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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facebook.com/ChicagoPublicHealth@ChiPublicHealth
312.747.9884
www.CityofChicago.org/Health
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