Brazos Valley Council of Governments
HIV Services Program Report
Name of Agency
HIV Service Delivery Area
Scope(s) of Work
Contract No.
Quarter Reported
Period Covered
Prepared By
If Initial Report
Check box→
Year
Name:
Title:
Email:
If Revised Report
Check Box→
Revision Date:
Revision Number:
Report Submission:
Reports must be emailed in MS Word format to khanle@bvcog.org and jessica.pierce@bvcog.org . A
confirmation email will be sent when the report is received. If a confirmation email is not received by the
business day following your submission, please re-submit the report.
Report Due Dates:
Reporting Period Due Date
Program Period 1 Apr – June
Program Period 2 July – Sept
Program Period 3 Oct – Dec
Program Period 4 Jan – Mar
July 20
Oct 20
Jan 20
Apr 20
**Due to short turnaround time for BVCOG to submit combined reports to DSHS, reporting due dates are
non-negotiable. Contractors are also required to comply with revision requests and must strictly adhere to
deadlines given for revised reports.
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REVISED: September 2011
I.
HIV PROGRAM AND SERVICE DELIVERY
A. STAFFING
1.
List staff changes that occurred during this quarter for positions that affect client services.
Check box if this is a RWB or SS funded position 
Staff Name And Title
2.
Date Departed
List all vacant program positions funded under RWB and State Services that may affect client services:
Position and Title
3.
Date Hired
Name of Contract
Charged (RW or SS)
% Time
Charged
Date Position
Became Vacant
Vacant for
More than 90
days?
Discuss any concerns related to staffing at your agency (e.g., positions vacant for more than 90 days, lack of funding
for a position, concerns regarding staffing/reporting structure).
B. FUNDING
1.
Describe in detail any services clients are requesting that you are not able to provide at this time, or provide on a
limited basis due to lack of funding or other barriers (e.g., you are only able to provide bus tokens and not gas cards
for rural clients). Please include the number of clients requesting the service, the barriers preventing access
to/provision of the service, and any actions your agency has taken to provide or increase access to the service.
2.
List and describe any waiting lists you currently have, anticipate starting soon, or if you are scheduling services out in
excess of three months due. If the waiting list is in place due to capacity or other issues, please explain that as well.
C.
QUALITY MANAGEMENT
1.
Describe quality management activities associated with the HIV Services Program that occurred during the quarter,
including, but not limited to, QM committee meetings, client satisfaction surveys, client focus groups, client file
reviews, staff trainings, etc. Attach the most up-to-date version of your QM Work Plan. (If any changes have been
made during the quarter, also attach an electronic copy of your quality management plan, copies of client satisfaction
survey results, if compiled during this quarter, should also be included. Attach QM Committee meeting minutes,
annual QM Plan evaluations, or other documentation from this quarter).
2.
Discuss your QM program. Include positive or negative issues with the program since the last report. (Examples
include the makeup of the committee as far as who you are considering adding to the committee. Include how this
combination of members works or could be improved on to make the meetings run more smoothly.)
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REVISED: September 2011
3.
Describe positive outcomes or concerns related to your quality management program at this time. These can include
the current makeup of your committee and plans to recruit new members; whether or not the current structure of
your QM program is working overall for your agency; any projects you are currently working on to improve services.
4.
Please answer the following questions regarding the progress you’ve made on improving your outcome measures
(the specific measures included in your contract) for this quarter.
a.
Describe which outcome measures your agency has been focusing on improving during the quarter and why.
This section should NOT include a statement that your agency is focusing on all measures because they are
required.
b.
Describe the activities you’ve implemented to improve the number of clients meeting the standards/measures.
c.
Describe the activities you’ve implemented to improve the quality, timeliness, and accuracy of the data entered
into ARIES for these measures. Explain any difficulties you’ve had in either collecting/entering data for the
measures or improving the numbers.
D. PROGRAM COORDINATION
1.
Goal 1 of the service system improvements as outlined in the current Comprehensive Services Plan is the reduction
of the number of people out of care/with unmet need in each HSDA. Describe activities that occurred during the
quarter designed to bring individuals who are out of care and aware of their positive status into care. Include results
or challenges experienced.
2.
Describe activities that occurred during the quarter to evaluate the effectiveness of the current service system,
and/or activities designed to improve the current service system that occurred during the quarter. These activities
may include removing barriers, increasing service capacity, increasing efficiency of service delivery, or addressing
issues related to service access, including creation of new access points or entry systems.
3.
Describe needs assessment activities that occurred during the quarter. Activities may include assessment of client
need for HIV medical or support services, and assessments of unmet need/out of care populations. Please include
any plans your agency has to resolve the identified needs.
4.
Other than those listed above, describe any new collaborative relationships developed to enhance continuity of HIV
medical or support services. Describe any areas in which you would like to develop collaborative relationships.
II.
ARIES Data Management and Improvement Activities
1.
Briefly describe the findings of any internal audits or actions performed this quarter to ensure the quality and
correctness of the ARIES data. Attach any documents referenced in your answer. Do NOT include general
statements, or copy and paste from previous reports. The information provided should be specific to actions
conducted during this quarter, and discuss findings and changes made as a result.
2.
Describe methods you have developed to improve the data, or efficiencies you have gained in your agency by using
the data in ARIES.
3.
Describe activities and any improvements made during the quarter in your agency’s process for data collection, entry
and oversight.
4.
Briefly describe improvements made during the quarter, if any, to the physical and/or electronic security of ARIES
data.
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REVISED: September 2011
5.
Describe any concerns related to ARIES that have arisen during the reporting period. This should include concerns
related to security of data, ARIES operation or data input. ARIES issues should reported immediately as they happen.
This quarterly report should report those that continue to impact your efficiency over time.
III. Questions for Year-End Report (only complete this section for the final report due April 20th)
1.
Report progress for the year for each objective in the agency’s QM Plan (including objectives for the plan as well as
QM Committee objectives). This should include the number of client chart reviews conducted, satisfaction surveys
administered, reviewed, and strategies implemented as a result, QM committee meetings, QM plan evaluations
completed, etc. Insert additional rows as needed.
QM Measurable Objectives
Progress
Comments
2.
Describe activities conducted during the year aimed at improving the HIV program. How has your agency and/or
services changed because of quality improvement activities? (e.g., streamlined paperwork, improved intake,
enhanced access to a service, increased number of mental health providers available to clients, extended office
hours, implemented risk assessment)
3.
Describe your QM Committee’s recommendations for changes and continued improvements to next year’s QM
program.
** Please submit your QM Plan for the coming year, along with an updated Work Plan
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REVISED: September 2011