RYAN WHITE PART A FUNDED MEDICAL CASE MANAGEMENT SERVICES IN THE BOSTON EMA

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1 RYAN WHITE PART A FUNDED MEDICAL CASE MANAGEMENT SERVICES IN THE BOSTON EMA February 12, 2015 Alexander Moran, Program Coordinator, Client Services Boston Public Health Commission

2 Purpose of Presentation 2 What Medical Case Management (MCM) services are funded by Ryan White Part A? Who uses these services? Provide information to guide the work of the Planning Council.

3 What is Medical Case Management? 3 MCM is a key service to ensure that PLWH are engaged in care, are retained in care, and are accessing all needed services and benefits. MCM is provided at both clinical and non clinical sites. Case Managers: Assess what services are needed Develop a plan on how to meet each need Coordinate with any external agencies if needed Continually monitor service needs to ensure needs are being met Document everything in writing The ultimate goal is to achieve self sufficiency and viral suppression. Source: Client Services Provider Manual FY 2014

4 Elements of Medical Case Management Services 4 Linkage and retention to primary care Medication adherence support Coordination of health insurance and other benefit issues Access to support services Housing Food Transportation to appointments Harm & Risk Reduction Support

5 Elements of Medical Case Management Services 5 Medical Case Management provides social and medical case management Agencies must provide or have linkages to provide: Housing Search & Advocacy Benefits Counseling Some MCM agencies have funds to help clients with transportation needs, while some refer out to different programs

6 Additional Case Management 6 Funded Under MAI Some additional MCM is funded with Minority AIDS Initiative (MAI) funds MAI funded agencies must have majority-minority clients, staff, & board. Source: Client Services Provider Manual FY 2014

7 Training Case Managers 7 A Training and Capacity Building program is funded through Medical Case Management (MCM TCB) In FY14, an Advisory Committee was formed and curriculum development has begun This will be A FREE program for Case Managers teaching core information on how to provide case management services Trainings will be held throughout the EMA and focus on the required elements of Case Management Source: MCM Training & Capacity Building RFP, 2014

8 There are 24 Agencies in the Boston EMA Funded to Provide MCM 8 Funding: 22 Part A general and 2 MAI Location: 16 in clinical sites and 8 in community based organizations Geography: 3 in NH, 10 in Boston, 11 in rest of MA Non-Part A funded MCM sites: 22 through MDPH

9 Total Medical Case Management Part A 9 Allocation in FY14 Part A (non-mai) FY14 Funding - $4,586,243 MAI FY14 Funding - $655,851 Total MCM Funding - $5,242,094

10 Number of Clients In FY13, 3,715 Individuals Received Part A Funded MCM Services FY11 FY12 FY13 Decrease in funding

11 Funding in dollars In FY13, Part A Invested $3.8M in MCM 11 $4,800, $4,600, $4,586, $4,400, $4,200, $4,000, $4,102, $3,800, $3,841, $3,600, $3,400, FY12 FY13 FY14

12 Clients by Ethnicity, FY13 12 Medical Case Management MAI Medical Case Management 1% Hispanic or Latino/a 2% Hispanic or Latino/a 35% Not Hispanic or Latino/a 51% 47% Not Hispanic or Latino/a 64% N=3,378 Unknown/Unr eported N=337 Unknown/Un reported

13 Clients by Race, FY13 13 Medical Case Management MAI Medical Case Management 15% 20% 36% White Black or African American Asian 21% 41% African American/ Black More Than One 27% 2% N=3,378 More than one race Unknown/Unr eported 38% N=328 Unknown/Un reported

14 Clients by Income Level, FY % 4% 9% 5% N=3,715 69% Equal or Below FPL % FPL % FPL Greater than 300% FPL Unknown/Unreported

15 Clients by Insurance Type, FY13 15 N=3,715 1% 9% 6% 16% Private Medicare 6% Medicaid 16% Other Public Insurance No Insurance Other 46% Unknown/Unreported

16 Clients by Housing Status, FY % 1% 2% N=3,715 10% Permanently Housed Non-Permanently Housed Institution Other Unreported 87%

17 Summary 17 Ryan White Part A funds a total of 24 MCM programs. Total Part A Medical Case Management funding is $5,242,094. These programs served 3,715 clients in FY13. Medical Case Management is a key service to ensure retention in care. Questions? Alexander Moran AMoran@bphc.org