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Happy spring! Thanks to you, 2016 was an incredibly busy, productive and impactful year. Here are some highlights:
- Ryan White Program income eligibility is increasing to 400% of the federal poverty level.
- The number of people living with HIV receiving Ryan White Program funding (including state and rebate funded services) increased by 4% in 2016 with a total of 4,290 unduplicated individuals served. Between 2012 and 2015, the number of PLWH utilizing services remained constant.
- An estimated 51% of Minnesotans living with HIV received Ryan White Program services.
The top five services received and the percentage of total clients receiving them were:
- Medical case management (57%)
- Food Bank/Home Delivered Meals (38%)
- Medical Transportation (36%)
- ADAP (34%)
- Outpatient Healthcare Services (27%)
For more details on service utilization please visit this link.
Ryan White Program services are successfully reaching disproportionately impacted populations:
Over 50% were people of color
- 41% were Black
- 11% were Hispanic or Latino
- 8% were American Indian, Asian/Pacific Islander or more than one race
31% were born outside the U.S.
- 15% were born in an African country
- 8% were born in a Latin American or Caribbean country
46% were men who have sex with men
85% of Ryan White Program service recipients had at least one HIV medical appointment in 2016.
86% of people who received Outpatient Healthcare Services had suppressed virus.
Thank you for all that you do to help Minnesotans living with HIV live healthy and vibrant lives and prevent new infections.
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Ryann Freeman joins Hennepin County’s Ryan White program as a program planner focused on rebate funding. Through the rebate focus that supports underserved and disproportionately affected populations, Ryann will take the lead on developing comprehensive cultural competency standards that will be integrated by all contracted providers. Ryann comes to Hennepin County from New York City, where she received a master’s of social work and was introduced to the field of HIV direct service and research. As the previous program manager of an HIV and aging integrated geriatric clinic and program, Ryann has experience working with aging people who live with HIV, and would love to discuss this small but growing demographic with anyone interested!
Jake Maxon recently left the Obama Administration, where he served in the White House Office of National AIDS Policy. Jake joins Hennepin County as the Positively Hennepin strategy coordinator. In this role, Jake will focus on building partnerships between the county, healthcare providers and leaders, as well as communities that the HIV epidemic directly affects. By building these partnerships, we will be able to achieve Positively Hennepin’s vision of a county where residents living with HIV have healthy, vibrant lives; where there are no new HIV infections, and where there is equitable access to HIV prevention and care. Jake brings first-hand experience and expertise around the National HIV/AIDS Strategy (NHAS) that was developed under the Obama Administration. His background at the national level has already contributed to the county’s Ryan White team, and we are eager to build upon the NHAS as we work to implement Positively Hennepin across the county.
Aaron Peterson joins the Ryan White team after serving as the executive director of Healing Words Foundation, a public health nonprofit in Brookings, South Dakota. With a background in mathematics and data systems management, Aaron will work as the data and outcomes coordinator on Hennepin County’s Ryan White team. Aaron is looking forward to creating data systems that will assist with all aspects of the Ryan White program and Positively Hennepin, and has already hit the ground running with great ideas about improving data displays for each provider we serve. Aaron considers himself an approachable “numbers guy” and hopes that he will be able to work with intergovernmental colleagues, providers, and consumers throughout the county to best meet their data outcomes and reporting needs.
Jeremy Stadelman Gauthier is originally from Colorado and made his way to the east coast for college in 2001. At George Washington University, Jeremy earned a bachelor's in anthropology and a master’s in public policy. Jeremy is proud to have focused his educational interests on the LGBT community, specifically as it relates to public health. After graduation, Jeremy worked in both higher education administration and government consulting. His most meaningful work, however, was as a reproductive rights counselor and advocate. It was through this work that Jeremy affirmed his passion for social justice. After a decade in Washington D.C., Jeremy headed back west, where he had a brief stint working in administration at UC Berkeley. Since his arrival in Minneapolis, Jeremy has worked with both the State of Minnesota and the City of Minneapolis, and he now looks forward to bringing his decade of experience to the Ryan White program in support of the Minnesota Council for HIV/AIDS Care and Prevention as their administrative specialist. Jeremy lives in downtown Minneapolis with his husband, Douglas, and their feisty dog, Nola.
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Hennepin County announced its new HIV strategy on World AIDS Day in December 2016. Since that announcement, Jake Maxon began work as Positively Hennepin's first strategy coordinator.
Implementing Positively Hennepin is Jake’s priority. In the months ahead, Jake will create the structures necessary to achieve Positively Hennepin’s two-year milestones and, ultimately, its vision. This effort will involve creating a data workgroup to quantitatively monitor key indicators of success (e.g., 90% of people living with HIV will know their status by 2019) and an outreach and partnership group to maintain meaningful relationships with communities that the HIV epidemic affects.
Also important to institutionalizing Positively Hennepin are HIV education trainings and client/outreach materials for staff outside of Hennepin County (preventing, treating, and stopping HIV is everyone's responsibility).
In just the first few months since Positively Hennepin’s launch, we are moving full steam ahead to make Hennepin County a place where all people living with HIV/AIDS have healthy, vibrant lives; where there are no new HIV infections, and where all have equitable access to HIV prevention and care.
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Quality definition
The HIV/AIDS Bureau (HAB) has defined “quality” as the degree to which a health or social service meets or exceeds established professional standards and user expectations.
Opportunity
Want to learn more about how to improve HIV/AIDS services? Join the MN HIV/AIDS Quality Learning Community.
You will receive emails about resources, webinars, conference calls, and trainings on a diversity of HIV/AIDS care related topics. There is no commitment in joining.
Integration
A new integrated MN HIV/AIDS Quality Management Advisory Committee formed this year with members representing MDH’s HIV prevention work, each Ryan White Part, data experts, and HIV/AIDS service providers and consumers. Learn more about the new QMAC here.
We are also seeking to fill one consumer position. If you are interested, apply here.
CAREWare quality improvement project
In response to many concerns and complaints about CAREWare by Ryan White providers, the Client Level Data Workgroup (made up of DHS, MDH, and Hennepin County) decided to sponsor a quality improvement project to see what could be done to make the CareWare data collection, entry, analysis, and reporting process easier.
Quality improvement coaches were brought in from the Minnesota Department of Health Public Health Practice Division to help providers and government staff map out the current CAREWare process. We then identified problems, and grouped the problems by theme. In the second meeting we regrouped our themes, identified root causes to the problems, and brainstormed solutions. The group finalized an action plan to get us started on next steps. Keep watching for more developments!
Reporting quality improvement project
Previously, every Ryan White provider had to email a quarterly report for each funded service area (e.g., medical case management, mental health, and medical transportation) and for each funding source (Part A or Part B).
In addition, providers had to report twice a year on quality improvement. This means some providers were sending up to 34 reports a year without clear understanding on what happened to those reports once Hennepin County received them.
This year providers will only submit one report per quarter per funding area (that includes reporting on quality improvement). This means that providers should send in no more than eight reports in a year (4 for Part A, 4 for Part B).
Hennepin County staff will review the reports for data quality, progress, questions, concerns, and requests, and respond to each and every report.
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Staff change
Walter Urey joined Hennepin County contract management in February 2017. Walter will oversee Ryan White contracts. Walter comes to Hennepin County with solid experience and a proven track record of success in the nonprofit and corporate sectors, most recently as a sales manager for American National Insurance Company. Walter holds a bachelor's in management information systems from Metropolitan State University and has a passion for the human services and public health field.
Josh Wiechmann is transitioning from his senior contract manager role. Josh accepted a new position within contract management and starts the position April 17. Josh wants to thank everyone for the patience they have shown, the information they provided, and for the opportunity to learn about all of the great work our providers do for the community.
Reminder - income eligibility change
Income eligibility to receive Ryan White Program services funded through either Part A (Hennepin County) or Part B (DHS) grants will increase from 300% to 400% of the Federal Poverty Level (FPG).
This change will be effective as follows:
- Hennepin County Part A administered contracts will increase eligibility beginning March 1, 2017.
- Hennepin County Part B and Rebate administered contracts will increase eligibility beginning April 1, 2017.
- DHS Part B and Rebate administered contracts will increase eligibility beginning July 1, 2017.
Financial eligibility to receive Emergency Financial Assistance will not increase and will remain at 200% FPG.
Income eligibility for programs funded through Program HH (ADAP) as well as Benefits Counseling programs already increased to 400% FPG in 2015 and will remain at that level.
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Part A services
Early intervention
- Full Proof Ministry
- HC Public Health Clinic
- NorthPoint
Emergency Financial Assistance
Food Bank/Home-delivered Meals
- Aliveness
- Minnesota AIDS Project
- Open Arms
Health Education/Risk Reduction
- HC Public Health Clinic
- Minnesota AIDS Project
- West Side
Health Insurance Premiums
Home & Community based Health
Housing
Legal
Medical Case Management (MCM)
- African American AIDS Task Force
- Allina
- Children's Minnesota
- HealthPartners
- Minneapolis Medical Research Foundation
- Sub-Saharan African & Youth Svs
- West Side
MCM - Adult Foster Care
MCM - Treatment Adherence
Medical Nutrition Therapy
Medical Transportation
- Sub-Saharan African & Youth Svs
Mental Health
- HCMC
- Sub-Saharan African & Youth Svs
- West Side
Outpatient & Ambulatory Medical Care
- HealthPartners
- HCMC
- West Side
Outreach
- Aliveness
- HC Public Health Clinic
Psychosocial Support
- African American AIDS Task Force
- Minnesota AIDS Project
- Sub-Saharan African & Youth Svs
- West Side
Substance Abuse Treatment - Outpatient
- Minneapolis Medical Research Foundation
- Minnesota AIDS Project
Part B services
Early Intervention
- Aliveness
- HC Public Health Clinic
Emergency Financial Assistance
Food Bank/Home-delivered Meals
- Aliveness
- Minnesota AIDS Project
- Open Arms
- Rural AIDS Action Network
Health Education/Risk Reduction
- Children's Minnesota
- Minnesota AIDS Project
Health Insurance Premiums
Housing
Legal
Medical Case Management
- African American AIDS Task Force
- Minneapolis Medical Research Foundation
Medical Nutrition Therapy
Medical Transportation
- African American AIDS Task Force
- Aliveness
- Allina
- HealthPartners
- HCMC
- HC Public Health Clinic
- Minnesota AIDS Project
- Rural AIDS Action Network
- West Side
Non Medical Case Management
Outpatient & Ambulatory Medical Care
Outreach
- Aliveness
- HC Public Health Clinic
Psychosocial Support
Substance Abuse Treatment - Outpatient
- Minneapolis Medical Research Foundation
- Minnesota AIDS Project
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Despite decades of public investments, innovations, and collaborations among people living with HIV, HIV advocates, community-based organizations, government, and healthcare and social service providers, HIV continues to be a persistent public health problem in Minnesota.
These investments, innovations, and collaborations have only managed to maintain the “status quo.” The rate of new HIV and AIDS diagnoses in Minnesota has remained steady at an average of 300 cases annually for the last ten years. We need new tools to combat Minnesota's HIV epidemic.
PrEP, which stands for pre-exposure prophylaxis, is a new tool and one of the most innovative and effective ways to prevent HIV. PrEP can be prescribed for uninfected persons who may have significant risk of HIV infection. Individuals prescribed PrEP take one pill daily to prevent becoming infected with HIV through sex or sharing injection drug use equipment. “Truvada” is the only medicine currently approved as PrEP by the U.S. Food and Drug Administration (FDA) and recommended by both the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). Truvada is a pill that contains two HIV medications and is only available through a prescription. In randomized clinical trials, especially the iPrEx study, PrEP showed high efficacy.
PrEP therapy has been called "evolutionary, a “game charger” and the “tipping-point” if fully implemented along with other traditional HIV prevention tools.
Since providers began offering PrEP in Minnesota, it has experienced very slow uptake that mirrors the national trend. The question is not whether PrEP works and is effective, but why so many people who would benefit from it do not take it.
PrEP is readily available from the primary healthcare provider as a prescription and is covered by most health insurance plans, including Medicaid. Uninsured persons can get assistance through the drug manufacturer patient assistance programs.
Local consumers who are interested and willing to take PrEP can access it at four publicly funded agencies, including: Hennepin County Health Department – Red Door clinic services; Hennepin County Medical Center – Positive Care Center; Youth and AIDS Projects – University of Minnesota, and Ramsey County Health Board – Clinic 555 services. Uninsured individuals willing to initiate PrEP may get assistance on how to get insurance at Minnesota AIDS project.
We are at a critical turning point in Minnesota’s HIV prevention history. Because PrEP is a relatively new intervention, most consumers and some healthcare providers may not be familiar with it. To expand PrEP availability throughout the state, we are in the process of compiling a list of healthcare providers currently or willing to prescribe PrEP for an online directory on the Minnesota Department of Health (MDH)’s website. The directory will contain agency/clinic name, address, phone number, and staff contact information.
If you are a PrEP prescriber and would like to be included in this directory, please send your agency contact information to Japhet Nyakundi at japhet.nyakundi@state.mn.us.
Your support as a consumer, HIV service or a healthcare provider in the promotion of PrEP will go a long way to reducing new HIV infections in Minnesota.
Ryan White Program funded Early Intervention, Outreach and Health Education and Risk Reduction providers and HIV medical case managers ought to be talking to their HIV+ clients about PrEP as a prevention option for their partners and routinely referring them to PrEP providers and resources.
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The recently formed Minnesota Council for HIV/AIDS Care and Prevention (MCHACP) combines the community planning requirements of HRSA Ryan White Part A and Part B and CDC HIV prevention. The council recently concluded its first year of business; 2016 was a busy year and major accomplishments include:
Lesa Nelson and Roger Ernst are serving as the council’s community co-chairs and McKinzie Woelfel is the Minnesota Department of Health (MDH) appointed co-chair. Carissa Weisdorf transitioned to the role of council coordinator last November after serving as the council’s administrative specialist for two and a half years. Jeremy Stadelman is the new council administrative specialist.
Five openings for council membership were recently filled during the annual election but there are still council membership spots available.
We are seeking applications from African American, African or Black men and women who are living with HIV and not employed with an agency that receives Ryan White or state HIV prevention funding. We are also seeking a member from the state Medicaid office to meet our required membership categories.
We accept applications for council membership all year and ask you to encourage clients and stakeholders to apply on the council’s website at http://mnhivcouncil.org/.
If you are interested in becoming involved in the council’s activities we have community membership options and all of our council and committee meetings are open to the public. An updated schedule of meetings is found on our website.
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