Chicago’s Transition to an Integrated Planning Council November 21, 2013

Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.

City of ChicagoMayor Rahm Emanuel

Chicago’s Transition to anIntegrated Planning Council

November 21, 2013 H.L. Anderson Nanette Benbow Christopher Widmer Governmental Co-Chair Deputy Commissioner Program Director

Peter McLoyd Cheryl PottsCommunity Co-Chair Community Co-Chair

Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.

City of ChicagoMayor Rahm Emanuel

Chicago’s Transition to anIntegrated Planning Council

Christopher Widmer – Director, Ryan White Part A, CDPH

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Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.

City of ChicagoMayor Rahm Emanuel

Chicago’s Transition to anIntegrated Planning Council

Peter McLoyd – Community Co-Chair

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Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.

City of ChicagoMayor Rahm Emanuel

Chicago’s Transition to anIntegrated Planning Council

Hannah Anderson – Government Co-Chair / CDPH

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Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.

City of ChicagoMayor Rahm Emanuel

Chicago’s Transition to anIntegrated Planning Council

Cheryl Potts – Community Co-Chair

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Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.

City of ChicagoMayor Rahm Emanuel

Chicago’s Transition to anIntegrated Planning Council

Nanette Benbow – Deputy Commissioner, CDPH

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Chicago Department of Public HealthCommissioner Bechara Choucair, M.D.

City of ChicagoMayor Rahm Emanuel

Chicago’s Transition to anIntegrated Planning Council

Chicago Area HIV Integrated Services Council

CAHISC

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Presentation Overview

• The Chicago EMA• Prevention & Care Planning Activities• Impetus for Integrated Planning • Process for Integrated Planning

Challenges Support & Endorsement Integration Work Group Selection Committee Tasks

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Presentation Overview

• New Configuration Initial Phase – Year 1 Initial Phase – Year 2 (proposed) Final Configuration Committee Structures Resources Lessons Learned Moving Forward

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Like other Eligible Metropolitan Areas(EMAs), the Chicago EMA is comprised of urban, suburban and rural communities. The Chicago EMA consists of 9 counties.

Of the EMA's residents, 94% live in urban areas,2% live in suburban areas and 4% live in rural areas. 85% of PLWHA in Illinois live in the EMA.

There are 33,856 people living with HIV and AIDS (PLWHA) in Illinois. Eighty five percent (28,741) reside in the EMA and 64.5% (21,844) reside in the city of Chicago.

Chicago EMA

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Prevention and Care PlanningActivities in Chicagofrom 1999 - 2006

• Consider value of joint Community Planning• Increase understanding between Prevention / Care• Create and implement a Strategic Plan• Identify data to create collective outcomes• Ensure the continuous involvement of all stakeholders• Identify and evaluate best practices• Prevention & Care Work Groups established

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November 2009 • Test Linkage to Care + Treatment

(TLC Plus) • (HPTN 065) (RM Granich, et al) December 2009 • HHS Revised Treatment Guidelines March 2010 • ACA signed into lawJuly 2010 • White House release National

HIV/AIDS Strategy (NHAS)2010 • ECHPP /12 Cities Project

February 2011 • CROI - Can Lowering Community

Viral Load Decrease New HIV Infections?

March 2011• Gardner CascadeAug. 2011 • HPTN 052 (M. Cohen et al)June 2012 • ACA and Supreme Court decisionJuly 2012 • CDC Revised HIV Planning

Guidance

Impetus for Integration

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Challenges

• Community Support• Ryan White Part A / Prevention balance• How to Integrate Housing?• Integrated Membership By-laws • Synchronize Planning Cycles• Prevention & Care Planning Guidance• Respectful transition of current members

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Level of Support

• HIV Stakeholders: Planning Council, HPPG, and other partners

• Federal Partners (HRSA & CDC)• Community Co-Chair Leadership• CDPH Leadership: STI/HIV Division and staff

commitment

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Endorsement

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Integration Work Group

Composition:•Twelve CDPH Employees: Prevention, Care, Housing, and Public Information•Fourteen Community Representatives: Leadership from PC and HPPG: 50% ConsumersTasks:•Review Prevention and Care Models •Create Integration Model •Hand-off charge to Selection Committee

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Selection Committee Tasks

• Review Ryan White Primer• Review CDC Prevention Planning Guidance • Develop Scoring Criteria • Review and Score Candidate Applications• Identify candidates slated for interviews• Present slate for review and vetting by CDPH• Present final slate to Steering Committee

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Initial Phase – Year 1• May 2011: Integration Workgroup– Membership recruitment put on hold recognizing imminent

changes

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Initial Phase – Year 1• May 2011: Integration Workgroup– Membership recruitment put on hold recognizing imminent

changes

• Dec 2011: Interim Bylaws, call for applications and new name – CAHISC

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Initial Phase – Year 1• May 2011: Integration Workgroup– Membership recruitment put on hold recognizing imminent

changes

• Dec 2011: Interim Bylaws, call for applications and new name – CAHISC

• Jan 2012: Selection Committee: New Applications

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Initial Phase – Year 1• May 2011: Integration Workgroup– Membership recruitment put on hold recognizing imminent

changes

• Dec 2011: Interim Bylaws, call for applications and new name – CAHISC

• Jan 2012: Selection Committee: New Applications• Feb 2012: Joint Meeting – the Council and HPPG– The Chicago Area HIV Services Council and the HIV Prevention

Planning Group voted on February 17, 2012 to dissolve both planning groups to create a streamlined planning process and ultimately a unified plan for the Chicago EMA.

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Steering Committee

Governance

OUTREACH

Capacity Building

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CAHISCInitial Phase – Year 1

Steering Committee

Governance

OUTREACH

Capacity Building

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CAHISCInitial Phase – Year 2

(Proposed)

Phase 2

• March 2012: Select applicants

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Phase 2

• March 2012: Select applicants• April/May 2012: The first CAHISC planning body,

strategic planning meeting.

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Phase 2

• March 2012: Select applicants• April/May 2012: The first CAHISC planning body,

strategic planning meeting• January 2013: The CAHISC steering committee held a

two-day strategic planning meeting to review integration progressReviewed epidemiological dataMembership survey results on integration processCompared HRSA and CDC community planning requirements7 new models were considered

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Current HIV Continuum of Care* Chicago EMA, 2010

Test Link & Treat Prevent

CDPH – STI/HIV Surveillance, Epidemiology and Research Section – 09/2012*Continuum revised 9/12Slide 28

Final Configuration . . .the CAHISC Structure

CAHISC Vision:

“Develop a city-wide plan that identifies and addresses how housing, treatment, substance abuse, mental health and other essential services can prevent HIV infection through suppressed viral load and behavioral interventions”

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CAHISC Council Model, 2/2013

Needs Assessment

Gap AnalysisPriority Interventions/Services

Needed resourcesQM

Gap AnalysisPriority Interventions/Services

Needed resourcesQM

Gap AnalysisPriority Interventions/Services

Needed resourcesQM

Gap AnalysisEnsure parity, inclusion and representation of all sectors

affected by HIV and contributing to the solution

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Primary Prevention and Early Identification

Goals:•Decrease the number of new HIV infections.•Increase number of people living with HIV who know their status.

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Linkage and Prevention

Goals:•Increase number of people linked to care.•Increase number of people retained in care.•Re-engaged people lost to care.

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Adherence/Access to ART& Viral Suppression

Goals:•Increase number of people accessing ART•Increase number of people adhering to ART•Increase number of people virally suppressed

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Membership andCommunity Engagement

Goal:•Ensure parity, inclusion and representation of all sectors and stakeholders affected by HIV.•Promote governance though bylaws.•Assure engagement of membership and other stakeholders in process.

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Steering CommitteeGoal:• Ensure the achievement of CAHISC’s deliverables.• Promote integration across committees.• Govern CAHISC and its activities.

Activities:• Lead the development of a comprehensive plan.• Promote communication and collaboration across committees.• Organize monthly full body meetings and presentations.• Monitor committee work plans.• Review and approve letters of support.• Establish need-based ad hoc committees (when necessary).

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CAHISC Resources

• Resources outlined in the MOU• Multi-program approach to support and funding• Deputy Commissioner guides CDPH roles with

CAHISC • Program Directors &liaisons support committees• Special units provide support: Evaluation and

Surveillance Units• Consultant

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Lessons Learned

• Need more time to complete and validate slate• Generated robust applications • Brought new leadership with new perspectives

& need for training• Standardized community planning process for

all HIV funding sources• Directly supports objectives of NHAS

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• Initially perpetuated “silos” but changed model to address this issue

• Selection of members was completely objective

• Time constraints and competing priorities for integration and funder requirements

• How does Housing factor into HIV planning?

Lessons Learned

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• How do we ensure that all members of CAHISC have equal voice and a “level playing field of knowledge”

• Commitment and stability of leadership critical (both CDPH and Steering Committee)

• Reasonable timelines to accomplish all work• Grantee staff have to be involved and at the

table every step of the way

Lessons Learned

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Moving Forward

Integrated Comprehensive Plan•Strategic Planning•Consider new Healthcare Landscape•Invite content experts as needed to inform the plan•Multi-agency / multi-funding approach•Summer 2014 . . .

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Moving Forward

• Integrated Comprehensive Plan represents a true health department / community partnership for Prevention, Care & Housing

• Creating the plan affords us the opportunity to listen, share, and ask important questions to get us to the collective/common goal

• The plan’s focus are the desired achievements above & beyond usual funding sources

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Contact Information

Christopher [email protected]

312-747-3295

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facebook.com/ChicagoPublicHealth@ChiPublicHealth

312.747.9884

www.CityofChicago.org/Health

[email protected]

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