Strengthening and Improving the HIV Care Continuum within

Strengthening and Improving the HIV Care Continuum within Ryan White HIV/AIDS Program Part A Jurisdictions Health Resources and Services Administration HIV/AIDS Bureau Division of Metropolitan HIV/AIDS Programs Abt Associates December 4, 2015 Abt Associates | pg 1

Content § Welcome § Purpose of Technical Assistance Cooperative Agreement § Overview § Questions & Answers Abt Associates | pg 2

Purpose of the Cooperative Agreement § Affect positive outcomes along the HIV care continuum by providing guidance and technical assistance using a collaborative learning approach and rapid improvement principles and practices § Apply data driven evidence based strategies for improving population level health outcomes § Scale-up interventions to improve HIV outcomes by stimulating action across jurisdictions and among many partners Abt Associates | pg 3

U. S. HIV Care Continuum Source: http: //aids. gov/federal-resources/policies/care-continuum/ Abt Associates | pg 4

HHS HIV Common Indicators Abt Associates | pg 5

Unique and Critical Role of Part A Jurisdictions § Roughly 72% of PLWH in the 53 Part A jurisdictions § Ever-changing epidemic, clinical & financial paradigm § Not just a set of discrete services but a communitybased system of care § Public health focus, data-driven, responsive procurement § HIV care continuum and evidence based/informed interventions Abt Associates | pg 6

Why Learning Collaborative? § Recipients learn from each other and from experts § Reliance on distance technology to grow and sustain “cyber teams” of self-selected individuals § Innovation fueled by frequent, non-hierarchical communication patterns § Work patterns characterized by transparency and openness to contributions from all participants Abt Associates | pg 7

Moving Forward § Technical guidance provided by Abt Associates and the National Expert Stakeholder Committee (NESC) members that will assist Part A jurisdictions with: – Identifying areas to address along the HIV Care Continuum – Developing targets and establishing baselines – Identifying specific populations and targeted interventions – Developing action plans and providing ongoing technical assistance § Host virtual consultation meetings § Recipients involved in learning collaborative will determine measures Abt Associates | pg 8

The Abt Team § Abt Associates – Michael Costa, Project Director – Liza Solomon, Senior Advisor – Alex Orr, Lead Liaison § National Alliance of State and Territorial AIDS Directors (NASTAD) – Ann Lefert, Lead (Expertise: RWHAP service providers, public health systems, data to care models, and targeted interventions) § Mission Analytics Group (MAG) – Peggy O’Brien-Strain, Lead (Expertise: RWHAP data collection, retrieval and submission, data quality control and quality improvement) § National Expert Stakeholder Committee (NESC) § Debbie Isenberg – Project Evaluator Abt Associates | pg 9

National Expert Stakeholder Committee (NESC) Name Ronald Bayer, Ph. D Organization Expertise Columbia University Social Justice and Ethics Nanette Benbow, MS Chicago Department of Public Health HIV Surveillance, Data Monitoring and Health Outcomes Jeff Crowley, MPH O’Neill Institute HIV/AIDS Policy, Strategy and Assessment David Evans Research Advocacy Project HIV Surveillance, Data Monitoring & Linkage to Care Ernest Hopkins, BA San Francisco AIDS Foundation HIV/AIDS Policy and Advocacy re: Black MSM Abt Associates | pg 10

National Expert Stakeholder Committee (NESC) Name Eve Mokotoff, MPH Organization Expertise HIV Counts Michael Mugevaro, MD, MHSc University of Alabama Clinical Research and Treatment Linda Scruggs, MHS Ribbon Consulting Group HIV/AIDS Surveillance Women and Youth Stakeholder Advocacy Patrick Sullivan, DVM, Emory University Ph. D HIV Surveillance, Data Monitoring and Health Disparities Jan Carl Parks, MA, MPA Part A Planning Council New York City Planning Council Abt Associates | pg 11

Glossary of Terms Working Definition Part A Recipient The EMA or TGA agency/organization that is the recipient of record. Part A Jurisdiction The geographical area served by the Part A recipient, including its network of partners and stakeholders. Learning A set or group of Part A recipient jurisdiction Collaborative representatives (referred to as teams) from multiple Part A jurisdictions working together on a specified domain. Learning A group of Part A recipient staff and stakeholder Collaborative /partner network representatives from a given Part A Team jurisdiction jointly participating in a Learning Collaborative. Abt Associates | pg 12

Glossary of Terms Working Definition Learning Collaborative Liaison An assigned staff member from the Abt Team who will act as the facilitator/convener of all Learning Collaborative calls and other group activities. Domain A set of related topics and focus areas specific to a common, approach strategy, method or outcome. Faculty A set of Abt Team staff, HAB staff and expert consultants available to deliver technical content, training and TA to support the work and goals of a Learning Collaborative. Learning Session Any group meeting of the sets of Part A teams that comprise a Learning Collaborative. Such a meeting could involve a formal training session by expert faculty, or a group meeting for internal discussion. Abt Associates | pg 13

Part A Learning Collaborative Team § Suggested Learning Collaborative Team Members: – Part A Staff (e. g. , Directors, CQM Staff, etc. ) – Planning Council Members – Ryan White Part B Program Staff – State and/or local HIV Surveillance Staff – HIV Service Providers – Integrated HIV Prevention and Care Planning Body Members § Teams may look different across Learning Teams and may be comprised of varying numbers of individuals Abt Associates | pg 14

Possible Learning Collaborative Domains § Data to Care* practices involving: – Part A RSR and ADR jurisdictional provider data – HIV surveillance data – Data sources (e. g. , Veterans Health Administration, Corrections, etc. ) – Service utilization data § Evidence-based/evidence-informed interventions targeting subpopulations (e. g. MSM, racial/ethnic minority, transgender, women, youth, etc. ) § ACA opportunities and challenges *Data To Care is a CDC “Effective Intervention” defined as using HIV surveillance data to identify HIVdiagnosed individuals not in care, link them to care, and support the HIV Care Continuum Abt Associates | pg 15

Learning Collaborative Platform § Online virtual platform that allows for bi-directional screen and video image sharing § Platform will serve as central mechanism for teams to interact, discuss, share, and collaborate § Functionality – Regular posting and sharing of information in “real time” – Synchronous and asynchronous communication – Online document repository – Expert moderated discussion boards – Peer to peer mentoring/ virtual site visit support – Request function for individualized TA Abt Associates | pg 16

Learning Collaborative (LC) Domain Selection Identification of Possible Domains Virtual Introductory Meeting Refine Domains Online Commentary and Response LC Selection Recipients’ Selection of LC Domains Initiate Virtual LC Abt Associates | pg 17

Phase 1: Identification of Possible Domains § Virtual introductory meeting with pre-assigned Part A grouping § Conducted over 10 -week period; no longer than 90 -minutes § Topics for discussion offered (HAB Priority Areas) and informed by the NESC § Open floor for discussion and suggestions from Part A recipients § Notes recorded analyzed January – March 2016 Abt Associates | pg 18

Phase 2: Refine Domains § Notes from virtual introductory meetings synthesized and themes identified by Project Team (HAB, Abt, NASTAD, MAG) and the NESC § Themes and suggested domains posted to Virtual Platform § Recipients invited to review and respond to suggested domains within 10 days of posting § Final domains chosen by Project Team and NESC March - May 2016 Abt Associates | pg 19

Phase 3: Learning Collaborative Selection § Recipients log into Virtual Platform and self- select domains of interest § Domain-specific readiness survey sent to recipient § Results added to recipient criteria matrix § Project Team and NESC review and finalize recipient domain groupings § Finalize technical content areas May - June 2016 Abt Associates | pg 20

Phase 4: Pilot § Launch Pilot Learning Collaborative – Regular, interactive meetings – Learning collaborative-based organized training and technical assistance sessions – Training and Technical Assistance outreach – Virtual platform § Determine Measures July - August 2016 Abt Associates | pg 21

Evaluating Success § Learning Collaborative Process – Rates of attendance and participation of Learning Collaborative teams – Learning team assessment of Learning Collaborative support (e. g. liaisons/facilitators, virtual platform function, training/TA, perceived value of LC participation in meeting goals) § Learning Collaborative Teams’ Goals – SMART Objectives tailored to each Learning Collaborative domain – Mixed methods: • Key Informant Discussions/ Interviews • Data Analysis (e. g. RSR, intervention-specific data collection) • Post Collaborative Activities (Sustainability) Abt Associates | pg 22

Next Steps § HIV Care Continuum Section of FY 16 Part A Application – Identify themes from FY 16 Part A applications around HCC – Shared with Abt Team AFTER Objective Review Committee (ORC) § Part A recipients participate in introductory sessions § Part A recipients self- select learning collaborative domain(s) based on areas of targeted improvement within the jurisdiction § Assign Learning Collaborative Team § Project Officer “check-in” during monthly monitoring calls Abt Associates | pg 23

Questions and Discussion