FY 2013 Ryan White Part A Clients by:  Gender  Age  Race  Ethnicity  Geography  Annual Income  Housing Status  Insurance Status  Clients at or below 100% FPL  HIV Status

N = 4,120 Men 2,681 (65%) Women 1,417 (34%) Transgender 22 (1%)

N = 4,120 Under 2 1 (>0.01%) 2 to (0.5%) 13 to (8%) 25 to 44 2,067 (50%) 45 to 64 1,605 (40%) (2%)

N = 4,120 Black/African American 3, 460 (87%) White 367 (9%) American Indian 25 (0.6%) Asian Pacific Islander 17 (0.4%) More Than 1 Race 206 (4%) Unknown 2 (0.04%)

N = 4,120 Non-Hispanic = 4,030Hispanic = 90

N = 4,120 TN Shelby = 3,695 (89%) Tipton = 38 (0.9%) Fayette = 25 (0.6%) AR Crittenden = 92 (2%) MS Desoto = 96 (2%) Tate = 10 (0.2%) Marshall = 15 (0.2%) Tunica = 20 (0.4%) Unknown 129 (3%)

N = 4,120 Unknown 498 (11%) More than 300% FPL 44 (1%) % FPL 282 (7%) % FPL 630 (16%) 100% or below FPL 2666 (65%)

N = 4,120 Stable/ Permanent – 3330 (81%) Non- Permanent – 236 (5%) Unknown – 535 (13%) Institution – 19 (1%)

N = 4,120 Private – 505 (12%) Medicare/caid – 1,489 (36%) No Insurance – 1,593 (38%) Other – 34 (1%) Unknown – 499 (11%)

N = 2,666 Medicaid – 773 (29%) Medicare – 479 (18%) No Insurance – 1228 (46%) Private – 186 (7%)

N = 4,088 HIV-Positive, not AIDS – 2,232 (55%) CDC Defined AIDS – 1,237 (30%) HIV-Positive, AIDS Status Unknown – 619 (15%)

FY13 RWA Unduplicated Clients: Utilization of Funded Core Services FY11 – FY13 RWA Unduplicated Clients: Utilization of Funded Core Services FY13 RWA Unduplicated Clients: Utilization of Support Services FY11 – FY13 RWA Unduplicated Clients: Utilization of Funded Support Services FY13 RWA Expenditures by Funded Core Services FY13 RWA Expenditures by Funded Support Services FY13 Allocations vs. Expenditures of Funded Core Services FY13 Allocations vs. Expenditures of Funded Support Services

Service Category Total Expenditures # Clients Average Cost per Client # Services Average # Services per Client Outpatient $2,577, ,358$1,9045,033 OP visits4.0 Local Pharmacy $32, $ prescriptions1.0 Oral Health $559, $1, visits2.0 Mental Health $77, $ visits3.0 Medical Nutrition Therapy $63, $ encounters1.0

Service Category Total Expenditures # Clients Average Cost per Client # Services Average # Services per Client Medical Case Management $969, ,667$264 34,341 encounters 10.0 Early Intervention Services $390, ,316$169 8,008 encounters 3.0 Substance Abuse Treatment $24, $ encounters9.0 TOTAL$4,323,654.47

Service Category Total Expenditures # Clients Average Cost per Client # Services Average # Services per Client Case Management (Non-medical) $70, $3481,815 encounters9.0 EFA $72, $ payments1.0 Food Bank $112, $ food bags/1232 food vouchers 3.0 Housing $33, $3, rent/deposit payment 6.0

Service Category Total Expenditures # Clients Average Cost per Client # Services Average # Services per Client Medical Transportation $37, ,605$23 4,017 bus passes, 2,183 gas cards, 60 cab trips, 29 round trips 4.0 Psychosocial Support $96, $3301,677 encounters6.0 Referral for Health Care/Support $26, $ referrals for care, 488 referrals for testing 5.0 Outreach 23, ,366$5 5,841 visits, 17,335 page views 1.0 TOTAL$471,663.53

FY13 Allocations vs. Expenditures of Funded Core Services FY13 Service Priority SERVICE CATEGORY Part A FY13 Allocations Part A FY13 Expenditures MAI FY13 Allocations MAI FY13 Expenditures 1 Outpatient /Ambulatory Health Services 55.00%45.08%5.00%2.12% 2AIDS Drug Assistance Program (ADAP)0.00%8.41%0.00%13.69% 5AIDS Pharmaceutical Assistance (local)0.75%0.57%0.00% 7Oral Health Care13.00%10.24%0.00% 4 Early Intervention Services1.00%0.51%75.00%58.72% 8Mental Health Services2.00%1.42%0.00% 9Medical Nutrition Therapy1.50%1.11%0.00% 3 Medical Case Management (incl. Treatment Adherence) 18.00%17.19%0.00% 15Substance Abuse Services - outpatient0.58%0.42%0.00%

FY13 Allocations vs. Expenditures of Funded Support Services FY13 Service Priority SERVICE CATEGORY Part A FY13 Allocations Part A FY13 Expenditures MAI FY13 Allocations MAI FY13 Expenditures 12 Case Management (non-Medical) 1.50%1.30%0.00% 14Emergency Financial Assistance 0.92%0.90%3.00%3.69% 10Food Bank/Home-Delivered Meals 2.00%1.38%7.00%5.21% 18Health Education/Risk Reduction 0.00% 0.50%0.00% 16Housing Services 1.00%0.59%3.50%0.00% 11Medical Transportation Services 0.75%0.57%2.00%1.25% 17Outreach Services 0.00% 4.00%6.31% 13 Psychosocial Support Services 1.50%1.69%0.00% 29 Referral for Health Care/Supportive Services 0.50% 0.00%

FY12-13 QM Performance Measures: HAB01: 2 Visits >= 3 months apart FY12-13 QM Performance Measures: HAB02: >= 2 CD4 Counts FY12-13 QM Performance Measures: HAB03: CD4<200 w/ PCP Prophylaxis FY12-13 QM Performance Measures: HAB04: AIDS Clients on HAART 2013 In+care Campaign Measures for Memphis TGA Comparing Memphis TGA In+care Measures Nationally as of 12/2013

FY12-13 QM Performance Measures

Other Funding Sources Ryan White Parts B, C, and D Medicaid Centers for Disease Control and Prevention HOPWA & Community Sources for EFA Substance Abuse Prevention and Treatment Food & Nutrition Services – WIC & Food Stamps Veteran Administration

Part B of the Ryan White HIV/AIDS Program provides grants to States and U.S. Territories. States and U.S. Territories may: provide services directly, contract with agencies, or work through subcontracts with Part B HIV Care Consortia

AR ADAP Utilization and Expenditures in the Memphis TGA

Part C provides grants directly to service providers to support EIS and ambulatory care for PLWHA No more than 10% of the budget can be allocated to administrative costs At least 75% of the balance remaining after subtracting administrative costs, must be used for core medical services

Outpatient/Ambulatory Medical Care Dental, Medical, Case Management Medical Transportation, Mental Health Nutritional Counseling & Supplements HIV testing Outpatient/Ambulatory Medical Care Mental Health

Part D funding is for women, infants, children, youth and their families. Le Bonheur Community Health & Well- Being receives part D funding and sub- grants to other organizations. Serves: Shelby, Fayette, and Tipton Counties in TN, Desoto County in MS, and Crittenden County in AR

All youth specific funding cut in All youth specific funding cut in Overall cuts of 60% in the last two years.Overall cuts of 60% in the last two years.

N=1,987 N=1,501 N=1,873

N = 60

N=44 N=61

Provides funds to states for HIV Prevention and testing programs States distribute the funds to local programs via the state Department of Health or local Consortia

TN Department of Health HIV Prevention Funding for Shelby, Tipton, and Fayette Counties

Testing sites in DeSoto, Marshall, Tate and Tunica DeSoto County Health Department Marshall County Health Department Tate County Health Department Tunica County Health Department Aaron E. Henry Health Services Center

Crittenden County is not covered in the scope of work for any funded grantees However, the grantees are not limited to serving only clients that reside in their scope of work Testing events occur in Crittenden County

Source: HIV Infected Veterans in VHA Care by State Arkansas Mississippi Tennessee

Administered by the U.S. Department of Agriculture, WIC provides federal grants to states Serves low-income pregnant / postpartum women and infants and children up to age five who are at nutritional risk WIC Special Supplemental Nutrition Program (SNP) – Provides nutritious supplemental foods, nutrition education, breastfeeding support, and health/social services referrals WIC Commodity Supplemental Food Program (CSFP) – Similar to SNP, but CSFP also serves elderly people and provides food rather than food vouchers Eligible people cannot participate in SNP and CSFP at the same time

Food Stamp programs are: – financed 100% by Federal funds, and – administered by the Departments of Human Services in TN, MS, and AR Client benefits can be redeemed at: – participating stores, – farmers’ markets, – direct marketing farmers, – homeless meal providers, – treatment centers, – group homes, and – others authorized to accept SNAP

Managed by the U.S. Dept. of Housing and Urban Development and serves PLWHAs living in all the counties of the Memphis TGA Services include – Tenant-Based Rental Assistance (TBRA) – Short-term Rent, Mortgage & Utility Assistance (STRMU) – Permanent Housing Facility – Short-term Housing Facility – Permanent housing placement – Housing information (e.g., flyers, pamphlets) – Support Services

(N= 997) N = 725 N = 997 N = 821 N = 1,076

Metropolitan Inter-Faith Association (MIFA) – Provides food, rent/mortgage, transportation, and utility assistance to eligible individuals MLG&W Utility Service Payment Assistance Programs – Includes the Federal Low Income Home Energy Assistance Program (LIHEAP), a non-emergency program that provides utility assistance in the form of a credit once per calendar year – Utility bill payment assistance programs have age, income, disability, need and other eligibility requirements