end+disparities Learning Exchange: Youth (aged 13-24) Health April 20, 2017 1:00-2:30 pm ET Michael Hager & Jane Caruso, NQC Devin Quinn & Nahuel Smith, Learning Exchange Spokespersons Barb Cuene, Children’s Hospital of Wisconsin Ana Garcia, University of Miami Michael Welcome to our April webinar focused on Youth aged 13-24. This is our fourth and final month that focuses on one of our four populations. Be sure to visit our website to learn more about past events.

Before we start… Please type your name, organization, city and state in the chat room Michael Please note that this webinar is being recorded for later replay by those who missed the call. Before we start our webinar, let’s take a moment and ask participants to introduce themselves via our chat room, which can be found on the right hand side of your screen, just underneath the participants section. There is a small box labelled Chat. Please enter your name, organization, city, and state so others can see who we have on the call today.

Ground Rules for Webinar Participation Actively participate and write your questions into the chat area during the presentation Do not put us on hold Mute your line by pressing the microphone button to the right of your name Please complete the post-webinar evaluation This call is recorded for replay for those who missed the webinar Michael Ground rules for todays webinar: - Actively participate and write your questions into the chat room; we have several staff and consultants who will answer your comments – I want to thank them and HAB representatives - Please mute your phone line; you can press the microphone button to the right of your name - Please complete the post-webinar evaluation, which will be sent to your email at the conclusion of the webinar. We look forward hearing from you. - As stated earlier the call will be recorded for replay for those who missed the webinar

Clemens Steinbock, MBA Director, NQC Michael introduces Clemens and turns it over to Clemens to provide words of welcome Clemens Steinbock, MBA Director, NQC

The end+disparities Learning Exchange a 9-month initiative that promotes the application of improvement interventions to reduce HIV-related disparities in four key subpopulations while building and sustaining a community of learners among Ryan White HIV/AIDS Program recipients. The Learning Exchange offers informational opportunities by content experts and utilizes the power of peer learning to facilitate local improvement efforts on eliminating HIV-related disparities. Michael

Communities of Learning: collaborative, QI campaign, Regional Groups Consultation: On/off-site coaching of recipients to advance their clinical quality management programs Together, we can make a difference in the lives of people with HIV. NQC provides assistance to RWHAP recipients to improve HIV care since gaps in HIV care still exist and advances are uneven across HIV populations. 250 recipients participated in 28 Regional Groups 51% of all recipients joined the largest HIV QI campaign; viral suppression increased from 70% to 76%, a statistically significant improvement Training and Educational Fora: monthly webinars, advanced trainings, online QI tutorials 40% of RWHAP recipients received TA and 95% would recommend TA to others 40 online QI tutorials are available; over 35,000 have been taken so far Intensity Information Dissemination: monthly newsletters, websites, publications, exhibits, QI awards Michael NQC is funded by the HRSA HIV/AIDS Bureau since 2004 and provides technical assistance to all RWHAP recipients to build their sustainable clinical quality management programs. Over 90% of all recipients have accessed intensive NQC offerings and take advantage of our various services. The Learning Exchange is an extension of these offerings. As you see in this graphic, NQC provides opportunities To participate in monthly webinars to learn more about QI – next week’s webinar focuses on the 2016 NQC Award winners To attend our 4 3-day face-to-face training programs or take one of 40 online tutorial we have available To request onsite assistance by our pool of QI experts To join one of our 28 Regional Groups, a local community of learning If you would like to learn more, please visit our website at NationalQualityCenter.org. over 90% of the 587 RWHAP recipients accessed NQC services ~1,300 individuals (61% of recipients) graduated from 45 three-day advanced trainings NationalQualityCenter.org | 212-417-4730

Agenda Welcome & Introductions Young Voices in Healthcare Part D Program Experiences in WI and FL Resource Sharing! Q & A Session Michael

Learning Objectives Name two solutions to implement that will assist adolescents transition into adult care. Describe considerations important to communicating effectively with youth, including specific technology solutions. Explain the concept of system co-design and why it is important to serving youth. Jane Read the learning objectives

Young Voices in HIV Care Jane We will be hearing from two consumers and two Ryan White program staff regarding their experience in receiving or serving youth living with HIV. We have folks from the north and the south and we have folks from cities and more rural to help us explore youth health outcomes.

Devin Quinn Learning Exchange Spokesperson Columbus, OH Jane, introduce Devin: Devin Quinn is a Peer Navigator for Nationwide Children’s Hospital as well as a public speaker and advocate for causes surrounding HIV. Devin has been living with HIV since 2012 and has used his voice in the community to raise awareness and understanding for those affected by HIV. Devin is also a board member of Youth Across Borders, a non for profit organization that specializes in fostering connections in young people via a service trip to an orphanage in rural Honduras known as Montana de Luz. Devin (3-5 minutes) Provide a sneak preview of your story and that you are excited to share more on next week’s partners in+care call. Specifically for this call: Explain a little bit about your motivations for joining end+disparities and what you hope can come from it What are the biggest misconceptions providers have about serving youth and engaging them in care? What are common missed opportunities that the health system has to youth? If you had 1-2 concrete steps any provider should take to better understand the youth they serve, what would they be?

Nahuel Smith Learning Exchange Spokesperson Charlottesville, VA Jane introduce Nahuel: Nahuel, who is originally from Argentina, has been a consumer for 11 years and currently resides in Charlottesville, Virginia, where he serves as the peer services coordinator for the University of Virginia Ryan White Clinic. Nahuel is an experienced peer educator, public speaker, and has worked to develop new approaches to engage people in care and prevention of HIV/AIDS. In his first professional role in the United States, he helped to shape design and management of a peer coach program and evaluate the resultant outcomes. He has effectively worked to bridge gaps between stakeholder groups in order to develop local and regional strategies for helping consumers with HIV/AIDS. Nahuel has successfully spearheaded initiatives to disseminate peer learning through campaigns, collaboratives, and other initiatives. Nahuel (3-5 minutes) Provide a sneak preview of your story and that you are excited to share more on next week’s partners in+care call. Specifically for this call: Explain a little bit about your motivations for joining end+disparities and what you hope can come from it What are the biggest misconceptions providers have about serving youth and engaging them in care? What are common missed opportunities that the health system has to youth? If you had 1-2 concrete steps any provider should take to better understand the youth they serve, what would they be?

Barb Cuene Children’s Hospital of Wisconsin Milwaukee, WI Jane introduce Barb: 1979 graduated with a BSN at College of St. Theresa in Winona, Minnesota 1991 received my Masters of Science in Nurse at Marquette University in Milwaukee 1993 started working in the Children’s Hospital of WI HIV Program mainly caring for babies with perinatal HIV infection. This was prior to the availability of antiretroviral therapy and times were very different back then. In 1994 we expanded to a state wide program caring for children, youth, and pregnant women, and women with HIV. In 1995 we drove across WI and educated providers about the need for testing pregnant women for HIV infection and then providing women with HIV care and treatment. I coordinate an intensive nurse case management program that spans across health care systems to serve vulnerable youth and women who face challenges in staying in care, taking their antiretroviral therapy, and reaching undetectable. Barb – 10-15 minutes on what you are doing in Wisconsin. What have you put in place at Children's’ Wisconsin? How did you develop this model? Are there special features that folks on the line need to know if they wanted to replicate it? What are some of the outcomes or improvements you have seen from your actions? What are the biggest challenges faced by the adolescents you serve? In and ideal world, if you could test any intervention (without worrying about time or financial or other resources) what would it be and why? For anyone starting to work with youth, what advice would you have for them?

Ana Garcia University of Miami Miami, FL Jane introduce Ana: Ana Garcia is a PhD Licensed Clinical Social Worker and an Assistant Professor of Clinical Pediatrics at the University of Miami Miller School of Medicine; she is also an Adjunct Professor in the School of Social Work at Barry University where she teaches graduate social work students. She has a 33 year long history working with the WICY population, first as a clinical social worker on the in-patient pediatric unit at Jackson Memorial Hospital, then as Co-Coordinator of the HRSA Pediatric AIDS Healthcare Demonstration Project. When the project became a Ryan White funded entity, she became the Pediatric Coordinator and has since performed duties in quality management, developing a Transition Protocol for aging pediatric patients, provided mental health services for the WICY, published on disclosure issues – fathers as leaders – the child welfare system and orphans – resilience, among many complex issues affecting HIV infected children/youth and their families. She remains a local, state and national expert in issues related to this vulnerable population. Ana – 10-15 minutes on what you are doing in Miami What have you put in place at U Miami? How did you develop this model? Are there special features that folks on the line need to know if they wanted to replicate it? What are some of the outcomes or improvements you have seen from your actions? What are the biggest challenges faced by the adolescents you serve? In and ideal world, if you could test any intervention (without worrying about time or financial or other resources) what would it be and why? For anyone starting to work with youth, what advice would you have for them?

Resource Sharing! What has worked for you? Jane Let’s have a conversation about what has worked to improve linkage, retention, and viral suppression for your patients as an HIV provider organization serving youth aged 13-24. What health equity problem have you tried to solve for your young patients, clients, and community members? What resources or strategies did you find helpful toward closing disparity gaps for youth? What advice do you have for others who are trying to bring health equity to the youth in your community? How do we ensure we are serving all youth equitably to help achieve optimal health outcomes? Ask Devin, Nahuel, Barb, and Ana if there are any resources they recommend and ask if they want Michael to show folks where they are located online (he will navigate to them in the webinar to show folks how to find them). Jane – please feel free to share your experience and tools/resource you’ve found useful, too.

Q&A Session Jane Now we open the discussion to general inquiries for the next 30 minutes. This is only needed if it wasn’t mixed in with the Resource Share!

Next Steps and Activities in end+disparities Coming Up! Next Steps and Activities in end+disparities Michael

Partners in+care Roundtable Discussions Each date is a clickable link with additional information to save in your calendar! April 27: Youth (13-24 years) Health May 25: Sustaining Our Gains June 22: Greater Than the Sum of its Parts Michael Each month we focus on another topic. Partners in+care roundtables will occur on the fourth Thursday of the month from 1-2pm ET. When we develop content for consumers to join the discussion, we’ll be sure to focus in on our challenges and opportunities in each area and will explore ways consumers can get involved in the work. The main toolkit available to us is the Partners in+care toolkit presented today, but there is plenty of room to introduce new tools and resources that are of interest to you

end+disparities Learning Exchange Webinars Each date is a clickable link with additional information to save in your calendar! May 18: Sustaining Our Gains June 14: Greater Than the Sum of its Parts Michael

Office Hours Opportunities April 21: Behavior vs Perinatal Infected Youth May 5: Journal Club with Dr Theodore Speroff Office Hours discussions are informal opportunities to dive deeper into core issues affecting our work They are participant led and directed based on YOUR questions! Michael Office Hours discussions are informal opportunities to dive deeper into the issues They are participant led and directed based on YOUR questions! Occur on various Fridays from 1-2pm ET (check the calendar on our website for exact dates and topics!)

Closing Remarks Michael Hager and Clemens Steinbock provide closing remarks. Ask Jane if she would like to add anything.

end+disparities Video Visit our NQC YouTube channel to see our 3min video about disparities in HIV care - www.youtube.com/NationalQualityCtr Michael A reminder to check out our video and the website! Another cool informational tool that we have developed is a short animated video about disparities in HIV care and outcomes. Please take a look and feel free to share with others. 21

THANK YOU! Michael

212-417-4730 NationalQualityCenter.org Info@NationalQualityCenter.org Michael 23