Ryan White Client Demographic Summary and Quality Management Report Lisa Krull Program and Quality...

Ryan White Client Demographic Summary and Quality Management

Report

Lisa KrullProgram and Quality Manager

1

Ryan White Client Demographic Summary

2

1508 (34.3%)

2873 (65.4%)

13 (0.3%)

FemaleMaleTransgender

2012 Ryan White Client Gender

N = 4,394


3

2012 Ryan White Client Age

2-13 3-24 25-44 45-64 65+0

500

1000

1500

2000

2500

25

274

2196

1786

113

N = 4,394


4

2012 Ryan White Client Race

N = 4,394

Black or A

frica

n American

White

More

than one ra

ce

Asian /

Pacific I

slander

American In

dian or Alaska

Native

Unknown

0500

1000150020002500300035004000 3693

454126 18 5 98


5

2012 Ryan White Client Ethnicity

N = 4,394

4286 (97.5%)

108 (2.5%)

Not HispanicHispanic

6

Ryan White Client Demographic Summary2012 Ryan White Client Annual Income

N = 4,394

Less than or equal to 100%

FPL

101-200% FPL 201-300% FPL More than 300% FPL

Unknown0

500

1000

1500

2000

2500

3000

3500

4000

3356

659256

70 53

7


2012 Ryan White Client Housing Status

N = 4,394

3892(88.6%)

308(7%)

153(3.5%)

41 (0.9%) Stable/Permanent

Non-Permanent/Unstable

Institution

Unknown

8


2012 Ryan White Client Insurance Status

N = 4,394

Private Medicare Medicaid No Insurance Unknown 0

200

400

600

800

1000

1200

1400

1600

1800

2000

520

772

1109

1883

110

Ryan White Client Demographic SummaryClient Insurance Status – at or below 100% FPL

N = 3,356 (clients with at or below 100% FPL)

Private Medicare Medicaid No Insurance Unknown0

200

400

600

800

1000

1200

1400

1600

154

604

1042

1506

50


10

2012 Ryan White Client HIV Status

N = 4,394

1141(26%)

1151(26.2%)

2102(47.8%)

CDC-Defined AIDS

HIV-positive (AIDS Status Unknown)

HIV-positive (Not AIDS)

11

Medical C

are

Loca

l ADAP

Oral Health EIS

Mental Health

Nutrition

MCM

SA Treatment

0

500

1000

1500

2000

2500

3000

3500

4000

1663

204

643

2136

274

1180

3477

41

2012 Ryan White Unduplicated Clients: Core Services

N = 4,394

12

2012 Ryan White Unduplicated Clients: Support Services

N = 4,394

NMCM EFAFood

HERR

Transporta

tion

Psychoso

cial

Housing

0

200

400

600

800

1000

1200

1400

1600

1084

146

1339

3

1424

320

6

13

Ryan White Core ServicesNumber Unduplicated Clients Served

2011 - 2012

Medical Care Local ADAP Oral Health EIS Mental Health Nutrition MCM SA Treatment0

500

1000

1500

2000

2500

3000

3500

4000

1662

162

646

2167

256

777

3353

16

1663

204

643

2136

274

1180

3477

41

2011 2012

14

Ryan White Support ServicesNumber Unduplicated Clients Served

2011 - 2012

*Outreach clients NOT unduplicated

NMCM EFAFood

HERR

Transporta

tion

Psychoso

cial

Housing

Outreach

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

1098

147

1266

3

1142

336

7

4411

1084

146

1339

3

1424

320

6

3838

2011 2012

15

2012 Performance Measure Data: Medical Providers

Provider 1

Provider 2

Provider 3

Provider 4

Provider 5

0%

20%

40%

60%

80%

100%

120%

% with 2 or more visits% with 2 or more CD4% with PCP prophylaxis (CD4 <200)% of AIDS patients on HAART

2012 In + Care Campaign

Measures 9/30/12 11/30/12 1/31/13 Part A National

Benchmark

Measure 1: Gap Measure% of patients who did not have a medical visit in last 6 months

35% 11% 12% 14%

Measure 2: Visit Frequency% of patients with at least 1 visit in each 6 month period of the 24 month measurement period

26% 70% 71% 67%

Measure 3: New Patients% of newly enrolled patients who had a visit in each 4 month period of the measurement year

48% 63% 60% 70%

Measure 4: Viral Load Suppression% of patients with a viral load <200 at last VL test in the measurement year

60% 64% 64% 72%

Survey of Consumers*Consumer Input Meeting 5-30-13

Service Category Reduce or Eliminate Keep or Increase

Substance Abuse Treatment

10/22 (45%) NA

Psychosocial Support 10/22 (45%) 7/10 (32%)

EFA Utility Assistance 7/10 (32%) 5/22 (23%)

Non Medical Case Management

5/22 (23%) NA

Outreach 5/22 (23%) NA

Food 22/22 (100%) NA

N=22

FY 2012 Cost Utilization Data

Service Category Expenditures # Clients Cost/Client # Services # Services/Client

Outpatient $2,389,778 1,663 $1,437 8,585 OP visits 5.2

Local Pharmacy $61,833 204 $303 518 prescriptions 2.5

Oral Health $608,732 643 $947 1,445 visits 2.2

Mental Health $92,286 274 $337 1,164 visits 4.7

Medical Nutrition Therapy $100,685 1,180 $85 1,948 encounters, 606 cases supplements 1.7

Medical Case Management $883,596 3,477 $254 32,431 encounters 9.3

Early Intervention Services $405,398 2,136 $190 8,218 encounters 3.8

Substance Abuse Treatment $25,149 41 $613 423 encounters 10

Case Management (Non-medical) $196,864 1,084 $182 3,736 encounters 3.4

EFA $66,659 146 $457 189 payments 1.3

Food Bank $277,274 1,339 $207 5,773 bags/1,815 vouchers 5.7

Housing $23,730 6 $3,955 55 rent/deposit payments 9.2

Medical Transportation $62,856 1,424 $44 9,432 bus passes, 3,044 gas cards, 265 cab trips, 108 client transport 9.0

Psychosocial Support $97,092 320 $303 644 individual/244 group encounters 2.8

Referral for Health Care/Support $48,480 252 $192 298 referrals for care, 578 referrals for testing 3.5

Outreach $38,398 3,838 $10 5,164 website visits, 15,656 page views 1.3

Non-Ryan White and Other Funding Sources

Martha MontgomeryData Analyst

Ryan White Part A Program

PSRA Data Presentation June 26, 2013 19

Other Funding Sources for PLWHA in the Memphis TGA

• Ryan White Funding• Part B, Part C, and Part D

• Medicaid• Centers for Disease Control and Prevention• Veterans Administration• Food and Nutrition Services

• Services for Women, Infants, and Children (WIC)• Food Stamp Programs

• Substance Abuse Prevention and Treatment• Housing and Financial Assistance

• Housing Opportunities for People with AIDS (HOPWA) • Community Sources for Emergency Financial/Rent Assistance

• Mid-South AIDS Fund

20PSRA Data Presentation June 26, 2013

Overview of Ryan White Part B• Part B funding is distributed to states for specific programs

• States may provide services directly, contract with agencies, or work through subcontracts with Part B HIV Care Consortia

• TN funds five regional Consortia (Southwest, West, Middle, East, Southeast) with Lead Agencies who contract with agencies to provide services

• State Programs offered in Tennessee– Outpatient medical services– Medical case management– AIDS Drug Assistance Program (ADAP)

• Insurance Assistance Program (IAP)• HIV Drug Assistance Program (HDAP)


Martha Montgomery

Part A funds most everything except for medications. The main expenditure on Part B is ADAP but there's also outpatient medical services and dental care.

Tennessee ADAP (TGA)

22

FY11 FY12 FY130

200

400

600

800

1000

1200

1400

1600

1199

14001448

482

538 500

ADAP Number Served

HDAP IAP

Num

ber S

erve

d

FY11 FY12 FY13$0

$2,000,000

$4,000,000

$6,000,000

$8,000,000

$10,000,000

$12,000,000

$14,000,000

$10,514,282 $8,277,702 $8,190,721

$1,944,336

$1,739,511 $1,770,936

ADAP Expenditures

HDAP IAP

$12,458,618

$10,017,213 $9,961,657

PSRA Data Presentation June 26, 2013Source: State of Tennessee Department of Health.

In the past two years, the number of ADAP clients in TN has increased by 16%; total expenditures have decreased by 20%.

23

Overview of Part B Funding in Tennessee in TGA

Service

FY 2011 (4/1/10 – 3/31/11) FY 2012 (4/1/11 – 3/31/12) FY 2012 (4/1/11 – 3/31/12)

Number Served Expenditure

Average Cost Per Person





ADAP 1681 $12,458,618 $7,411 1938 $10,017,213 $5,169 1948 $9,961,657 $5,114

OMS NA NA NA 44 $12,483 $284 29 $13,566 $468

MCM 706 $188,350 $267 180 $50,004 $278 204 $61,712 $303

TOTAL 2,387 12,646,968 7,678 2,178 10,079,700 5,708 2,181 10,036,935 5,884

PSRA Data Presentation June 26, 2013

Source: State of Tennessee Department of Health.

Mississippi & Arkansas ADAP (TGA)

24

FY11 FY12 FY130

10

20

30

40

50

60

70

4047

58

Number Served in MS

FY11 FY12 FY13$0

$50,000

$100,000

$150,000

$200,000

$250,000

$300,000

$278,462 $294,576 $314,638

ADAP Expenditures in MS

FY11 FY12 FY1305

101520253035404550

32 2732

Number Served in AR

FY11 FY12 FY13$0

$50,000 $100,000 $150,000 $200,000 $250,000 $300,000 $350,000

$244,148 $239,820 $324,000

ADAP Expenditures in AR


In the past two years, the number of ADAP clients in MS has increased while the number in AR has remained relatively stable; MS expenditures increased 13% and AR expenditures increased 33%.

Part C Requirements

25

Part C funds comprehensive primary health care in outpatient settings for PLWHA

No more than 10% of the budget can be allocated to administrative costs

At least 75% of the balance remaining after subtracting administrative costs, must be used for core medical services


Overview of Ryan White Part C

• Part C provides grants to service providers to support EIS and ambulatory care for PLWHA

• Part C funds go to– East Arkansas Family Health Center

• Outpatient/Ambulatory Medical Care, Dental, Medical Case Management, Medical Transportation, Mental Health, Nutritional Counseling & Supplements, and HIV Testing

– Adult Special Care Clinic at the Regional Medical Center• Outpatient/Ambulatory Medical Care, Mental Health


27

Note: Part C fiscal year is January 1 to December 31.


Ryan White Part C Funding in TGA

2011 20120

500

1000

1500

2000

2500

3000

3500

4000

204 182

31932925

Number of Clients Served

EAFHC ASCC

2011 2012 $-

$200,000

$400,000

$600,000

$800,000

$1,000,000

$1,200,000

$1,400,000

$299,384 $299,384

$813,705 $974,325

Part C Budget

EAFHC ASCC

$1,113,089$1,273,709

In the last year, the total Part C budget in the Memphis TGA has increased by 14%. The total number of clients served has decreased by 9%.

Overview of Ryan White Part D• Part D funding is for women, infants, children, youth

and their families• Part D funds are provided through networks in

regional areas• Community HIV Network serves– Tennessee: Shelby, Fayette, and Tipton counties– Mississippi: DeSoto county– Arkansas: Crittenden county

• Any eligible consumer can receive services in those counties, even if they are from another county


Part D Programs• Previous year (8/1/11–7/31/12)

– $353,153 to MAYAH– $777,888 to Memphis HIV

Family Care Program

• Current year (8/1/12–7/31/13)– All MAYAH funding was cut– Memphis HIV FCP was cut to

$500,000• A 6-7% cut is anticipated for the

next grant year

29

2011-2012 2012-2013 2013-2014$0

$200,000

$400,000

$600,000

$800,000

$1,000,000

$1,200,000

$777,888 $500,000 $467,500

$353,133

Part D Programs

Memphis HIV Family Care Program (FCP)Memphis Adolescent/Young Adult HIV Program (MAYAH)


Part D funding in the Memphis TGA has been cut by 60% in the last two years.

Part D Programs• Changes to services in the 2012 – 2013 grant year

– All Part D youth initiatives were pooled with standard Part D funding, resulting in the loss of $353,133 for the MAYAH program

– Medical case management and social work services provided by ASCC and St. Jude were cut• Medical Case Management is no longer a core medical service

– All Hope House services (psychosocial support and social work) were cut

• Funded services for 2012 – 2013– Le Bonheur Infectious Disease Clinic provides social work and advocacy by Le

Bonheur FCP staff– Adult Special Care Center provides outpatient/ambulatory medical– St. Jude provides outpatient/ambulatory medical– UTMG provides social work and advocacy by Le Bonheur FCP staff and

obstetrical care– Oral health care is provided by two dental practices


Part D Programs


HIV Family Care Program 8/1/11-4/30/12 3/1/12-2/28/13Medical case management

(women) 1041 138Outpatient

(pregnant women/infants) 156 168Psychosocial support services

(women/families) 63 5Non-medical case management

(women/families) 63 22

Youth served by MAYAH 8/1/11-4/30/12 3/1/12-2/28/13Medical case management (youth) 201 0

Outpatient (youth) 248 0Psychosocial support services (youth) 57 0

Mental health (youth) 21 0

In the next year, the majority of Part D funds will likely be used for medical services; MCM and support services will not be funded.

Tennessee Medicaid (TennCare)

PSRA Data Presentation June 26, 2013 32

Source: Bureau of TennCare. Data include only PLWHA; totals are based on the county where the recipient lived.

In the last year, Tennessee’s Medicaid expenditures in the Memphis TGA have decreased by 6%. The total number of clients served has decreased by 25%.

2010 (N=1,987)2011 (N=1,887)

2012 (N=1,501)

$- $2,000,000 $4,000,000 $6,000,000 $8,000,000

$10,000,000 $12,000,000 $14,000,000 $16,000,000 $18,000,000

$6,071,679 $5,375,250

$4,469,966

$9,823,105 $11,179,129

$10,533,770

TennCare Expenditures and Number Served in Shelby, Fayette, & Tipton Counties

Medical Expenditure Pharmacy Expenditure

Mississippi Medicaid

33

Source: Mississippi Division of Medicaid. Note: Data includes only PLWHA. Medicaid coverage in Mississippi requires that a person have proof of income eligibility and be determined disabled. Most PLWHA do not qualify for Medicaid until they are in advanced stages of illness and meet the disability requirements. PSRA Data Presentation June 26, 2013

2010 (N=67)2011 (N=79)

2012 (N=73)

$-

$100,000

$200,000

$300,000

$400,000

$500,000

$600,000

$700,000

$800,000

$900,000

$252,167 $425,554 $643,694

$265,692 $199,925

$176,308.83

MS Medicaid Expenditures and Number Served in DeSoto, Marshall, Tate, & Tunica CountiesMedical Expenditure Pharmacy Expenditure

In the last year, Mississippi’s Medicaid expenditures in the Memphis TGA have increased by 58%. The total number of clients served has increased by 9%.

Martha Montgomery

On May 15, 2012, Vicky Donaho sent the table with the breakdown for 15 different types of claims. This is FY12 YTD as of 5/15/12Medicaid coverage in Mississippi requires that a person have proof of income eligibility and bedetermined disabled. Most PLWHA do not qualify for Medicaid until they are in advanced stages ofillness and meet the disability requirements. Mississippi does have a Home-Based Program that provides IV therapy and aerosolized pentamidine for medically or chronically dependent HIV-infected patients intheir home.

Arkansas Medicaid

34

Source: Arkansas Department of Health. Data includes only PLWHA. Fiscal Year 12-13 is June 1, 2012 – May 31, 2013. Medicaid services in Crittenden county include Medical Care, Private Duty Nurse, Medical Services, Outpatient Services, Surgery, and Home Health PSRA Data Presentation June 26, 2013

FY 10-11 (N=44)FY 11-12 (N=61)

FY 12-13 (N=61)

$-

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

$140,000

$92,471

$125,917 $133,605

AR Medicaid Expenditures and Number Served in Crittenden County

In the last year, Arkansas’ Medicaid expenditures in the Memphis TGA have increased by 44%. The total number of clients served has increased by 39%.

Centers for Disease Control and Prevention (CDC)

• Provides funds to states for HIV Prevention and testing programs

• States distribute the funds to local programs via the state Department of Health or via Consortia


Tennessee Department of Health Projects (CDC) Funding

15 HIV testing sites, 5 prevention/outreach programs in TGA in 2012

36

CY 2010 CY 2011 CY 20120

10,000

20,000

30,000

40,000

50,000

60,000

33,58039,204

50,935

15,795 14,890

24,386

CDC Testing/Prevention in TN in TGA

Number of HIV Tests conductedNumber Served with Prevention/Outreach Programs

2010 2011 2012$0

$200,000

$400,000

$600,000

$800,000

$1,000,000

$1,200,000

$1,000,000 $1,000,000 $1,000,000

$417,000 $478,000

$407,800

CDC Funding for Prevention/Outreach in TN in TGA

HIV Testing Prevention and Outreach


In the last two years, TN CDC funding in the Memphis TGA has been relatively stable. Both the numbers of HIV tests conducted and clients served with outreach/prevention has increased by more than 50%.

Mississippi Department of Health Projects (CDC) Funding

• Testing sites in DeSoto, Marshall, Tate and Tunica• DeSoto County Health Department• Marshall County Health Department• Tate County Health Department• Tunica County Health Department• Aaron E. Henry Health Services Center

37

Source: State of Mississippi Department of Health.

CY 2011 CY 2012Number of HIV Prevention Activities

and Outreach Programs/Agencies 7 6

CDC Cooperative Agreement for Prevention $2,023,284 $1,090,150

CDC Expanded Testing Initiative $821,152 $320,577

Table 9: HIV Prevention and Testing in MS in TGA


Over the past two years, MS CDC funding in the Memphis TGA has decreased by more than 50%.

Martha Montgomery

Kendra Johnson sent this is a PDF file on 5/30/2012. On 5/30/2012 I contacted her to clarify that the figures are correct, since is significantly lower than 2011, and ask for any insight on this decrease.

Arkansas Department of Health Projects (CDC) Funding

• Crittenden County is not covered in the scope of work for any funded grantees– However, the grantees are not limited to serving only clients that

reside in their scope of work

• Testing events occur in Crittenden County

38

Source: State of Arkansas Department of Health

CY 2011 CY 2012Number of Community Based

organizations for HIV prevention 6 7

CDC Funding for Community Based organizations $329,409 > $300,000

Table 10: HIV Prevention and Testing in AR in TGA


Over the past two years, AR CDC funding in the Memphis TGA has been relatively stable.

Martha Montgomery

per phone call to Kellye McCartney at agency on 6/4/12: the state gets about 1.6 million for salaries, admin., etc., but none goes specifically to Crittenden county. there are 7 community based organizations in the state, but none in Crittenden, though the orgs may serve people outside of their county so Crittenden co. people may benefit. also there are special testing events in Crittenden county several times a yaer. CDC funding for these 7 community-based organizations is about and slightly over $300,000.

U.S. Dept. of Veteran Affairs• VA claims to be the largest provider of HIV care in the U.S.

– 21 Veterans Integrated Service Networks (VISNs), consisting of over 1,100 medical centers, community-based outpatient clinics, and other providers

– TN is in VISN 9, MS and AR are in VISN 16– Nationwide, the number of Veterans living with HIV has been stable

(about 1 / 250); information specific to the Memphis TGA is limited


2009 2010 2011Arkansas 245 253 258Mississippi 438 372 425Tennessee 636 646 681

Number HIV Infected Veterans in Care

Note: The number of Veterans in Veterans Health Administration (VHA) care who filled a VHA outpatient prescription for a HIV antiviral medication (ARV) during the calendar year, and/or who ever had Clinical AIDS based on an AIDS-defining opportunistic infection prior to or during the calendar year. There is limited data available specific to the Memphis TGA.

Source: HIV Infected Veterans in VHA Care by State. http://www.publichealth.va.gov/quality/reports/hiv-in-care-by-state-2009.asphttp://www.publichealth.va.gov/quality/reports/hiv-in-care-by-state-2010.asphttp://www.publichealth.va.gov/quality/reports/hiv-in-care-by-state-2011.asp

Martha Montgomery

Nationwide, the number of HIV-infected Veterans in health care has been relatively stable over the past 5 years with approximately 9 percent entering VA health care and approximately 9 percent leaving (including deaths) VA health care in a given year.

U.S. Dept. of Veteran Affairs• HIV Testing Rates in the VA

– Historically low due to restrictions• As of 2009, <10% of Veterans in VA care had ever tested for HIV • Over 50% of HIV patients at the VA had AIDS at time of diagnosis

• August 2009: Policy changes allowed for widespread testing in the VA

• July 2010: VA was designated as one of the lead Federal agencies for the National HIV/AIDS Strategy (NHAS); primary goals include: – Reducing HIV incidence – Increasing access to care and optimizing health outcomes – Reducing HIV-related health disparities

40

Sources: http://www.publichealth.va.gov/quality/reports/index.asp; http://aids.gov/federal-resources/national-hiv-aids-strategy/nhas-operational-plan-va.pdf


Martha Montgomery

While NHAS does not list VA as an agency directly involved in activities related to the goals of NHAS, the VA can and will support initiatives to achieve them...


U.S. Dept. of Veteran Affairs• VA HIV providers adhere to HHS guidelines for HIV health care

– 98% of Veterans living with HIV had hepatitis C screening; 80% receive hepatitis B screening and vaccination

– 93% have routine CD4+ lymphocyte count– 86% who require PCP prophylaxis are on the recommended medications– 80% receive antiviral medications for treatment

42

Sources: Department of Veterans Affairs (2009). The State of Care for Veterans for HIV/AIDS (http://www.hiv.va.gov/provider/state-of-care/index.asp). Department of Veterans Affairs National HIV/AIDS Strategy Operational Plan (http://aids.gov/federal-resources/national-hiv-aids-strategy/nhas-operational-plan-va.pdf).

2009 2010 2011Veterans with an outpatient visit 5,713,265 5,888,599 6,114,034

Veterans ever tested for HIV 524,267 795,126 1,221,328Veterans ever tested for HIV (%) 9.2% 13.5% 20.0%

National VA Testing Rates


Nationally and in each VISN, the percentage of Veterans ever tested for HIV more than doubled in two years (2009-2011).

Services for Women, Infants, and Children (WIC)• Administered by the U.S. Department of Agriculture, WIC provides

federal grants to states • Serves low-income pregnant / postpartum women and infants and

children up to age five who are at nutritional risk• WIC Special Supplemental Nutrition Program (SNP)

– Provides nutritious supplemental foods, nutrition education, breastfeeding support, and health/social services referrals

• WIC Commodity Supplemental Food Program (CSFP)– Similar to SNP, but CSFP also serves elderly people and provides food

rather than food vouchers

• Eligible people cannot participate in SNP and CSFP at the same time


WIC Services in Memphis TGA

44

Sources: WIC Program Grant Levels by State. http://www.fns.usda.gov/wic/fundingandprogramdata; WIC Program Monthly Data - Participation. http://www.fns.usda.gov/pd/wicmain.htm

FFY 2010 FFY 2011 FFY 2012 FFY 2013$0

$20,000,000

$40,000,000

$60,000,000

$80,000,000

$100,000,000

$120,000,000

$140,000,000 $127,115,461 $126,150,085 $128,479,260 $122,716,796

$98,986,082 $91,444,337 $88,188,725 $84,577,473

$73,448,817 $74,733,382 $71,575,020 $69,734,786

WIC Program Grant Levels by State

Tennessee Mississippi Arkansas


Martha Montgomery

For last year's data presentation, we said "Approximately $73 Million for WIC in Arkansas, allocations not available specific to Crittenden County"


45

Sources: WIC Program Grant Levels by State. http://www.fns.usda.gov/wic/fundingandprogramdata; WIC Program Monthly Data - Participation. http://www.fns.usda.gov/pd/wicmain.htmNote: Federal Fiscal Year (FFY) 2013 is October 1, 2012 through September 30, 2013; number of participants for WIC programs in FFY 2013 is not yet available.


FFY 2010 FFY 2011 FFY 20120

25,000

50,000

75,000

100,000

125,000

150,000

175,000 170,588 161,578 162,775

102,224 97,277 94,773

98,963 93,461 94,293

Participants in WIC Program by State

Tennessee Mississippi Arkansas

Martha Montgomery

For last year's data presentation, we said "Approximately $73 Million for WIC in Arkansas, allocations not available specific to Crittenden County"



FFY 2011 FFY 2012 FFY 2013 $-

$1,000,000

$2,000,000

$3,000,000

$4,000,000

$5,000,000

$6,000,000

$7,000,000

$8,000,000

$4,783,199 $6,164,700

$6,791,084

$673,372

$600,352 $681,773

WIC Funding Available in the Memphis TGA

Tennessee (Shelby, Tipton, Fayette) Mississippi (DeSoto, Marshall, Tate, Tunica)

Approximately $70 million is available for WIC in Arkansas; allocations specific to Crittenden County are not available.

In the last two years, WIC funding in the Memphis TGA has increased by 37%.

Food Stamp Programs• Food Stamp programs are financed 100% by Federal funds and

administered in the Memphis TGA by the Departments of Human Services in TN, MS, and AR

• Client benefits can be redeemed at participating stores, farmers’ markets, direct marketing farmers, homeless meal providers, treatment centers, group homes, and others authorized to accept SNAP (“authorized firms”)

• To improve access to healthy foods, USDA has developed a strategic plan to increase farmers’ market participation in SNAP

– The number of authorized firms increased by >40% in the past five years

– The number of farmers’ markets and direct marketing farmers increased 327% in the past five years


Source: United States Department of Agriculture (USDA) Food and Nutrition Service (FNS)

Food Stamp Programs



In the past decade, food stamp benefits have more than quadrupled nationally from $18,256,200,000 to $74,619,460,000

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012$0.0

$10.0

$20.0

$30.0

$40.0

$50.0

$60.0

$70.0

$80.0

$18.3 $21.4

$24.6 $28.6 $30.2 $30.4

$34.6

$50.4

$64.7

$71.8 $74.6

Client Benefits (in Billions)

Federal Fiscal Year

Food Stamp Programs


In the past decade, the number of clients receiving food stamp benefits has more than doubled nationally from 19 million to 46 million.

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

19.121.3

23.825.6 26.5 26.3

28.2

33.5

40.3

44.746.6

Number of Clients (in Millions)

Federal Fiscal Year


Food Stamp Programs


For the Memphis TGA, Shelby County is in Tennessee’s 9th congressional district; Mississippi’s 1st congressional district includes all of DeSoto, Marshall, Tate Counties and Tunica County is in the 2nd congressional district; Crittenden County is in Arkansas's 1st congressional district. Source: United States Department of Agriculture (USDA) Food and Nutrition Service (FNS)

TN (Shelby) MS (DeSoto, Tate, Tunica) AR (Crittenden)

Households Receiving Benefits 46,217 (19.6%) 35,263 (13.9%) 42,884 (18.7%)

Median Income $15,684 $13,328 $13,191

Percent with Children <18 56.7% 60.4% 58.0%

Overview of Households Receiving Benefits in Memphis TGA (2010)

Tennessee Mississippi ArkansasMonthly Benefit $133.86 $122.54 $122.59

Average Monthly Benefits by State (per person)

Across all three states in the Memphis TGA, 17% of households receive food stamps. On average, annual household income of food stamp recipients is $14,000 and more than half have children under age 18.

Substance Abuse Prevention and Treatment

51

Allocations for Shelby, Tipton and Fayette counties

FY 09-10 FY 10-11 FY 11-12$0

$1,000,000

$2,000,000

$3,000,000

$4,000,000

$5,000,000

$6,000,000

$7,000,000

$8,000,000

$9,000,000

$10,000,000

$2,231,659 $3,311,727

$4,484,289

$3,274,954

$4,224,066

$3,992,518 $898,321

$839,490 $721,547

Federal Preven-tion

Federal Treatment

State Treatment


Source: Tennessee Department Mental Health, Division of Alcohol and Drug Abuse Services. State Fiscal Year 2011-2012 is July 1, 2011 - June 30, 2012.

Martha Montgomery

figures are from email from Taryn Sloss on May 21, 2012; per phone conversation on May 22, 2012: state allocates funds to the general fund and dedicated funds are set aside specifically for certain projects; this includes state general fund amounts and dedicated state funds; all of the money is for substance abuse preventin and treatment in these 3 counties

Substance Abuse Prevention and Treatment

52

Source: Tennessee Department Mental Health, Division of Alcohol and Drug Abuse Services. State Fiscal Year 2011-2012 is July 1, 2011 - June 30, 2012.

Allocations for Shelby, Tipton and Fayette counties


FY 09-10 FY 10-11 FY 11-12$0

$1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 $6,000,000 $7,000,000 $8,000,000 $9,000,000

$10,000,000

$6,404,934

$8,375,283 $9,198,354

Allocations for substance abuse prevention and treatment have increased about 44% in the past two years.

Martha Montgomery

figures are from email from Taryn Sloss on May 21, 2012; per phone conversation on May 22, 2012: state allocates funds to the general fund and dedicated funds are set aside specifically for certain projects; this includes state general fund amounts and dedicated state funds; all of the money is for substance abuse preventin and treatment in these 3 counties

Housing Opportunities forPeople with AIDS (HOPWA)

• The U.S. Dept. of Housing and Urban Development manages the HOPWA program for low-income persons living with HIV/AIDS

• Serves PLWHA living in Fayette, Shelby and Tipton counties in TN, DeSoto, Marshall, Tate and Tunica counties in MS, and Crittenden county, AR

• Services include– Tenant-Based Rental Assistance (TBRA)– Short-term Rent, Mortgage & Utility Assistance (STRMU)– Permanent Housing Facility– Short-term Housing Facility– Permanent housing placement (e.g., first month’s rent, utility deposits)– Housing information (e.g., flyers, pamphlets)– Support Services (e.g., case management, life skills management,

employment assistance/training)


54

Source: City of Memphis, Division of Housing and Community Development, Annual Action Plans.


FY11 FY12 FY13 FY14$0.00

$500,000.00

$1,000,000.00

$1,500,000.00

$2,000,000.00

$2,500,000.00 $2,279,322.50 $2,044,449.

00 $1,835,799.

50 $1,620,183.39

HOPWA Budget


Over four years (FY11-FY14) HOPWA funding in the Memphis TGA decreased 30%.

Martha Montgomery

Budgets come from annual action reports by the City of Memphis House AuthorityFY2012 budget includes $1,649,970 FY12 funds and $394,479 prior year fundsFY2013 budget includes $1,654,292.32 funds and $181,506.68 prior year fundsThese figures are different from the award amounts listed in the Grant Narrative p. 13

55

Source: City of Memphis, Division of Housing and Community Development.

FY10 FY11 FY12 $-

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

$3,000,000

$2,385,365

$2,177,710

$1,544,651

HOPWA Expenditures



The number of households served in FY 2012 is down 12% from FY 2010.

FY10 FY11 FY120

200

400

600

800

1000

1200

725

997

821

Number Served by HOPWA

Num

ber

of H

ouse

hold

sSe

rved

56

Source: City of Memphis, Division of Housing and Community Development.

HOPWA Expenditures by Agency

Services Provided by HOPWA Agencies1. Tenant-Based Rental Assistance (TBRA); Short-Term Rent, Mortgage & Utility Assistance (STRMU); Permanent Housing Facility-Operating; Permanent housing placement (first month’s rent, rent/utility deposits); Support Services (case management, Wellness University, etc.)

2. Short-Term Housing Facility; Support Services (mental health, A&D); Housing Information (flyers, pamphlets)3. Homemaker Services; Support Services (case management)4. Tenant-Based Rental Assistance (TBRA); Support Services (case management, life skills management, employment assistance/training)

5. Tenant-Based Rental Assistance (TBRA); Support Services (case management, transportation)

FY 2010 (7/1/09 - 6/30/10) FY 2011 (7/1/10 - 6/30/11) FY 2012 (7/1/11 - 6/30/12)







Friends For Life 470 $1,393,765 $2,965 883 $1,391,529 $1,576 712 $828,830 $1,164

Peabody House 116 $306,992 $2,646

55 $281,236 $5,113 49 $229,440

$4,682

Meritan 35 $96,059 $2,745 38 $173,136 $4,556 35 $134,095 $3,831

Hope House 10 $202,012 $20,201 13 $182,870 $14,067 17 $171,643 $10,097

Urban Family Ministries 9 $159,828 $17,759 8 $148,939 $18,617 8 $180,643 $22,580

Family Services of the

Mid-South 85 $226,709 $2,667 - - - - - -

TOTAL 725 $2,385,365 $3,290 997 $2,177,710 $2,184 821 $1,544,651 $1,881


Other Community Sources for Emergency Financial or Rental Assistance

• Metropolitan Inter-Faith Association (MIFA)– Provides food, rent/mortgage, transportation, and utility assistance to eligible individuals

• MLG&W Utility Service Payment Assistance Programs– Pay the utility bills of people whose utilities have been or are at risk of being shut off– Includes the Federal Low Income Home Energy Assistance Program (LIHEAP), a non-

emergency program that provides utility assistance in the form of a credit once per calendar year

– Utility bill payment assistance programs have age, income, disability, need and other eligibility requirements


Transportation 642 clients 37,359 tripsFood 3,210 clients 447,976 meals

Utility Assistance 1,601 households $502,876 on utility bills

Mid South AIDS Fund A Community Partner of AIDS United Housed at the Methodist Healthcare Foundation Funding decisions made by the Board of Directors Awards grants to local programs for education, stigma reduction,

prevention and access to care regarding HIV/AIDS 2012 Grantees include: Memphis Center for Reproductive Health (CHOICES); Christ

Community Health Services; Church Health Center; St. Paul Baptist Church; Planned Parenthood of the Greater Memphis Region

58

2011 Budget 2012 Budget$0

$20,000

$40,000

$60,000

$80,000

$100,000 $92,000

$82,000


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