BALTIMORE CITY HEALTH DEPARTMENT RYAN WHITE PART … EMAv2.pdf · 2018. 7. 20. · planning council...
Transcript of BALTIMORE CITY HEALTH DEPARTMENT RYAN WHITE PART … EMAv2.pdf · 2018. 7. 20. · planning council...
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Planning Council Meeting
May 15 th, 2018
Ryan White Office
BALTIMORE CIT Y HEALTH DEPARTMENT
RYAN WHITE PART A/MAI PROGRAM
CLIENT-LEVEL DATA PRESENTATION
FISCAL YEAR 2017 MARCH 1ST 2017 THROUGH FEBRUARY 28 TH 2018
BALTIMORE ELIGIBLE METROPOLITAN
AREA (EMA)
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Improve the quality of l ife for people living with HIV/AIDS and
their families in Baltimore City and surrounding counties
Provide comprehensive guidance to Ryan White providers and
the Baltimore Planning Council to ensure compliance with
Ryan White legislations and standards of care
Objective
Demonstrate FY 2017 client level data for priority setting and
resource allocation
MISSION
BCHD RYAN WHITE PROGRAM
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Total Consumers Served by Ryan White N = 12,486
Received any Ryan White defined service regardless of payer
Payers in Baltimore EMA
o Part A/MAI - BCHD
o Part B/MAI - MDH
o State Special Funds – MDH
o Medicare
o Medicaid
o Private Insurance
o Other Insurance payer sources
Federal Poverty Level < 500%
Exclusionso consumers with an unconfirmed HIV Diagnosis
o consumers with an HIV Status of Indeterminate & < 2 years of age
o consumers with an FPL > 500%
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At a glance, who are the Ryan White consumers in the
Baltimore Eligible Metropolitan Area (EMA)?
N = 12,486
o 61% Males
o 37% Females
o 2% Transgender persons
o 77% Black/African Americans
o Mean Age = 48
o 72% Stable Permanent Housing
o 6% Unstable/Temporary/Non-Permanent Housing
o 12% New to Ryan White services in the Baltimore EMA
(first service date within fiscal period)
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DEMOGRAPHICS
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2 to 12
0.25%13 - 24
4%
25 - 44
32%
45 - 64
56%
65+
8%
Age Group N = 12,486
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Unknown/Unreported
20%
100% to 138%
10%
139% to 200%
5%
201% to 250%
4%
251% to 400%
3%
401% to 500%
1%
Below 100% FPL
57%
Federal Poverty Level N=12,486
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Hemophilia
0.09%
Heterosexual
39%
IDU
14%
MSM
23%
MSM and IDU
0.60%
Not Specified
20%
Other
0.30%
Perinatal
2%Transfusion
0.63%
HIV Risk Factor N = 12,486
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IHS
0.01%
Medicaid
45%
Medicare
22%
No Insurance
7%
Other
1%
Private
22%
Unknown
0.26% VA, Tricare and Other
Military Health Care
0.23%
Insurance Status N = 12,486
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SERVICE UTILIZATION
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0%
1%
3%
6%
9%
10%
11%
17%
58%
81%
0%
2%
4%
9%
11%
14%
12%
18%
69%
83%
0% 20% 40% 60% 80% 100%
Hospice Care
Home & Community Based Health
Services
Substance Abuse Outpatient
Medical Nutrition Therapy
Health Insurance Premiums
Early Intervention Services
Mental Health
Oral Health
Medical Case Management
Outpatient Ambulatory Health
Services
CO
RE
ME
DIC
AL S
ER
VIC
E C
ATE
GO
RY
% Clients FPL Below 100% n=7,131
% All Clients N=12,486
Core Medical Services
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0%
1%
5%
6%
7%
14%
14%
15%
21%
24%
0%
1%
7%
7%
8%
20%
15%
20%
19%
31%
0% 20% 40% 60% 80% 100%
Substance Abuse Residential
Services
Other Professional Services
(Legal)
Housing Services
Psychosocial Support
Food Bank Home Delivered Meals
Emergency Financial Assistance
Case Management non-medical
Service Outreach
Health Education Risk Reduction
Medical Transportation
Su
pp
ort
Se
rvic
e C
ate
go
ry
% Clients FPL Below 100% n=7,131
% All Clients N=12,486
Support Services
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13%
7%
12%
15%
5%
7%
10%
8%
8%
60%
78%
65%
65%
50%
61%
65%
54%
56%
26%
14%
22%
19%
42%
27%
24%
33%
32%
1%
1%
1%
1%
4%
4%
1%
4%
4%
0%
0%
0%
0%
0%
1%
0%
0%
0%
0% 20% 40% 60% 80% 100%
Home & Community Based Health Services n=186
Substance Abuse Outpatient n=333
Medical Nutrition Therapy n=772
Health Insurance Premiums n=1,177
Early Intervention Services n=1,252
Mental Health n=1,380
Oral Health n=2,121
Medical Case Management n=7,259
Outpatient Ambulatory Health Services n=10,094
Percentage of consumers
Co
re M
ed
ica
l S
erv
ice
Ca
teg
ory
Core Medical Services by Age Group
2 to 12 13 to 24 25 to 44 45 to 64 65+
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0%
8%
5%
8%
10%
7%
6%
5%
9%
7%
70%
68%
63%
58%
66%
57%
50%
51%
64%
64%
30%
22%
29%
26%
23%
33%
35%
40%
24%
25%
0%
2%
3%
8%
2%
3%
9%
4%
3%
3%
0%
0%
0%
0%
0%
0%
1%
0%
0%
0%
0% 20% 40% 60% 80% 100%
Substance Abuse Residential n=23
Other Professional Services (Legal) n=143
Housing Services n=625
Psychosocial Support n=738
Food Bank Home Delivered Meals n=845
Emergency Financial Assistance n=1,688
Case Management non-medical n=1,731
Service Outreach n=1,917
Health Education Risk Reduction n=2,635
Medical Transportation n=2,981
Percentage of consumers
Su
pp
ort
Se
rvic
e C
ate
go
rySupport Services by Age Group
2 to 12 13 to 24 25 to 44 45 to 64 65+
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MINORITY AIDS INITIATIVE (MAI)
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4%
11%
16%
17%
17%
48%
0% 20% 40% 60% 80% 100%
Medical Nutrition Therapy
Health Education Risk Reduction
Service Outreach
Mental Health
Medical Case Management
Medical Transportation
Percentage of consumers accessing BCHD MAI funded services
MA
I S
erv
ice
Ca
teg
ory
Minority AIDS Initiative (MAI) N = 1,628
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RETENTION IN HIV MEDICAL CARE
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Retention in
HIV Medical
Care
Baltimore
EMA
Numerator
Baltimore
EMA
Denominator
Baltimore
EMA
Percentage
National
Average
8,211 10,514 78% 82%
Note:
Nation Average based upon 2016 Ryan White HIV/AIDS Program Annual Client Level Report
Ryan White HIV/AIDS Program Services Report (RSR)
Retention in HIV Medical CareRetention in HIV medical care is defined as PLWH who had at least 1 outpatient ambulatory health
services (OAHS) visit in the measurement year, with a second visit at least 90 days after.
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67% 66%
72%
82%85%
78%82%
0%
20%
40%
60%
80%
100%
2 to 12 13 to 24 25 to 44 45 to 64 65+ Baltimore
EMA
National
Average
Pe
rce
nta
ge
of
Co
nsu
me
rs
Age Group
Retention in Care by Age Group
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78% 78%
67%
78%
82%
0%
20%
40%
60%
80%
100%
Female Male Transgender Baltimore EMA National Average
Pe
rce
nta
ge
of
Co
nsu
me
rs
Gender
Retention in Care by Gender
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79%
90%
83%87%
84%83%
62%
78%
85%
0%
20%
40%
60%
80%
100%
Pe
rce
nta
ge
of
Co
nsu
me
rs
Federal Poverty Level
Retention in Care by Federal Poverty Level
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VIRAL LOAD SUPPRESSION
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Viral Load
Suppression
Baltimore
EMA
Numerator
Baltimore
EMA
Denominator
Baltimore
EMA
Percentage
National
Average
7,851 9,047 87% 85%
Note:
Nation Average based upon 2016 Ryan White HIV/AIDS Program Annual Client Level Report
Ryan White HIV/AIDS Program Services Report (RSR)
Viral Load Suppression
Viral suppression is calculated among PLWH who had at least 1 OAHS and at least 1
viral load during the measurement year. Viral suppression is defined as a most recent
viral load test result
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93%
76%
82%
89%
94%
87%85%
0%
20%
40%
60%
80%
100%
2 to 12 13 to 24 25 to 44 45 to 64 65+ Baltimore
EMA
National
Average
Pe
rce
nta
ge
of
Co
nsu
me
rs
Age Group
Viral Load Suppression by Age Group
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86%88%
84%87%
85%
0%
20%
40%
60%
80%
100%
Female Male Transgender Baltimore EMA National Average
Pe
rce
nta
ge
of
Co
nsu
me
rs
Gender
Viral Load Suppression by Gender
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86% 88%91%
87%
91% 92%
84%87%
85%
0%
20%
40%
60%
80%
100%
Pe
rce
nta
ge
of
Co
nsu
me
rs
Federal Poverty Level
Viral Load Suppression by Federal Poverty Level
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10,514
8,211
6,643
5,547
0
2,000
4,000
6,000
8,000
10,000
12,000
In Care Retained in Care Prescribed ART Virally Suppressed
Baltimore-Towson EMA Ryan White HIV Care Continuum, FY 2017
78%
of
those
in care63% of
those in
care
81% of
those
retained
53% of those
in care
68% retained
84% of those
prescribed
ART
Ryan White consumers
who had at least two HIV
medical visits spaced by
at least 90 days apart
Ryan White
consumers who
had at least one
HIV medical visit
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A Ryan White documented HIV care visit in CAREWare are
those who have had a funded RW visits. Variances in clinical
and demographic data are attributed to individual Program
operations & Ryan White consumers receiving care outside of
the network of Ryan White Providers.
LIMITATIONS
Data Source:
Maryland CAREWare All Client Data extract 05/10/2018 for period
covering 03/01/2017 through 02/28/2018
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THANK YOU!
QUESTIONS??STEPHON EFFINGER
STEPHON.EFFIN GER@BALTIMORECIT Y.GOV
410-545-1912
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mailto:[email protected]