client level data and minnesota careware provider meeting may 22, 2014
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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)
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
*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.
Persons Living with HIV/AIDS in Minnesota and those entered into
CAREWare by Gender 2013
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
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)
Persons Living with HIV/AIDS in Minnesota and those entered into
CAREWare by Race 2013
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
0%
10%
20%
30%
40%
50%
60%51%
22%
13%9%
2% 2% 2% 0%
39%
28%
8% 10% 9%2% 1% 2%
Surveillance (n=7,723) MN CAREWare (n=4,261)
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
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
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
Persons Living with HIV/AIDS in Minnesota and those entered into
CAREWare by Age 2013
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
<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%
Surveillance (n=7,717) MN CAREWare (n=4,261)
Minnesota CAREWare by Risk Factor (n=4,261) 2013
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
0%
5%
10%
15%
20%
25%
30%
35%
40%35%
30%
23%
6%2% 1% 1% 1% 1% 0%
Persons Living with HIV/AIDS in Minnesota and those entered into
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
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
Minnesota Surveillance (n=7723) and CAREWare (n=4,261) by HIV/AIDS
Status 2013
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
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
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
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
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
(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
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
(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
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
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
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
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
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
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
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
-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
Data Source: MN CAREWare and Minnesota HIV/AIDS Surveillance MN CAREWare: Annual Review
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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