined service regardless of payer

Payers in Baltimore EMA

o Part A/MAI - BCHD

o Part B/MAI - MDH

o State Special Funds – MDH

o Medicare

o Medicaid

o Private Insurance

o Other Insurance payer sources

Federal Poverty Level < 500%

Exclusionso consumers with an unconfirmed HIV Diagnosis

o consumers with an HIV Status of Indeterminate & < 2 years of age

o consumers with an FPL > 500%

7/19/2018 3

At a glance, who are the Ryan White consumers in the

Baltimore Eligible Metropolitan Area (EMA)?

N = 12,486

o 61% Males

o 37% Females

o 2% Transgender persons

o 77% Black/African Americans

o Mean Age = 48

o 72% Stable Permanent Housing

o 6% Unstable/Temporary/Non-Permanent Housing

o 12% New to Ryan White services in the Baltimore EMA

(first service date within fiscal period)

7/19/2018 4

7/19/2018 5

DEMOGRAPHICS

2 to 12

0.25%13 - 24

4%

25 - 44

32%

45 - 64

56%

65+

8%

Age Group N = 12,486

7/19/2018 6

7/19/2018 7

Unknown/Unreported

20%

100% to 138%

10%

139% to 200%

5%

201% to 250%

4%

251% to 400%

3%

401% to 500%

1%

Below 100% FPL

57%

Federal Poverty Level N=12,486

Hemophilia

0.09%

Heterosexual

39%

IDU

14%

MSM

23%

MSM and IDU

0.60%

Not Specified

20%

Other

0.30%

Perinatal

2%Transfusion

0.63%

HIV Risk Factor N = 12,486

7/19/2018 8

IHS

0.01%

Medicaid

45%

Medicare

22%

No Insurance

7%

Other

1%

Private

22%

Unknown

0.26% VA, Tricare and Other

Military Health Care

0.23%

Insurance Status N = 12,486

7/19/2018 9

7/19/2018 10

SERVICE UTILIZATION

0%

1%

3%

6%

9%

10%

11%

17%

58%

81%

0%

2%

4%

9%

11%

14%

12%

18%

69%

83%

0% 20% 40% 60% 80% 100%

Hospice Care

Home & Community Based Health

Services

Substance Abuse Outpatient

Medical Nutrition Therapy

Health Insurance Premiums

Early Intervention Services

Mental Health

Oral Health

Medical Case Management

Outpatient Ambulatory Health

Services

CO

RE

ME

DIC

AL S

ER

VIC

E C

ATE

GO

RY

% Clients FPL Below 100% n=7,131

% All Clients N=12,486

Core Medical Services

7/19/2018 11

0%

1%

5%

6%

7%

14%

14%

15%

21%

24%

0%

1%

7%

7%

8%

20%

15%

20%

19%

31%

0% 20% 40% 60% 80% 100%

Substance Abuse Residential

Services

Other Professional Services

(Legal)

Housing Services

Psychosocial Support

Food Bank Home Delivered Meals

Emergency Financial Assistance

Case Management non-medical

Service Outreach

Health Education Risk Reduction

Medical Transportation

Su

pp

ort

Se

rvic

e C

ate

go

ry

% Clients FPL Below 100% n=7,131

% All Clients N=12,486

Support Services

7/19/2018 12

7/19/2018 13

13%

7%

12%

15%

5%

7%

10%

8%

8%

60%

78%

65%

65%

50%

61%

65%

54%

56%

26%

14%

22%

19%

42%

27%

24%

33%

32%

1%

1%

1%

1%

4%

4%

1%

4%

4%

0%

0%

0%

0%

0%

1%

0%

0%

0%

0% 20% 40% 60% 80% 100%

Home & Community Based Health Services n=186

Substance Abuse Outpatient n=333

Medical Nutrition Therapy n=772

Health Insurance Premiums n=1,177

Early Intervention Services n=1,252

Mental Health n=1,380

Oral Health n=2,121

Medical Case Management n=7,259

Outpatient Ambulatory Health Services n=10,094

Percentage of consumers

Co

re M

ed

ica

l S

erv

ice

Ca

teg

ory

Core Medical Services by Age Group

2 to 12 13 to 24 25 to 44 45 to 64 65+

7/19/2018 14

0%

8%

5%

8%

10%

7%

6%

5%

9%

7%

70%

68%

63%

58%

66%

57%

50%

51%

64%

64%

30%

22%

29%

26%

23%

33%

35%

40%

24%

25%

0%

2%

3%

8%

2%

3%

9%

4%

3%

3%

0%

0%

0%

0%

0%

0%

1%

0%

0%

0%

0% 20% 40% 60% 80% 100%

Substance Abuse Residential n=23

Other Professional Services (Legal) n=143

Housing Services n=625

Psychosocial Support n=738

Food Bank Home Delivered Meals n=845

Emergency Financial Assistance n=1,688

Case Management non-medical n=1,731

Service Outreach n=1,917

Health Education Risk Reduction n=2,635

Medical Transportation n=2,981

Percentage of consumers

Su

pp

ort

Se

rvic

e C

ate

go

rySupport Services by Age Group

2 to 12 13 to 24 25 to 44 45 to 64 65+

7/19/2018 15

MINORITY AIDS INITIATIVE (MAI)

4%

11%

16%

17%

17%

48%

0% 20% 40% 60% 80% 100%

Medical Nutrition Therapy

Health Education Risk Reduction

Service Outreach

Mental Health

Medical Case Management

Medical Transportation

Percentage of consumers accessing BCHD MAI funded services

MA

I S

erv

ice

Ca

teg

ory

Minority AIDS Initiative (MAI) N = 1,628

7/19/2018 16

7/19/2018 17

RETENTION IN HIV MEDICAL CARE

Retention in

HIV Medical

Care

Baltimore

EMA

Numerator

Baltimore

EMA

Denominator

Baltimore

EMA

Percentage

National

Average

8,211 10,514 78% 82%

Note:

Nation Average based upon 2016 Ryan White HIV/AIDS Program Annual Client Level Report

Ryan White HIV/AIDS Program Services Report (RSR)

Retention in HIV Medical CareRetention in HIV medical care is defined as PLWH who had at least 1 outpatient ambulatory health

services (OAHS) visit in the measurement year, with a second visit at least 90 days after.

7/19/2018 18

67% 66%

72%

82%85%

78%82%

0%

20%

40%

60%

80%

100%

2 to 12 13 to 24 25 to 44 45 to 64 65+ Baltimore

EMA

National

Average

Pe

rce

nta

ge

of

Co

nsu

me

rs

Age Group

Retention in Care by Age Group

7/19/2018 19

78% 78%

67%

78%

82%

0%

20%

40%

60%

80%

100%

Female Male Transgender Baltimore EMA National Average

Pe

rce

nta

ge

of

Co

nsu

me

rs

Gender

Retention in Care by Gender

7/19/2018 20

7/19/2018 21

79%

90%

83%87%

84%83%

62%

78%

85%

0%

20%

40%

60%

80%

100%

Pe

rce

nta

ge

of

Co

nsu

me

rs

Federal Poverty Level

Retention in Care by Federal Poverty Level

7/19/2018 22

VIRAL LOAD SUPPRESSION

Viral Load

Suppression

Baltimore

EMA

Numerator

Baltimore

EMA

Denominator

Baltimore

EMA

Percentage

National

Average

7,851 9,047 87% 85%

Note:

Nation Average based upon 2016 Ryan White HIV/AIDS Program Annual Client Level Report

Ryan White HIV/AIDS Program Services Report (RSR)

Viral Load Suppression

Viral suppression is calculated among PLWH who had at least 1 OAHS and at least 1

viral load during the measurement year. Viral suppression is defined as a most recent

viral load test result

93%

76%

82%

89%

94%

87%85%

0%

20%

40%

60%

80%

100%

2 to 12 13 to 24 25 to 44 45 to 64 65+ Baltimore

EMA

National

Average

Pe

rce

nta

ge

of

Co

nsu

me

rs

Age Group

Viral Load Suppression by Age Group

7/19/2018 24

86%88%

84%87%

85%

0%

20%

40%

60%

80%

100%

Female Male Transgender Baltimore EMA National Average

Pe

rce

nta

ge

of

Co

nsu

me

rs

Gender

Viral Load Suppression by Gender

7/19/2018 25

7/19/2018 26

86% 88%91%

87%

91% 92%

84%87%

85%

0%

20%

40%

60%

80%

100%

Pe

rce

nta

ge

of

Co

nsu

me

rs

Federal Poverty Level

Viral Load Suppression by Federal Poverty Level

10,514

8,211

6,643

5,547

0

2,000

4,000

6,000

8,000

10,000

12,000

In Care Retained in Care Prescribed ART Virally Suppressed

Baltimore-Towson EMA Ryan White HIV Care Continuum, FY 2017

78%

of

those

in care63% of

those in

care

81% of

those

retained

53% of those

in care

68% retained

84% of those

prescribed

ART

Ryan White consumers

who had at least two HIV

medical visits spaced by

at least 90 days apart

Ryan White

consumers who

had at least one

HIV medical visit

A Ryan White documented HIV care visit in CAREWare are

those who have had a funded RW visits. Variances in clinical

and demographic data are attributed to individual Program

operations & Ryan White consumers receiving care outside of

the network of Ryan White Providers.

LIMITATIONS

Data Source:

Maryland CAREWare All Client Data extract 05/10/2018 for period

covering 03/01/2017 through 02/28/2018

7/19/2018 28

THANK YOU!

QUESTIONS??STEPHON EFFINGER

STEPHON.EFFIN GER@BALTIMORECIT Y.GOV

410-545-1912

7/19/2018 29

mailto:stephon.effinger@baltimorecity.gov