Transitional Grant Area North Central Texas HIV Planning Council for the Fort Worth/Arlington Transitional Grant Area 2016 – 2019 Comprehensive Needs Assessment

Objectives Establish Service Priorities; To prepare the Integrated Care and Prevention Plan; To identify barriers to care; To provide information necessary for the Request for Proposals/contracting process; To provide baseline data for evaluation; To help providers improve service access and quality; and For the Administrative Agency to prepare federal and other grant applications.

Data Collection Consumer Survey Convenience Sampling for Consumer Survey; 180 Consumer Survey Respondents; Provider Survey Targeted Sampling of Provider Staff 52 Provider Survey Respondents Literature Review Included reports from: NASTAD DSHS CDC HRSA Boston EMA

Identified Themes Barriers to Care Redundancy & Volume of Paperwork; In-Person Recertification; Lack of Transportation Lack of Knowledge/Use of 30-day Conditional Eligibility by Providers Linkage to Care Lacking Sense of Urgency for Getting newly diagnosed into Care; Structural barriers prevent optimal linkage environment; Ryan White Provider staff requiring documentation to care for clients.

Identified Themes (cont) Transportation Medical Transportation Services are not adequate to meet client needs for retention in care; Fort Worth T Transportation Services inadequate for the HSDA; Education HIV and HIV Services education struggling at all levels: Staff to Client; Management to Staff.

Recommendations Barriers to Care “Explore the actual source “Explore use of ARIES system to share information across agencies and eliminate the need for multiple intakes to access services. Develop processes to improve coordinated care between providers as recommended in the National HIV/AIDS strategy. Another option to explore is having a centralized intake.” Barriers to Care “The administrative agency requires that all annual and six-month recertifications take place in person. This is inconvenient for clients. Clients often use services at more than one RW provider and must have an in person appointment at each for their recertification…Develop an alternate process for recertification for clients who are low acuity.” “Explore the actual source of these burdens and clarify these requirements. From this, develop a policy paper to address the administrative, structural, and systems barriers found and provide recommendations to reduce the burden.”

“…consider funding EIS as a service category under other funding to Recommendations “…consider funding EIS as a service category under other funding to provide extended HIV counseling and testing, outreach, case management, and outpatient/ambulatory medical care…” Linkage to Care “Improve the triage system to get higher acuity clients into care faster – reiterating to providers that proof of diagnosis serves as sufficient documentation for 30 days to provide care to the client. Consider incorporating resources that have been recommended by Red Carpet models or Texas HIV Syndicate linkage group into various service categories.” “Continue to ensure that services are provided in a linguistically appropriate and culturally sensitive manner. Ensure written materials, including flyers, are available in Spanish at an appropriate reading level.”

Recommendations Education Transportation Education “…explore the services where transportation is listed as a major and common barrier to determine if alternative structures to provide the service might help to alleviate the barrier. Evaluate if services can be provided at different days or times to meet transportation options. Determine if any services can be provided through means other than in person (e.g., web-based services, telecommunication).” Recommendations Education “Expand on the finding that certain staff (i.e., doctors, nurses, case managers) are more “trustworthy” when it comes to clients retaining educational messages. Specifically, review the education needs at all levels of staff and evaluate the interactions happening between that level of staff and clients..” Education “Encourage agency staff and Planning Council member involvement in coalitions where they can continue to education non-HIV specific stakeholders on the current state of HIV client needs in the region.”

Questions?