Needs Assessment Slides for Module 4 Topic: Needs Assessment Components for PC/PB Implementation

Needs Assessment Components for PC/PB Implementation PLWH Service Needs and System of Care Overview of PC/PB Responsibilities for Gathering Needs Assessment Data Assessment of PLWH Needs and Barriers Resource Inventory Profile of Provider Capacity and Capability Assessment of Service Needs and Gaps

Training Objectives Following the training on needs assessment components for PC/PB implementation, participants will be able to: Identify the 3 components of a RWHAP Part A needs assessment the PC/PB implements directly Describe the scope of an assessment of PLWH service needs and barriers Explain why the PC/PB needs to understand the system of care Describe and differentiate a Resource Inventory and a Profile of Provider Capacity and Capability

Overview of PC/PB Responsibilities for Needs Assessment Receive information from recipient/surveillance staff on: Epidemiologic Profile Estimate of Unmet Need Estimate of PLWH Unaware of their Status Gather information on: PLWH Service Needs and Barriers Current System of Care, including Resource Inventory and Profile of Provider Capacity and Capability Use all available data to for Assessment of Service Needs and Gaps

Assessment of Service Needs & Barriers Provides information about the service needs of PLWH in and out of care, including: Need for specific core medical and support services Experiences with care, including success in accessing services Identified barriers to entering and remaining in care and obtaining needed services Service models and strategies that support entry into and retention in care How co-occurring conditions and external factors (e.g., homelessness, substance use, mental health issues, poverty) affect access to and retention in care

Assessment of Service Needs & Barriers Carried out by the PC/PB, often with recipient help Usually includes: Some form of general PLWH survey A special study of PLWH currently or recently out of care Also may include smaller assessments that reach PLWH through methods such as: Focus groups with specific PLWH subpopulations Telephone interviews Key informant interviews Town hall meetings

Assessment of Service Needs & Barriers May involve special studies of particular PLWH subpopulations, geographic areas, and/or service categories For example: Transition from adolescent to adult care for young PLWH Access to transportation inside and outside the central city and how it affects access to care Wait times for obtaining mental health services Often includes service provider perspectives on PLWH needs, obtained through: Surveys Focus groups Key informant interviews

Quick Activity A: Assessing Service Needs & Barriers It has been 4 years since your PC/PB’s last PLWH survey. Last year you did 5 focus groups, with young African American MSM, Latino immigrants (in Spanish), transgender women, heterosexual men, and PLWH who are over 55. You heard a lot about service needs and barriers, but groups had only 5-10 participants each and most lived in the central city. Your committee feels it is time to do another large-scale PLWH survey. What are the likely benefits of such a survey? What are 3-4 things you might do to make the survey as valuable as possible in understanding service needs and barriers?

Quick Activity B: Assessing Service Needs and Barriers of PLWH Out of Care As part of its assessment of service needs and barriers, your committee wants to learn about the needs of PLWH who are out of care so you can find ways to reduce unmet need. You want to interview PLWH who have not received HIV-related medical services (or a viral load test or CD4 count) for at least a year or who have re-entered care in the past 6 months. What are the 4-5 most important things you need to learn about these out-of-care PLWH? Why?

Resource Inventory A regularly updated, comprehensive listing and description of HIV-related services available to PLWH in the EMA or TGA, regardless of funding source: Providers of both core medical services & support services RWHAP Part A subrecipients, providers funded under other RWHAP Parts, and non-RWHAP providers Should provide at least the following information: Types of services provided Locations and hours Number of clients served Funding sources Sometimes includes additional data like languages spoken, key target populations

Scope of a Resource Inventory

Resource Inventory Should identify the full range of medical and support services available to PLWH Usually developed under PC/PB supervision Used in integrated/comprehensive plan development and for PSRA decision making Frequently becomes – or is based on – a Resource Guide for service providers and clients Sometimes printed Often available online, ideally in a searchable format Should be updated annually for PC/PB use, and more frequently for online listings

Quick Activity C: Planning for a Resource Inventory Your jurisdiction has an online listing of Part A-funded services and a hard-copy Resource Guide for providers and clients, developed by the recipient but last updated 5 years ago. This year you plan to develop a comprehensive HIV Resource Inventory. What is some of the most important information to obtain? How might you gather the information needed for the Resource Inventory? Should you use the results to prepare an online or hard- copy Inventory for use beyond the PC/PB? Why or why not?

Profile of Provider Capacity and Capability Provides information on service capacity and staff capability of service providers in an EMA or TGA to meet the needs of PLWH Includes the extent to which services are available, accessible, and appropriate to PLWH overall and to specific subpopulations Includes providers funded through RWHAP Part A, other Parts, public insurance, or other sources Emphasis on providers serving RWHAP Part A-eligible PLWH – e.g., people with limited incomes who depend on RWHAP for some or all their HIV-related care

Key Factors in Analyzing Provider Capacity and Capability Availability: level or number of “slots” within a service category that exist in a specified geographic area and whether there are waiting lists Accessibility: the extent to which services in a particular geographic area can be obtained conveniently by people who need them, based on location, access to public transportation, service hours, wait time, and Americans with Disabilities Act (ADA) compliance Appropriateness: the extent to which services meet the needs of various PLWH subpopulations, in terms of languages spoken and cultural competence with regard to race/ethnicity, sexual orientation, gender, and identity

Developing the Profile of Provider Capacity and Capability PC/PB gathers data from service providers, usually through provider surveys or interviews, then: Aggregates data by service category Reviews and analyzes data by location within the EMA or TGA Identifies overall service gaps (limited availability) Analyzes accessibility by service category and geographic location Analyzes appropriateness for specific populations, with focus on PLWH groups with low rates of linkage to care, retention in care, and viral suppression Geographic disparities - differences in access to needed services based on where an individual lives

Quick Activity D: Understanding the System of Care Last year your PC/PB did a PLWH survey of 510 people from diverse backgrounds and all parts of your EMA/TGA. It found that PLWH views about their ability to access needed services varied a lot by geographic area, race/ethnicity, gender/gender identity, and age. This year you are planning a survey of RWHAP-funded and non-funded service providers to better understand the current system of care. What is some of the most important information to obtain? You will use your Resource Inventory in planning the survey. Should you survey all the providers in the Inventory? Why or why not?

Assessment of Service Needs and Gaps Last component of needs assessment Analysis of data from all needs assessment components Review of additional data provided by the recipient on client characteristics and service utilization What services are being used and by whom? Identification of: Service needs, overall & for particular PLWH subpopulations Barriers to service access and retention Service gaps Appropriateness of services for different PLWH groups Implications for decision making

Understanding Service Gaps Epi, Unmet Need, Unaware PLWH Data, plus Assessment of Service Needs & Barriers Resource Inventory & Profile of Provider Capacity & Capability Gaps determine needed RWHAP Part A allocations

Sum-Up PC/PB responsible for obtaining, collecting, and analyzing needs assessment data as a basis for priority setting and resource allocation and other decision making Direct data gathering required for: Assessment of service needs and barriers of PLWH in and out of care Information on the system of care, including a Resource Inventory and Profile of Provider Capacity and Capability Review and analyze all needs assessment data to identify service needs, barriers, and gaps Use needs assessment findings in PSRA and other decision making