State Hard at Work on Integrated HIV Prevention and Care Plan

As mandated by the Health Resources and Services Administration, HIV/AIDS Bureau (HRSA/HAB) and the Centers for Disease Control, Division of HIV/AIDS Prevention (CDC/DHAP), the State of Ohio has begun working on a five-year plan on HIV prevention and care needs, existing resources, barriers and gaps within jurisdictions, and how it plans to address them for 2017-2021. The plan is due to the federal government by the end of September, 2016, so there will be a full schedule to achieve this goal in the coming months. Traditionally, HIV care and HIV prevention produced separate plans and submitted them to their respective federal agencies. This is a great opportunity to think about integrated care and prevention and set goals for the state.

Presented with this opportunity to develop an integrated plan, the Integrated Plan Steering Committee (The Center for Community Solutions is a member) is looking at the big picture and assessing the barriers, gaps, and needs of all people living with HIV/AIDS in Ohio. In other words, the committee is looking beyond just people served by the Ohio Department of Health care (Ryan White Part B HIV/AIDS Program) and prevention programs to develop a plan that will improve services and target investments that provide the greatest impact. The committee has representation from the Governor’s Office of Health Transformation, and the Ohio departments of Health, Medicaid, Aging, and Mental Health and Addiction Services, the Joint Medicaid Oversight Committee (JMOC), the Cleveland and Columbus Ryan White Part A programs, AIDS service organizations, Medicaid managed care organizations, and many other stakeholders in order to take this broader look.

The committee convened for the first time in November, 2015, and has met monthly since then to work through the required components of the plan (CDC and HRSA Plan Guidance).

  • Section I: Statewide Coordinated Statement of Need/Needs Assessment

A. Epidemiologic Overview
B. HIV Care Continuum
C. Financial and Human Resources Inventory
D. Assessing Needs, Gaps, and Barriers
E. Data: Access, Sources, and Systems

  • Section II: Integrated HIV Prevention and Care Plan

A. Integrated HIV Prevention and Care Plan
B. Collaborations, Partnerships, and Stakeholder Involvement
C. People Living with HIV and Community Engagement

  • Section III: Monitoring and Improvement

In March 2016, more than 100 stakeholders from across Ohio gathered to identify and prioritize needs, gaps, and barriers that keep individuals from moving through the HIV Care Continuum and to inform the state’s plan. Recognizing the importance of community feedback, there will be meetings in nine regions of the state, one meeting for all stakeholders and another for HIV service consumers in each location, to garner additional input.

A frequent topic of discussion as we move ahead in the planning process is how to coordinate care for people living with HIV/AIDS (PLWHA) with various sources of insurance coverage. To this end, the group has developed a subcommittee to tackle this issue. The subcommittee is thinking about ways that data can be shared between the Ryan White Part B and Medicaid systems to ensure PLWHA are getting the care and services they need. A recent study published in Clinical Infectious Diseases shows that PLWHA who have Medicaid or private insurance supplemented by Ryan White have better treatment outcomes.

As the planning process moves ahead, JMOC’s subcommittee on Ohio Department of Health (ODH) programs is following up on the issues laid out in the JMOC report on ODH treatment programs. The first subcommittee meeting on April 27 focused on the Ryan White Part B HIV/AIDS Program. The Center for Community Solutions, along with Equitas Health/Ohio AIDS Coalition and ODH, was asked to testify before the subcommittee and discuss ways that the Ryan White program can improve care and access for PLWHA.

CCS will continue to provide updates as the integrated plan and the JMOC processes move forward.