1. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel Chicago’s Transition to an Integrated Planning Council November 21, 2013 H.L. Anderson Nanette Benbow Christopher Widmer Governmental Co-ChairDeputy CommissionerProgram Director Peter McLoydCheryl PottsCommunity Co-Chair

2. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel Chicago’s Transition to an Integrated Planning Council Christopher Widmer – Director, Ryan White Part A, CDPH Slide 2

3. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel Chicago’s Transition to an Integrated Planning Council Peter McLoyd – Community Co-Chair Slide 3

4. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel Chicago’s Transition to an Integrated Planning Council Hannah Anderson – Government Co-Chair / CDPH Slide 4

5. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel Chicago’s Transition to an Integrated Planning Council Cheryl Potts – Community Co-Chair Slide 5

6. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel Chicago’s Transition to an Integrated Planning Council Nanette Benbow – Deputy Commissioner, CDPH Slide 6

7. Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel Chicago’s Transition to an Integrated Planning Council Chicago Area HIV Integrated Services Council CAHISC Slide 7

8. Presentation Overview The Chicago EMA Prevention & Care Planning Activities Impetus for Integrated Planning Process for Integrated Planning  Challenges  Support & Endorsement  Integration Work Group  Selection Committee Tasks Slide 8

9. Presentation Overview New Configuration  Initial Phase – Year 1  Initial Phase – Year 2 (proposed)  Final Configuration  Committee Structures  Resources  Lessons Learned  Moving Forward Slide 9

10. Like other Eligible Metropolitan Areas (EMAs), the Chicago EMA is comprised of urban, suburban and rural communities. The Chicago EMA consists of 9 counties. Of the EMA's residents, 94% live in urban areas, 2% live in suburban areas and 4% live in rural areas. 85% of PLWHA in Illinois live in the EMA. There are 33,856 people living with HIV and AIDS (PLWHA) in Illinois. Eighty five percent (28,741) reside in the EMA and 64.5% (21,844) reside in the city of Chicago. Chicago EMA Slide 10

11. Prevention and Care Planning Activities in Chicago from 1999 - 2006 Consider value of joint Community Planning Increase understanding between Prevention / Care Create and implement a Strategic Plan Identify data to create collective outcomes Ensure the continuous involvement of all stakeholders Identify and evaluate best practices Prevention & Care Work Groups established Slide 11

12. November 2009 Test Linkage to Care + Treatment (TLC Plus) (HPTN 065) (RM Granich, et al) December 2009 HHS Revised Treatment Guidelines March 2010 ACA signed into law July 2010 White House release National HIV/AIDS Strategy (NHAS) 2010 ECHPP /12 Cities Project February 2011 CROI - Can Lowering Community Viral Load Decrease New HIV Infections? March 2011 Gardner Cascade Aug. 2011 HPTN 052 (M. Cohen et al) June 2012 ACA and Supreme Court decision July 2012 CDC Revised HIV Planning Guidance Impetus for Integration Slide 12

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14. Challenges Community Support Ryan White Part A / Prevention balance How to Integrate Housing? Integrated Membership By-laws Synchronize Planning Cycles Prevention & Care Planning Guidance Respectful transition of current members Slide 14

15. Level of Support HIV Stakeholders: Planning Council, HPPG, and other partners Federal Partners (HRSA & CDC) Community Co-Chair Leadership CDPH Leadership: STI/HIV Division and staff commitment Slide 15

16. Endorsement Slide 16

17. Integration Work Group Composition: Twelve CDPH Employees: Prevention, Care, Housing, and Public Information Fourteen Community Representatives: Leadership from PC and HPPG: 50% Consumers Tasks: Review Prevention and Care Models Create Integration Model Hand-off charge to Selection Committee Slide 17

18. Selection Committee Tasks Review Ryan White Primer Review CDC Prevention Planning Guidance Develop Scoring Criteria Review and Score Candidate Applications Identify candidates slated for interviews Present slate for review and vetting by CDPH Present final slate to Steering Committee Slide 18

19. Initial Phase – Year 1 May 2011: Integration Workgroup – Membership recruitment put on hold recognizing imminent changes May 2011December 2011January 2012February 2012 Slide 19

20. Initial Phase – Year 1 May 2011: Integration Workgroup – Membership recruitment put on hold recognizing imminent changes Dec 2011: Interim Bylaws, call for applications and new name – CAHISC May 2011December 2011January 2012February 2012 Slide 20

21. Initial Phase – Year 1 May 2011: Integration Workgroup – Membership recruitment put on hold recognizing imminent changes Dec 2011: Interim Bylaws, call for applications and new name – CAHISC Jan 2012: Selection Committee: New Applications May 2011December 2011January 2012February 2012 Slide 21

22. Initial Phase – Year 1 May 2011: Integration Workgroup – Membership recruitment put on hold recognizing imminent changes Dec 2011: Interim Bylaws, call for applications and new name – CAHISC Jan 2012: Selection Committee: New Applications Feb 2012: Joint Meeting – the Council and HPPG – The Chicago Area HIV Services Council and the HIV Prevention Planning Group voted on February 17, 2012 to dissolve both planning groups to create a streamlined planning process and ultimately a unified plan for the Chicago EMA. May 2011December 2011January 2012February 2012 Slide 22

23. PreventionNA/GAEval/QM Priority setting CareNA/GAEval/QM Priority setting HousingNA/GAEval/QM Priority setting Member Services Processes Steering Committee Governance OUTREACH Capacity Building Slide 23 CAHISC Initial Phase – Year 1

24. NA/GA PreventionCare Housing & Other Services Eval/QM PreventionCare Housing & Other Services Priority Setting PreventionCare Housing & Other Services Member Services Processes Steering Committee Governance OUTREACH Capacity Building Slide 24 CAHISC Initial Phase – Year 2 (Proposed)

25. Phase 2 March 2012: Select applicants March 2012April/May 2012January 2013 Slide 25

26. Phase 2 March 2012: Select applicants April/May 2012: The first CAHISC planning body, strategic planning meeting. March 2012April/May 2012January 2013 Slide 26

27. Phase 2 March 2012: Select applicants April/May 2012: The first CAHISC planning body, strategic planning meeting January 2013: The CAHISC steering committee held a two-day strategic planning meeting to review integration progress  Reviewed epidemiological data  Membership survey results on integration process  Compared HRSA and CDC community planning requirements  7 new models were considered March 2012April/May 2012January 2013 Slide 27

28. Current HIV Continuum of Care * Chicago EMA, 2010 Test Link & Treat Prevent CDPH – STI/HIV Surveillance, Epidemiology and Research Section – 09/2012 *Continuum revised 9/12 Slide 28

29. Final Configuration... the CAHISC Structure CAHISC Vision: “Develop a city-wide plan that identifies and addresses how housing, treatment, substance abuse, mental health and other essential services can prevent HIV infection through suppressed viral load and behavioral interventions” Slide 29

30. Primary Prevention and Early Identification Linkage and Retention to CareAdherence/Access to ART &Viral Suppression Membership and Community Engagement CAHISC Council Model, 2/2013 Needs Assessment Gap Analysis Priority Interventions/Services Needed resources QM Gap Analysis Priority Interventions/Services Needed resources QM Gap Analysis Priority Interventions/Services Needed resources QM Gap Analysis Ensure parity, inclusion and representation of all sectors affected by HIV and contributing to the solution Slide 30

31. Primary Prevention and Early Identification Goals: Decrease the number of new HIV infections. Increase number of people living with HIV who know their status. Slide 31

32. Linkage and Prevention Goals: Increase number of people linked to care. Increase number of people retained in care. Re-engaged people lost to care. Slide 32

33. Adherence/Access to ART & Viral Suppression Goals: Increase number of people accessing ART Increase number of people adhering to ART Increase number of people virally suppressed Slide 33

34. Membership and Community Engagement Goal: Ensure parity, inclusion and representation of all sectors and stakeholders affected by HIV. Promote governance though bylaws. Assure engagement of membership and other stakeholders in process. Slide 34

35. Steering Committee Goal: Ensure the achievement of CAHISC’s deliverables. Promote integration across committees. Govern CAHISC and its activities. Activities: Lead the development of a comprehensive plan. Promote communication and collaboration across committees. Organize monthly full body meetings and presentations. Monitor committee work plans. Review and approve letters of support. Establish need-based ad hoc committees (when necessary). Slide 35

36. CAHISC Resources Resources outlined in the MOU Multi-program approach to support and funding Deputy Commissioner guides CDPH roles with CAHISC Program Directors &liaisons support committees Special units provide support: Evaluation and Surveillance Units Consultant Slide 36

37. Lessons Learned Need more time to complete and validate slate Generated robust applications Brought new leadership with new perspectives & need for training Standardized community planning process for all HIV funding sources Directly supports objectives of NHAS Slide 37

38. Initially perpetuated “silos” but changed model to address this issue Selection of members was completely objective Time constraints and competing priorities for integration and funder requirements How does Housing factor into HIV planning? Lessons Learned Slide 38

39. How do we ensure that all members of CAHISC have equal voice and a “level playing field of knowledge” Commitment and stability of leadership critical (both CDPH and Steering Committee) Reasonable timelines to accomplish all work Grantee staff have to be involved and at the table every step of the way Lessons Learned Slide 39

40. Moving Forward Integrated Comprehensive Plan Strategic Planning Consider new Healthcare Landscape Invite content experts as needed to inform the plan Multi-agency / multi-funding approach Summer 2014... Slide 40

41. Moving Forward Integrated Comprehensive Plan represents a true health department / community partnership for Prevention, Care & Housing Creating the plan affords us the opportunity to listen, share, and ask important questions to get us to the collective/common goal The plan’s focus are the desired achievements above & beyond usual funding sources Slide 41

42. Contact Information Christopher Widmer Christopher.Widmer@cityofchicago.org 312-747-3295 Slide 42

43. facebook.com/ChicagoPublicHealth @ChiPublicHealth 312.747.9884 www.CityofChicago.org/Health HealthyChicago@CityofChicago.org Slide 43