Welcome to the HRSA Project Officer
Webinar on the HIV-MHRC
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HIV Medical Homes Resource Center
Welcome and Introductions
Lauresa Washington
HIV Medical Homes Resource Center
An Overview of the
HIV-Medical Homes Resource Center
HRSA Cooperative Agreement # 11-068
Andrea Norberg, MS, RN
Co-Principal Investigator
HIV Medical Homes Resource Center
Webinar Overview
Introduction to the MH-NRC
Introduction to the patient-centered medical
home
HIV medical homes in the Ryan White HIV/AIDS
program
Goal, objectives and key actions of the MH-NRC
Introduction to the MH-NRC needs assessment
Questions and comments
HIV Medical Homes Resource Center
Personnel
HRSA/HAB
CEPC/UCSF


Thomas (Tom)
Bodenheimer, MD
FXB Center

 Andrea Norberg, MS,
RN
Steven (Steve) Bromer,
MD

Ronald (Ron)
Goldschmidt, MD

Kevin Grumbach, MD
Lauresa Washington,
MHSA
 Carolyn Burr, EdD, RN
 Deborah Storm, PhD
 Denise Anderson-Carr,
MPH, RD
HIV Medical Homes Resource Center
Francois Xavier Bagnoud Center, School of
Nursing, University of Medicine and
Dentistry of New Jersey
HIV Medical Homes Resource Center
The Center for Excellence in Primary Care in
HIV (CEPC), Department of Family and
Community Medicine, University of California
at San Francisco
HIV Medical Homes Resource Center
What is a Patient Centered Medical Home?
A model for delivering primary care
Characteristics:
•Enhanced access to care
•Care Plans
•Care continuity
•Patient-centered care
•Practice-based team care
•Shared decision making
•Comprehensive care
•Cultural competency
•Coordinated care
•Quality measurement and
improvement
•Population management
•Patient self management
•Health IT
•Evidence -based
HIV Medical Homes Resource Center
•Patient feedback
•New payment systems
The HIV Medical Home
Can this model be adopted by
specialists?
HIV Medical Homes Resource Center
The Medical Home in Ryan White HIV
Programs: what positions these programs
for success?
HIV Medical Homes Resource Center
Overall Goal
The HIV-MHRC will provide support to Ryan
White grantees and service providers to
understand the requirements of and
successfully apply for and become certified
medical homes. We will build on the
principles of primary care that are at the
heart of the patient- centered medical home.
HIV Medical Homes Resource Center
Objective One: Utilize experts in HIV care
delivery, medical home, healthcare systems,
and consumers as members of a National
Advisory Committee to assess strengths,
limitations and potential unmet needs of
Ryan White Program agencies related to
their seeking certification to become a
medical home and retaining clients in care
within first six months.
HIV Medical Homes Resource Center
Key Actions
 Develop and convene advisory committee for onein-person meeting and 2 annual conference calls.
 Develop and analyze needs assessment.
 Conduct key informant interviews as needed to
clarify issues raised in the needs assessment.
HIV Medical Homes Resource Center
Objective Two: Critically evaluate tools,
guidelines, and on-line materials related to
certification as a medical home for use by or
adaptation for Ryan White agencies and
disseminate during first six months and ongoing
HIV Medical Homes Resource Center
Key Actions
 Create a repository of relevant resources and post on the
TARGET Center website, linking them to the AETC NRC.
 Identify successful strategies within Ryan White clinical
sites that can be leveraged nationally to assist other
clinical sites.
 Gather information from needs assessment, workshop
interactions and technical assistance calls.
 Identify strategies to address fiscal impacts and concerns
that will challenge grantees, such as the cost of the
certification.
HIV Medical Homes Resource Center
Objective Three: Facilitate the preparation of selected Ryan
White programs to apply for certification as medical homes
by providing technical assistance through four regional
strategic planning workshops, and regular conference calls
in year 1 and ongoing.
HIV Medical Homes Resource Center
Key Actions
 Promote regional workshops and develop application process.
Identify 6-10 Ryan White program grantees in each of the four
regions for participation in strategic planning workshops.
 Develop training agenda, training materials, and evaluations.
 Implement logistical planning, send invitations and support
regional meetings. Develop materials in Spanish as needed.
 Conduct 4 regional 1½ day strategic planning workshops for
6-10 agencies each in Year 1.
 Conduct follow-up evaluation.
HIV Medical Homes Resource Center
Objective Four: Increase availability of technical
assistance for Ryan White programs related to HIV
medical home certification by developing and
offering a series of interactive webinars that
replicate the regional strategic planning workshop
process and offer specific guidance on aspects of
HIV medical home certification beginning in Y1.
HIV Medical Homes Resource Center
Key Actions Starting in Y2
 Adapt the agenda, content, and interactive
exercises from the workshop to a six-part
webinar series.
 Invite RW clinical programs that applied to
the workshops, but could not be
accommodated to participate in the webinar
series.
 Conduct and evaluate the series.
HIV Medical Homes Resource Center
Progress of the HIV-MHRC to Date
 Established
 Charter Created
 Communication Plan (two conference calls and one in-person
meeting)
HIV Medical Homes Resource Center
Routine Communication
 Bi-weekly calls with grantee
 Monthly calls with UCSF
 Bi-weekly internal meetings (FXB Center)
HIV Medical Homes Resource Center
Marketing of HIV-MHRC
 Logo created
 1 Page introduction to the HIV- MHRC on the TARGET Center
website: http://www.careacttarget.org/ta_providers.asp
 1 Pager also linked through AIDS Education and Training
Center (AETC), National Resource Center (NRC)
 Posted on Face Book and Twitter
HIV Medical Homes Resource Center
Needs Assessment
 Developed
 IRB approved with determination of “non-human subjects”
research
 Created in Survey Monkey
 To be disseminated shortly to Ryan White Grantees (Parts A,B,C
and D)
 Scheduled for introduction to HRSA/HAB project officers via
webinar
HIV Medical Homes Resource Center
HIV PCMH Needs Assessment for Ryan
White HIV/AIDS Program Clinical Grantees
Deborah Storm, PhD
Director of Research and Evaluation
HIV Medical Homes Resource Center
Needs Assessment Goals
Inform HIV-MHRC activities and resources
Learn about RW clinical programs, patients
and personnel
Understand clinical grantees’ interests,
needs and readiness regarding PCMHs
HIV Medical Homes Resource Center
PCMHs and Clinical RW Programs
Limited information about PCMHs in RW
programs
2010-11 Readiness for meaningful use of health
information technology (HIT) and PCMH
recognition survey of federally qualified health
centers (FQHCs)
• Geiger Gibson / RCHN Community Health
Foundation Research Collaborative. M
Cunningham, A Lara, P Shin.
39% of 714 respondents received RWCA
funding
HIV Medical Homes Resource Center
Results of FQHC Survey
< 6% have received NCQA PCMH recognition
About 50% interested in PCMH recognition
66% want TA and training on preparation for
applying PCMH recognition
69% have adopted electronic health records
(EHR)
91% plan to apply for Medicaid meaningful use
incentives in 2 years
HIV Medical Homes Resource Center
Needs assessment objectives
 Describe HIV and primary care services
 Assess readiness for pursuing HIV-PCMH
development
 Identify existing services/resources/strengths that
support the development of HIV-PCMHs
 Identify barriers/gaps to HIV-PCMH development
and recognition/certification
 Identify clinics/practices for participation in strategic
planning workshops
HIV Medical Homes Resource Center
Methods
 48 item online survey about clinics/practices
 Distribution: RW HIV/AIDS program
grantees
• Part A: TGA, EMA
• Part B: States
• Part C: Adult Care
• Part D: Women, children and families
 Respondents: Clinical program directors or
designees
HIV Medical Homes Resource Center
Challenges in conducting NA
 Distribution of questionnaire to all clinical
sites providing RW HIV/AIDS medical care
• Some grantees distribute to contractors
 Defining maximum number of potential
respondents
• Number of clinical sites funded to provide
medical services vs other services funding
from multiple parts of the RW program
 Response rate
HIV Medical Homes Resource Center
Next Steps
 Distribution and data collection: February,
2012
 Initial email sent 2/1/12, follow-up email by
about 2/14/12
 Questions from sites
 Analysis and report: March, 2012
 Distill lessons learned for resource
development and HIV-MHRC activities
HIV Medical Homes Resource Center
Next Steps
 Distribution and data collection: February,
2012
 Initial email sent 2/1/12, follow-up email by
about 2/14/12
 Questions from sites
 Analysis and report: March, 2012
 Distill lessons learned for resource
development and HIV-MHRC activities
HIV Medical Homes Resource Center
Questions and Comments
HIV Medical Homes Resource Center