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Welcome to Ryan White
Fall Fest!
ISDH Announcements • DIS Appreciation Day!!
• Award Notification
• New Staff Introductions
• Open Positions
• Ryan White Services Specialist
• Services AA
Festival Clarifications• Facilities Location (s)
• Lunch will be served at noon
• If you have questions, ask a festival friend (wearing pumpkin lanyards)
• We have a photo booth!! During breaks, please take advantage and use
the hashtag #IndyRWFallFest19
• Have fun!
ICEBREAKER
What makes a “successful
grantee?”
Successful Grantee Basics
• Understand the basics of the Ryan White Program
• Understand Program and Fiscal Requirements
• Read your updated contract Attachment A
• Understand RW Service Categories and Service Standards
• Submit timely invoices
• Provide timely monthly reports
• Provide accurate client data
Successful Grantee Basics
• Assess client needs and understand which RW categories can
best meet those needs
• Understand your agency’s capacity and the power of
networking
• Utilize the resources ISDH has developed or is developing
• Keep an open mind and think outside the box
Communication Basics
Teamwork• You are funded to provide services, but you have to work with your
staff and staff at ISDH. This means:– Being accountable for your grant and the work that goes into it.
– Being open, honest, and respectful in your communication with ISDH.
– Accepting that things change sometimes, and doing the best you can as an agency to adapt within the guidelines that ISDH gives you.
• Everyone appreciates a helping hand every now and then. Do not hesitate in helping others, and utilize networking to help your agency out.– If another agency is doing something wonderful, contact them for more
information.
Be Honest and Ethical
• Grantees are to be honest about changes and questions with their funding. ISDH also agrees to be honest and open about funding with grantees.
– Learn from mistakes in past years, but be open to make new changes.
– Don’t wait for questions to be answered, reach out immediately for answers.
– Remember that if you have a question, chances are someone else has the same question.
• Self criticism and being willing to receive feedback (good and bad) is essential to becoming a successful grantee.
Be a Clear Communicator
• It’s important to communicate well and express yourself in a clear manner, whether in writing or speaking.– Be concise and to the point.
– Make sure if you don’t get a response within 48 hours, follow up with a phone call.
• Include at least TWO ISDH staff members on each email– Knowing who to email can be confusing. To avoid the confusion, always
include at least two ISDH staff members on each email.
• Be sure of information when communicating with the public.– Make sure you verify new programs, new eligibility, or new financial
information with ISDH before releasing it to outside partners or clients.
Who is Who?• Prevention
• DIS
• Health Foundation
• NMCM
• Consultants
Who do I email?
• What emails do I use?
– Prevention: [email protected]
– DIS: [email protected]
– Ryan White Services: [email protected]
– Non-Medical Case Management: [email protected]
– Medical Services: [email protected]
** Invoicing for RW Services and NMCM: [email protected]
Tips for Communication
We are all busy, below are some tips for communication:
• Brief and To The Point
– Leadership follows several programs and several priorities.
– Present information in concise, bulleted formats to help them digest information quickly.
– Prioritize your information, starting with what you most want them to remember.
– Long, wordy sentences will lead to confusion and missing relevant facts.
• Only the Facts, Please
– Don’t interject assumptions or personal opinions about the subject.
– Note clear, objective facts.
– Reference specific legislation and policy when needed.
Tips for Communication
• Be Prepared With Background– Leadership may know a lot or a little about the subject matter.
– Provide only the most relevant background information in your bulleted document.
– Include more detailed background information in your talking points, in case you are asked to provide more historical context.• SCM numbers, specific month, service categories
• Justify Recommendations– If you are making recommendations, then clearly justify them. Know them
inside and out.• ISDH wants to hear all concerns, comments, and answer clarifications.
Recover and Stay Well
• We could not provide this funding without your agencies, so take
care of yourself and model that for your staff!
• Relax, recover and use your spare time wisely.
– Take your breaks during the day, and get up and move. Take a walk
outside, or go sit somewhere peaceful.
– Find a hobby you like.
– Be attentive to your family and friends, doing things together you enjoy.
– Take time off, and don’t keep checking e-mails away from the office.
– Get enough sleep.
Ryan White Fundamentals
The Ryan White HIV/AIDS Program
• The Ryan White HIV/AIDS Program (RWHAP) funds a comprehensive system of care that includes primary
medical care and essential support services for people living with HIV who are uninsured or underinsured. The
RWHAP is managed through the HIV/AIDS Bureau (HAB) of the Health Resources and Services Administration
(HRSA).
• The Program works with cities, states and local community-based organizations to provide HIV care and
treatment services.
• The RWHAP is divided into several Parts, defined by the authorizing legislation.
• ISDH HIV Services Program (HSP) administers Part B funds (which includes funds for the AIDS Drug
Assistance Program, or ADAP and Part B Supplemental funds). Part B funds are granted to U.S. states and
territories.
The Ryan White HIV/AIDS Program
• Ryan White Part B funds must be used for allowable HIV-related services to eligible individuals
• Services that may be provided are noted in the Ryan White Care Act Legislation.
• HRSA further defines what those services are and how they may be provided through policy
• Policy Clarification Notice 16-02 is the ultimate resource!
• Of all services funded:
• At least 75% must be “core medical” services.
• No more than 25% can be spent on “support” services.
Ryan White Requirements
Ryan White Part B funds must be: • Used for HIV-related services.
• Provided to low-income people, but states can define “low-income”
• Used for specific services
• Reflect back on PCN 16-02 for these services!
• Remember that at least 75% of service dollars must be “core” services, and no more
than 25% “support” services
• Applied and Used with certain Administrative caps
Ryan White Eligibility
• Clients must be HIV positive
• Clients must be HIV positive and meet state program income eligibility requirements
• Clients must live in the State of Indiana and be able to provide current residency
Eligibility must be recertified every 6 months
Annual recertifications must involve obtaining updated documents
Six-month recertifications may be done through “self-attestation”
Payor of Last Resort and Allowability
• By statute, RWHAP grant funds may not be used for any item or service for which payment has been made,
or can reasonably be expected to be made by any other payer.
• Every effort should be made to have other payers cover services.
• Clients must be screened for eligibility for other coverage, like Medicaid.
• Providers must attempt preauthorization or exception processes required by insurers before relying upon RW funds
• Recipients must assess whether services paid for and provided are allowable under law and policy,
and are HIV-related
• If steps are not taken to ensure allowability, penalties can be issued including: recouping funds that may
have already been paid, contractors may have to pay the state back, and the state may have to pay the
federal government back.
Allowability
• Recipients must assess whether services paid for and provided are
allowable under law and policy, and are HIV-related.
– Consequences can include recouping funds that may have already been
paid. If activities have been deemed unallowable, contractors may have
to pay the state back, and the state may have to pay the federal
government back.
• PCN 16-02 covers the HRSA allowability for service categories
– ISDH service standards combine PCN 16-02 and Indiana specific
guidance
Networking NineEach round of the Networking Nine is to allow you to mingle with other people in the room.
We Encourage:
• Finding someone you may not know who has your same dot color and introducing yourself
• Talking with others in the room about their funding, innovative ways to collaborate, and overall meeting new
faces!
• Have FUN!
Break
Ryan White
Service Standards
Service Standards • Ryan White HIV/AIDS Program (RWHAP) recipients must develop Service
Standards for every funded service category, to be followed by every funded
subrecipient.
Service Standards establish minimal expectations that any provider must meet when
providing a service.
•Foundation of a clinical quality management (QM) program and subrecipient
monitoring
•Provide a framework from which processes and outcomes are measured
•Define the core components and activities of a service category
•Used by the recipient to define expectations for service procurements.
Service Standard Development
• Service standards establish the minimal level of service or care
that a HRSA RWHAP funded agency or provider may offer
within a state, territory or jurisdiction.
• Service standards related to HRSA RWHAP Core Medical
Services must be consistent with U.S. Department of Health and
Human Services’ Clinical Guidelines for the Treatment of HIV,
as well as other pertinent clinical and professional standards.
ISDH Service Standard Process
• Internal Committee of ISDH staff led the development of service
standards. Committee sought advice and feedback from:
– Professionals within the field
– Internal ISDH Programs
–Other Ryan White Part B programs
–Consultant Team
–Marion County Public Health Department Ryan White Programs
Revisions Since June 12th• Based on Feedback from the June 12th Summer Camp Meeting and
comments received after:
– A service unit was added to the Housing Service Category to account for
staff time
– Further aligned with Marion County and continue to partner in service
standard development
– Recovery Coach added under Substance Abuse Outpatient
Universal StandardA Universal Standard is one overarching Standard that addresses common elements to all Service
Standards.
A Universal Standard includes elements such as:
•General Eligibility and Recertification
oSome Service Categories may require specific criteria for service eligibility above and
beyond common eligibility
•Client Rights and Responsibilities
•Grievance Process
•Cultural and Linguistic Competency
•Privacy and Confidentiality
Uses of Standards • Subrecipient monitoring
•Recipients are responsible for ensuring the development, distribution, and use of the service
standards (i.e., site visits and chart reviews). Service Standards are important to ensure that services
are provided to clients in a consistent manner across service providers.
• Quality Management
•Service standards are the foundation for the clinical quality management program, and provide the
framework and service provision from which processes and outcomes are measured.
• RFP and Contracts
•Service standards define the core components of a service category to be included in the model of
service delivery for each funded service category, and should be included in RFPs.
• Consumer Information
ISDH Service Standards
• Format
• Service Definition
• Program Guidance
• Key Services Components and Activities
• HSP Service Standards
• Standard and Documentation
• Subservices
• Service Unit Definition
Continual Review
• Advisory Council subcommittee facilitating the review and revisions
• If interested in joining please contact [email protected]
• If you have specific program questions please contact the HIV Services
Program
Service Standard Review
Select a Service Standard from the folder and review it
with your table. Discuss how you will use this with your
individual programs.
Questions?
Networking NineEach round of the Networking Nine is to allow you to mingle with other people in the room.
We Encourage:
• Finding someone you may not know who has your same dot color and introducing yourself
• Talking with others in the room about their funding, innovative ways to collaborate, and overall meeting new
faces!
• Have FUN!
Lunch!
Data Collection and
Reporting
Current Data Collection
• For those collecting data, you are use to the Excel data collection sheets
• All Ryan White Funded entities will be required to report client level data
• Non-Medical Case Management services started July 1st 2019
• For those not entering into spreadsheets, you should anticipate this process to
begin January 2020.
Agency Name (Choose one from drop-down list)
HIVe ID(should begin with a 5,6,
or 100)First Name Last Name
Date of Birth (mm/dd/yyyy)
Current Gender Identity (Choose one from drop-
down list)
Service Category(Choose one from drop-down list)
Date of Service (mm/dd/yyyy)
Data Elements
• Data tracked on the client level data include:
– Agency name, HIVe ID, Name, DOB, Gender Identity, Service Category, and Date of Service
• Additional Data Elements Required by HRSA are being pulled from HIVe and the Medical Services Applications
Why Data Collection?
• ISDH and Marion County have been meeting weekly to discuss the complexities
of what CAREWare looks like on a State-wide platform
• To maintain data integrity and to track patterns of services across the state, we use
the spreadsheet tracking system
• Think about the Ryan White Services Report! (RSR)
• The spreadsheet tracking system will remain the data collection tool used
Things to Remember
• Alignment with subservices and service units
• Eligible scope reporting
• Contact us with any questions
Why does it matter?
Client Level Data Requirement of Ryan
White Federal Funding
Which is reported in the
Ryan White Services
Report Annually
The above
process is not
only required…
BUT it also helps regain funding yearly and
expand programming for ISDH. This
includes Prevention, DIS, and other
Supportive Services Programs
Additional Reporting • Monthly report
– Programmatic updates, aggregate data, request for technical assistance
• Quarterly reporting
– Client level data and financial updates
• Annual reporting- Ryan White Services Reporting
– Client level data for the calendar year, typically includes 2 contract periods
– Crosses Ryan White programs and any service categories offered
HIVe Reminders
Top Three ThingsWhen verifying eligibility in HIVe focus on the following:
1. Check the HIVe ID
2. Check the Next Recertification date
3. Check the language at the bottom of the page
Data Activity!
Scenario One
A client comes in to access a food gift card.
List every step you would take to verify the client accessing
this service and reporting it for data.
Scenario One StepsQuestions to ask: What is my agency funded for?
Is the food gift card out of Ryan White funding? If no- what is the agency’s process to verify
that gift card delivery? If yes- did I do the proper process below?
Steps to take:
- Verify the client in HIVe to confirm they are eligible and enrolled
- If they are, you can give the gift card, if not- refer client to their NMCM
- After you give the gift card, you should log the interaction on the data collection tool
Scenario TwoClient is accessing a OAHS service, but the client has
private insurance. The appointment will be billed for the
physicians time with the client in a Ryan White funded
clinic.
What steps should be taken to verify and report data on
this client interaction?
Scenario Two StepsStep One- Verify eligibility and enrollment in HIVe.
Step Two- Determine how many service units were
provided under the OAHS service category and ensure
services align with Service Category/Service Standards.
Step Three- Record in client level data spreadsheet under
the OAHS Service Category.
**Remember- When any percentage of a physician or
clinic is being funded by Ryan White dollars every client
seen that is eligible for Ryan White services must be
reported.**
Scenario ThreeAn agency is funded for NMCM, Food Bank, and Housing. Client
comes into the agency and meets with their Ryan White funded
NMCM. In the course of the interaction the Client receives a Food
Bank funded gift card and food. Client also finds out their housing
assistance application was approved and a check for their rent will be
going out that day.
What questions should you ask? What services are reportable to ISDH
for this client and how would that information be provided?
Scenario Three Steps Questions to ask: An agency is funded for NMCM, Food Bank, and Housing. Client
comes into the agency and meets with their Ryan White funded NMCM. In the
course of the interaction the Client receives a Food Bank funded gift card and food.
Client also finds out their housing assistance application was approved and a check
for their rent will be going out that day.
Steps to take:
- Verify the client in HIVe to confirm they are eligible and enrolled
- Determine how the staff serving the client are funding
- For anyone funded by Ryan White funds you will need to report the data onto
the corresponding spreadsheet. Be sure to be aware of different contracts and
each one’s spreadsheet.
New Programs!
Networking NineEach round of the Networking Nine is to allow you to mingle with other people in the room.
We Encourage:
• Finding someone you may not know who has your same dot color and introducing yourself
• Talking with others in the room about their funding, innovative ways to collaborate, and overall meeting new
faces!
• Have FUN!
Break
Town Hall
Activity • As a table, come up with one question in regards to the following:
• How ISDH can support your programs more
• How our services can be marketed more to clients
• Outstanding questions you still have on anything!
• Once you have your question, nominate one person to write your question on the
white board paper posted around the room.
• Each person will take a post it and walk around to each question. Your goal is to
either write a response on your post it, a follow up question, or just a YES/NO if
you agree or disagree with the question.
Town Hall
Follow- Up
