Hennepin County Public Health Department Minnesota Department of Human Services Minnesota Department...

CLIENT LEVEL DATA AND MINNESOTA CAREWARE PROVIDER

MEETINGMAY 22, 2014

Hennepin County Public Health DepartmentMinnesota Department of Human Services

Minnesota Department of Health

Data Presentation

2013 Funding Sources for Clients in Minnesota CAREWare

Source Amount

Part A $5,285,469

Part B ADAP $5,700,789

Part B Base $1,918,262

State $2,400,000

Rebate $6,018,500

TOTAL $21,232,020

Minnesota Ryan White Funding and HIV Prevalence2000 - 2013

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

$6,000,000

$7,000,000

$8,000,000

$9,000,000

$10,000,000

$11,000,000

$12,000,000

$13,000,000

$14,000,000

4000

4500

5000

5500

6000

6500

7000

7500

8000

Part A + B Award

MN HIV Prevalence

YEAR

Fu

nd

ing

Nu

mb

er

of

Pe

op

le L

ivin

g w

ith

HIV

Persons Living with HIV/AIDS in Minnesota Receiving Funding for

Services entered into MN CAREWare 2013

Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review

ADAP Part A Part B Rebate State All Funding-10%

0%

10%

20%

30%

40%

50%

60%

20%

43%

33%

6%

14%

55%

Surveillance (n=7,723)

Clients in Minnesota CAREWare as Percent of HIV Prevalence

2009 - 2013

2009 2010 2011 2012 20130%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

54% 55% 55% 57% 55%

Persons Living with HIV/AIDS in Minnesota and those entered into

CAREWare by Current Residence 2013

Greater

MN; 15%

TGA* 85%

MN Surveillance Total Number = 7,680 (43 Missing Data)

Greater MN; 13%

TGA* 87%

MN CAREWare Total Number = 4,261 (73 missing data)


*The two Wisconsin counties that are apart of the TGA were not included due to surveillance only looking at Minnesota. Ryan White clients consisted of 8 clients from the two Wisconsin counties.


CAREWare by Gender 2013


Male Female Transgender0%

10%

20%

30%

40%

50%

60%

70%

80% 76%

24%

71%

28%

10%

Surveillance (n=7,723) MN CAREWare (n=4,261)


CAREWare by Race 2013


0%

10%

20%

30%

40%

50%

60%51%

22%

13%9%

2% 2% 2% 0%

39%

28%

8% 10% 9%2% 1% 2%


Persons Living with HIV/AIDS in Minnesota CAREWare by

Gender and Race (non-Hispanic) 2013

White21%

Black, Af.

Amer.38%

Black, African Born17%

Two or More9%

His-panic6%

Amer. Indian

4%

Asian/ Pacific2%

Unk/ Missing/ Other

3%

Female Number = 1,202


White47%

Black, Af. Amer.24%

Black, African Born

5%

Two or

More8%

His-panic11%

Amer. Indian

1%

Asian/ Pacific

1%

Unk/ Missing/ Other

2%

Male Number = 3,000


CAREWare by Age 2013


<13 yrs

13-19 yrs

20-24 yrs

25-29 yrs

30-34 yrs

35-39 yrs

40-44 yrs

45-49 yrs

50-54 yrs

55-59 yrs

60+ yrs

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

1% 1%

3%

6%

10% 10%

13%

18% 18%

11% 11%

1% 1%

4%

8%

10%11%

13%

17%16%

9% 9%


Minnesota CAREWare by Risk Factor (n=4,261) 2013


0%

5%

10%

15%

20%

25%

30%

35%

40%35%

30%

23%

6%2% 1% 1% 1% 1% 0%


CAREWare by Male MSM Risk Factor 2013

MSM; 74%

Non-MSM; 26%

MN Surveillance Male Total Number = 5,849

MSM; 68%

Non-MSM; 32%

MN CAREWare Male Total Number = 3,000


Minnesota Surveillance (n=7723) and CAREWare (n=4,261) by HIV/AIDS

Status 2013


CDC de-fined AIDS47%HIV-pos-

itive (not

AIDS)53%

HIV/AIDS Status Surveillance

CDC defined AIDS47%HIV-positive

(not AIDS)47%

HIV-positive (AIDS status unknown)

4%Unknown

2%

HIV/AIDS Status CAREWare

Minnesota CAREWare by Household Income (n=4,261) 2013


Blank 0 1 to 999 1,000 to 4,999

5,000 to 9,999

10,000 to

19,999

20,000 to

39,999

40,000 to

99,999

> 100,000

0%

5%

10%

15%

20%

25%

30%

35%

3%

15%17%

30%

9%

13%12%

2%0%

Minnesota CAREWare by Poverty Level (n=4,261) 2013


(Blank) 0% 1% - 100% 101% - 200%

201% - 300%

301% - 400%

>400%0%

10%

20%

30%

40%

50%

60%

70%

3%

15%

59%

13%8%

1% 0%

Minnesota CAREWare by Housing Status(n=4,261) 2013


(Bla

nk)

Inst

itutio

n

Non-p

erm

anen

tly H

ouse

d

Other

Stab

le/P

erm

anen

t

Unkno

wn

/ Unr

epor

ted

Unsta

ble

0%10%20%30%40%50%60%70%80%90%

1% 2%8%

2%

77%

7% 3%

Minnesota CAREWare by Form I Had Medical Appt. (n=4,261)

2013


Had A Medical Appt.85%

A Referral Was Made2%

Did not have Medical Appt. or

Referral13%

Minnesota CAREWare by Form I Had Medical Appt. 2013


Had A

Med-ical

Appt.

75%

A Re-fer-ral

Was Mad

e1%

Did not

have Med-ical

Appt. or Re-fer-ral

24%

No Medical Case Management

(n=1248)

Had A

Med-ical

Appt.93%

A Re-ferral Was

Made3%

Did not

have Med-ical

Appt. or

Re-ferral

5%

Medical Case Management

(n=3013)

Minnesota CAREWare by Planning Council Category Core Medical

Services (n=4,261) 2013


0%

20%

40%

60%

36%

3% 3% 1%

52%

1%

19% 21%9% 12% 14%

35%

4%

Minnesota CAREWare by Planning Council Category Support

Services (n=4,261) 2013


-10%

0%

10%

20%

30%

40%

50%

60%

22% 23%

9%18%

12%21%

7% 8%1%

38%

1% 3%

Persons Living with HIV/AIDS in Minnesota Receiving Funding for

Services as a Percent of Total CAREWare Clients


2009 2010 2011 2012 20130%

10%

20%

30%

40%

50%

60%

70%

80%

MCMADAPTransportationEFAFood

Interactive Discussion

How Are You Using Data?

Training Update

CAREWare Reports

CAREWare

CAREWare Updates Two Upgrades in 2014

First upgrade done by June 16 Second upgrade in late October/early

November

June Upgrade Biggest change is Annual Review tab Addition of case manager name

Fall Upgrade Changes in Ryan White HIV/AIDS Program

Services Report (RSR) reporting requirements

Hispanic Subgroup Mexican, Mexican American,

Chicano Puerto Rican Cuban Another Hispanic, Latino/a or

Spanish origin

Asian Subgroup Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian

Native Hawaiian/Pacific Islander Subgroup

Native Hawaiian Guamanian or Chamorro Samoan Other Pacific Islander

Other New Fields Sex at Birth

Biologic sex assigned to client at birth Male or Female

HIV Positive Test Date Confirmatory test with positive result

OAMC Link Date Client’s first HIV primary care visit after

positive HIV test

Changes in Response Options “Unknown” No Longer Available

Enrollment status Ethnicity Housing status HIV/AIDS status Health insurance coverage

HIV Risk Factor “Other” deleted as response option “Unknown” changed to “Not reported or

not identified”

Changes in Response Options

Poverty Level Calculations Below 100% 100 – 138% 139 – 200% 201 – 250% 251 – 400% 401 – 500% Greater than 500%

Changes in Response Options

Health Insurance Coverage Private - Employer Private - Individual Medicare Medicaid, CHIP or other public plan VA, Tricare and other military health

care Indian Health Services (IHS) No Insurance/Uninsured Other plan

Fields No Longer Required

Date of Death

Fields Not Being Deleted in MN First service date Geographic unit code (zip code) AIDS diagnosis year

Future Changes Question about primary language Question about disability status All eligible services reported in RSR

Surveillance Data to CAREWare

Share Limited Surveillance Data for Clients Who Give ConsentHIV diagnosis dateAIDS diagnosis dateHIV statusAll CD4 labs (date, type of test, result)All viral load labs (date, type of test,

result)

Note: HIV/AIDS Surveillance System = eHARS (enhanced HIV/AIDS Reporting System)

Benefits of Having Surveillance Data in CAREWare

More efficient information management:

Case managers won’t have to spend time calling clinics for lab results

Clinic staff won’t have to spend time calling case managers back with lab results

Providers will have easy access to diagnosis dates

Benefits of Having Surveillance Data in CAREWare – Improved

Client Care Easy availability of CD4 and viral

load values will strengthen case managers’ ability to:

Coordinate clients’ HIV medical care

Monitor clients’ health status

Monitor clients’ quality of care

Benefits of Having Surveillance Data in CAREWare

Availability of diagnosis dates, CD4 and VL data will strengthen grantees’ ability to evaluate the following for clients served by Ryan White/state funding:

Linkage to care after diagnosis

Retention in care

Community viral load

Update on Project

Interest at National Level CDC, HRSA, grantees CDC developing a program that could be

used by any jurisdiction Hoping to make available for testing in July

2014

Timeline for some of the following steps will depend on CDC

Estimated Timeline Pilot

4 sites volunteered: Clinic 42, MAP, West Side, YAP Meet in August to develop messages, explain project Gather ROIs from MCM clients Sept – Dec 2014 Provide feedback on process early 2015 Import pilot data into CW in early March 2015

All Providers Meet in December to explain project in more detail Gather ROIs Jan – March 2015 Provide feedback on process April 2015 Import data into CW in May 2015 Provide feedback on utility of data Provide feedback as project matures

Questions

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