Backup — original pdf

Backup

Planning Council Directive to the Grantee Directive # 01-2021 Creation Date: July 6, 2021, Revised August 28, 2023 and September 26, 2023 Directive regarding Directive for the EIS, MCM, and OAHS Service Categories regarding Community Health Workers for Ending the HIV Epidemic in the Austin TGA. In order to develop or leverage current Community Health Worker programs that will be designed as peer based to improve HIV Care Continuum outcomes for people with HIV/AIDS-contributing to the End of the HIV Epidemic in the Austin Transitional Grant Area (TGA). The model must use peers: individuals living with HIV/AIDS who are in care and come from priority Early Identification of Individuals with HIV/AIDS (EIIHA) and Minority AIDS Initiative (MAI) populations (including Black MSMs, Latinx MSMS, Black women, and Trans POC) determined based on data. The model must be based on a central agency that is responsible for training, and oversight with peers assigned to and serving as staff. Defining Community Health Worker (CHW) Community Health Worker Definition: American Public Health Association (APHA) definition : As trusted members of the localities in which they work, CHWs serve as the liaisons between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. CHWs also build individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support, and advocacy. Defining “Peer”: A peer can be defined as a person with the same cultural background as the clients, or as a person who has these similarities and is living with HIV. Some projects have found that a peer who is known to be living with HIV often has immediate rapport and credibility with the client given this shared life experience. Others believe it is helpful but less important than many other personal characteristics and experiences. For example, while it is sometimes assumed that the best match for a young Latinx MSM of color is a peer who is also a young Latinx MSM, at least one of the SPNS projects found that a slightly older Note: This Directive is provided to the Grantee in accordance with the Ryan White HIV/AIDS Program Part A Manual, Section XI, Chapter 4, and Policy#2 (Guidance) of the Austin Area HIV Planning Council Approved 08.23.23 with Allocation Edit Approved 09.25.23 female can be equally effective, because the person reminds the client of a trusted female figure such as a sister or cousin. Goals: to improve HIV Care Continuum outcomes for people with HIV/AIDS-contributing to the End of the HIV Epidemic in the Austin Transitional Grant Area (TGA) • Diagnose: Testing, linkage to care, and re-linkage to care for those PWH who are fallen out or were never in care • Prevent: Ensuring people are aware of their HIV status via testing; educating people about treatment, transmission, and prevention. Linking to appropriate services needed as relates to social determinants of health. • Treat: Link newly diagnosed and previously diagnosed HIV positive people or re-link to care. Develop relationships with service providers and agencies. Use relationships with these relationships to make referrals. • Respond: CHWs are in the community and can respond to outbreaks as needed. -Improve PWH knowledge and ability to navigate system of care; increase access to care for PWH; promote or ensure independence -Educate PWH about the biological and biomedical aspects of HIV/AIDS, care, and/or treatment Ryan White Part A Service Categories: Early Intervention Service (EIS), including MAI Medical Case Management (MCM), including MAI for medical appointment and treatment adherence The FY24 Allocations for this Directive will allocate funds in the following: 38% of the approved FY24 Allocations for each service category above, will be used for Peer Support for a total of $ 380169.48 Peer Support Directive (CHW Directive) and Service Category Spending Details FY24 Allocation ($) 78459.74 Service Category Early Intervention Services (EIS) Early Intervention Services MAI Medical Case Management, including treatment adherence (MCM) Medical Case Management - MAI Community Health Worker Directive Total 20936.48 220050.78 60722.48 380169.48 Note: This Directive is provided to the Grantee in accordance with the Ryan White HIV/AIDS Program Part A Manual, Section XI, Chapter 4, and Policy#2 (Guidance) of the Austin Area HIV Planning Council Approved 08.23.23 with Allocation Edit Approved 09.25.23  Provider Type One central agency in the Part A jurisdiction to recruit, train, assign-to practicum site agencies, supervise, and ensure evaluation of the Pilot Program. Central Agency’s Responsibilities: - Recruit peer trainees, certification of CWHs using the State CHW program preferred Identify field placement sites among subrecipients with funding for the appropriate - service category - Establish a Community Advisory Committee that will include Ryan White Part A consumers and/or care givers - Provide training to service site supervisor - Establish peer support group and site supervisors support group - Provide at least 2 weeks of pre-service training for peers, then 1 day a week of training for the next 6-8 weeks, then ½-1 day per month of training throughout the pilot period - Provide initial training and ongoing group meetings for site supervisors - Monitor and oversee sites - Collect and review data from service sites and prepare evaluation of pilot program, directly or through an independent evaluator Populations to be Targeted - - Lost to care – defined as having “unmet need” – no HIV medical care or viral load test in last 12 months Loosely connected to care o sporadic visits or missed visits to doctor o non-adherent to treatment - Recently diagnosed and either did not receive an initial medical appointment in first month, did not return after first appointment, or missed appointments with case managers or other service personnel All PWH who quality for Ryan White Part A Services with a focus on MAI and EIIHA populations - Required Service Components Program must work through key points of entry or re-entry (such as testing sites, hospital emergency rooms, homeless shelters, substance abuse treatment programs, referral-entry programs for those persons recently released from incarceration, etc.) and must ensure that all required service components are provided. Duties of the Peer Note: This Directive is provided to the Grantee in accordance with the Ryan White HIV/AIDS Program Part A Manual, Section XI, Chapter 4, and Policy#2 (Guidance) of the Austin Area HIV Planning Council Approved 08.23.23 with Allocation Edit Approved 09.25.23 - - Identify potential clients through outreach to points of entry, including medical providers, case managers, and other RWHAP and non-RWHAP providers Link to care, retain in care, or recapture client for care; this includes providing referrals and facilitating access and linkage to care - Provide health literacy/health education/counseling as needed - Connect or reconnect the client to their Case Manager - Be a part of the client’s linkage process for least 3 appointments and for up to 6 - Be part of the client’s Treatment or Care Team (generally including at least the medical provider and case manager) months Case Closure Criteria: - 3 – 6 months of services - Close the case when client is unresponsive (after 3 months of contact effort) or when they have successfully been adhering to treatment (making 3-intial appointment or 75% of scheduled appointments) - After this, former clients can still call their peer for assistance for another 6 months as needed Case load size - 10 – 20 (FTE) depending on severity of client need To be defined in collaboration with AA based upon recommendations from data provided by AA. Peer Requirements/Qualifications: Language capacity and skills based upon needs of population served - - Consumer of HIV services, not necessarily through Ryan White - High School/GED or be prepared to demonstrate equivalent literacy skills, including reading comprehension and report writing - Criminal Background Check for barriers to participation in the program (e.g., a sexual crime of a predatory nature, abuse and violent offenses or equivalent only) Characteristics: Characteristics of particular importance include the following: - Commitment to helping PWH enter and remain in care - Ability to empathize - Strong interpersonal skills - Ability to organize and multi-task - Good judgment - Ability to document services via a tablet or computer Employment - Full-time or part-time o Take into consideration, any barriers or impact employment may have on some peer applicants’ SSI and additional benefits Note: This Directive is provided to the Grantee in accordance with the Ryan White HIV/AIDS Program Part A Manual, Section XI, Chapter 4, and Policy#2 (Guidance) of the Austin Area HIV Planning Council Approved 08.23.23 with Allocation Edit Approved 09.25.23 - Salary commensurate with local CHW salary/wages and experience. Average CHW salary in the Austin area is $40836 - Benefits provided Responsibilities of Service Sites the Treatment Team - Provide supervision by a Clinician or Medical Case Manager and include the peer on - Agree to participate in all required training/support activity - Document peer performance, activities, and/or training needs in monthly reports to the Central Agency or Recipient - Commit to hire the peer after successful completion of per-service training and introductory period of up to 3 months, and continue providing employment after 2 years if funding is available. - Grant Peer limited access to client files Metrics: To be established based upon the collaborative efforts and recommendations from data provided by AA. - Number of peer contacts with clients - Number of clients returned to care - Number of clients keeping their initial 3 appointments after diagnosis - Number of clients keeping at least 75% standard of care visits - Number of clients adhering to Treatment Plan - Number of clients attaining and maintaining viral suppression Note: This Directive is provided to the Grantee in accordance with the Ryan White HIV/AIDS Program Part A Manual, Section XI, Chapter 4, and Policy#2 (Guidance) of the Austin Area HIV Planning Council Approved 08.23.23 with Allocation Edit Approved 09.25.23