1. Welcome to the HRSA Project Officer Webinar on the HIV-MHRC Is this your first time using Adobe Connect? Here are some useful tips:  If you call in by phone, please mute your computer speakers to avoid echoes.  Please press *6 to mute or “un-mute” your phone line. HIV Medical Homes Resource Center

2. Welcome and Introductions Lauresa Washington HIV Medical Homes Resource Center

3. 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

4. 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

5. Personnel HRSA/HAB  Lauresa Washington, MHSA FXB Center  Andrea Norberg, MS, RN  Carolyn Burr, EdD, RN  Deborah Storm, PhD  Denise Anderson-Carr, MPH, RD CEPC/UCSF  Thomas (Tom) Bodenheimer, MD  Steven (Steve) Bromer, MD  Ronald (Ron) Goldschmidt, MD  Kevin Grumbach, MD HIV Medical Homes Resource Center

6. Francois Xavier Bagnoud Center, School of Nursing, University of Medicine and Dentistry of New Jersey HIV Medical Homes Resource Center

7. 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

8. What is a Patient Centered Medical Home? A model for delivering primary care Characteristics: Enhanced access to careEnhanced access to care Care continuityCare continuity Practice-based team carePractice-based team care Comprehensive careComprehensive care Coordinated careCoordinated care Population managementPopulation management Patient self managementPatient self management Health ITHealth IT Evidence -basedEvidence -based Care PlansCare Plans Patient-centered carePatient-centered care Shared decision makingShared decision making Cultural competencyCultural competency Quality measurement and improvementQuality measurement and improvement Patient feedbackPatient feedback New payment systemsNew payment systems HIV Medical Homes Resource Center

9. The HIV Medical Home Can this model be adopted by specialists? HIV Medical Homes Resource Center

10. The Medical Home in Ryan White HIV Programs: what positions these programs for success? HIV Medical Homes Resource Center

11. 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. Overall Goal HIV Medical Homes Resource Center

12. 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

13. Key Actions  Develop and convene advisory committee for one- in-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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. Routine Communication  Bi-weekly calls with grantee  Monthly calls with UCSF  Bi-weekly internal meetings (FXB Center) HIV Medical Homes Resource Center

22. 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 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. Methods  48 item online survey about clinics/practices  Distribution: RW HIV/AIDS program grantees Part A: TGA, EMAPart A: TGA, EMA Part B: StatesPart B: States Part C: Adult CarePart C: Adult Care Part D: Women, children and familiesPart D: Women, children and families  Respondents: Clinical program directors or designees HIV Medical Homes Resource Center

30. Challenges in conducting NA  Distribution of questionnaire to all clinical sites providing RW HIV/AIDS medical care Some grantees distribute to contractorsSome 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 programNumber 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

31. 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

32. 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

33. Questions and Comments HIV Medical Homes Resource Center