1 in+care Campaign Pre-Work Webinar October 12, 2011 Clemens Steinbock Director National Quality Center

2 Agenda Introductions – 10 min Campaign Update – 10 min Pre-Work Assignments – 25 min Next Steps – 5 min Q & A – 10 min

3 Campaign Update

4 This HIV Campaign is designed to facilitate local, regional, and state-level efforts to retain more HIV patients in care and to prevent HIV patients falling out of care while building and sustaining a community of learners among Ryan White providers.

5 Non-EngagerSporadic UserFully Engaged [1] Health Resources and Services Administration, HAB. August Outreach: Engaging People in HIV Care Summary of a HRSA/HAB 2005 Consultation on Linking PLWH Into Care. [2] Eldred L, Malitz F. Introduction [to the supplemental issue on the HRSA SPNS Outreach Initiative]. AIDS Patient Care STDS 2007; 21(Suppl 1):S1–S2.

6 Campaign Framework participation in the Campaign is voluntary and Ryan White grantees across all funding streams and subgrantees are invited to join participating agencies enroll for a 12-month commitment routine reporting of performance data on up to 4 uniform Campaign-related measures routine submission of a simple progress report to highlight improvement strategies and challenges

7 Campaign Framework monthly webinars provide content expertise and promote peer sharing participating agencies have access to coaches for support where possible, regional/local meetings of Campaign participants are held consumers will be involved in this Campaign wherever possible

8 162 HIV providers have joined the Campaign

9 caring for 224,688 people living with HIV

10 # of in+care Participants by Zip Code (n=162)

11 # of in+care Campaign Participants by Part Funding (n=159)

12 # of Programs by Number of Unduplicated Patients per Year (n=104)

13 How do you rate the agency’s level of QI experience? (n=136)

14 To what extent has your agency recently engaged in retention activities? (n=138)

15 Campaign Database Allows participating agencies to self-report their performance data based on established indicator definitions Individuals need to register to access the database Organizations can sign up to form a group of grantees, which would allow them to generate group reports, such as HIVQUAL regional groups Immediate access to individual scores trended over time to group scores to regional/national benchmarking reports to reports based on common search criteria Coaches have access to individual/groups scores to better assist participating agencies

16 Technical Working Group Chaired by Dr. Bruce Agins and Dr. Laura Cheever Comprised of distinguished experts in the field of retention, including clinical experts, researchers, national stakeholders and other strategic thinkers from the Ryan White and other health care communities Committee provides suggestions on 3-4 retention measures to be used in Campaign

17 Pre-Work Assignments

18 A) Convene a Team Meeting Conduct a meeting with your quality improvement team and Establish team roles for this project Review Pre-work documents Articulate your agency goals for the Campaign Engage others in your agency Review next steps and responsibilities

19 B) Review Lessons Learned Document Complete the template provided to submit retention indicator definitions your agency currently uses Describe retention activities your organization has conducted, including interventions, overall lessons learned and advice for others Submit retention tools: documents, forms, checklists, call scripts, charts, instructions, or other relevant items

20 C) Discovering Your Retention Follow-up Pool The following tool was developed to help providers determine their Retention Follow-up Pool The Retention Follow-up Pool is the group of HIV patients out of care from your HIV program who can benefit from re-engagement activities This group is made up of two sub-populations: Patients not in care for unknown reasons Patients not in care for addressable reasons

# of Active Patients (HIV patients with at least one HIV primary care visit in the first six months (Jan- Jun) of 2010) # of Retained Patients (HIV patients with HIV primary care visit(s) in the second six months (Jul-Dec) of 2010) # of Out of Care Patients (HIV patients with NO HIV primary care visit(s) in the second six months (Jul-Dec) of 2010) Active Caseload A=B+C A B C

23 Step A: Active Caseload 1.To determine ‘# of Active Patients’ count the number of unduplicated HIV patients with at least one HIV primary care visit between Jan. 1, 2010-Jun 30, 2010 and enter into field (A) 2.From this list of active patients count the number of patients with at least one HIV primary care visit in the second half of the year - between Jul 1, 2010-Dec 31, enter the number in the ‘# of Retained Patients’ field (B) 3.Count the number of patients who did not have at least one HIV primary care visit in the second half of the year and enter the number in the ‘# of Out of Care Patients’ (C) field. The ‘# of Out of Care’ patients refers to patients not in care at your site 4.Ensure that the # of Retained Patients plus # of Out of Care Patients equals the # of Active Patients (A=B+C)

25 Step B: Determine Your Out of Care Pool 5.From the list of ‘Out of Care Patients’ count the number of patients who fit into the following categories, and enter them in to their appropriate fields: Incarcerated (must be currently incarcerated for a period of at least 3 months, and must not be known to be scheduled for release in jurisdiction in period of Jul 1, 2010 – Dec 31, 2010) (F) Deceased (G) Moved (based on a change of permanent address to a location outside of your organization’s reach), or receives HIV care from another site (during the second six month period) (H) 6.Add the numbers in F, G, and H. Enter this number into the ‘# of Patients who are Incarcerated, Deceased, Moved, Receive HIV Care Elsewhere’ field (D)

# of Out of Care Patients (HIV patients with NO HIV primary care visit(s) in the second six months (Jul-Dec) of 2010) Out of Care Pool # of Patients who are Incarcerated, Deceased, Moved, Receive HIV Care Elsewhere (HIV patients with documented reasons for being out of care) # of Patients who Require Follow- up (HIV patients who are out of care with potential for re-engagement) C=D+E C DE

27 Step C: Determine Your Retention Follow-up Pool 7.From the list of ‘Out of Care Patients’ (C) count the number of patients remaining after removing patients who counted towards the ‘# of Patients who are Incarcerated, Deceased, Moved, Receive HIV Care Elsewhere’ field (D) and enter this number into the ‘# of Patients who Require Follow-up’ field (E)

Retention Follow-up Pool # of Patients who Require Follow-up (HIV patients who are out of care with potential for re- engagement) # of Patients with Unknown Reasons for Being Out of Care # of Patients with Known Reasons for Being Out of Care other than those who are Incarcerated, Deceased, Moved, Receive HIV Care Elsewhere E I J E=I+J

29 8.From the ‘Patients who Require Follow-up’ count the number of patients who are not in care for known reasons for being out of care other than those incarcerated, deceased, moved, receive HIV care elsewhere’ and enter this number into the ‘# of Patients with Known Reasons for Being Out of Care Other than those Incarcerated, Deceased, Moved, Receive HIV Care Elsewhere’ field (J) (Example of a ‘Known Addressable Reason’: Patient has in the past, communicated problems with acquiring effective transportation to and from site of care.) 10.From the ‘Patients who Require Follow-up’ count the number of patients who are not in care for unknown reasons and enter this number into the ‘# of Patients with Unknown Reasons for Being Out of Care’ (I) 11.Ensure that the number of patients in I and J add up to E Step C: Determine Your Retention Follow-up Pool

30 Next Steps

31 -Complete Pre-Work Assignments - Oct 26 -Kick-off Webinar – Oct 26 -Indicator Release and Database Introduction -First Data Collection Cycle Next Steps

32 Q&A

33 in+care Campaign Campaign Headquarters: National Quality Center (NQC) 90 Church Street, 13 th floor New York, NY Phone: incarecampaign.org