SHOW ME THE MONEY!Understanding the Allocation process

Where does the money come from?

Federal Government

City/AACO

Community Service

Providers

Planning Council budgets to Service Categories

AACO contracts with service providers

Feds grant funds based on epidemic and grant application

al·lo·cate  (l-kt)tr.v. al·lo·cat·ed, al·lo·cat·ing, al·lo·cates

› To distribute according to a plan; allot: allocate rations for a week-long camping trip.

› allocation - the act of distributing by allotting or apportioning; distribution according to a plan

Deciding how to divide the EMA’s grant money is a little like deciding how to cut a pie.

There are prioritized service categories (Medical Case Management, Transportation, etc.) that must be budgeted (or allocated) money.

The categories are allocated amounts based on information gathered by the Planning Council:

› Service Utilization Data (How are the services used?)› Spending History (Which categories need money

throughout the year? Which categories under-spend?)› Other funding available for services (Medicaid, Ryan

White Part B, D, etc.)› Unit Cost Data (How much does it cost to provide the

service?)

The EMA received $ 22 million in Ryan White Part A funds in 2011

75% of that must be allocated to “core services”

25% or less can be allocated to “supportive services”

Philadelphia EMA allocated almost 85% to core services and about 15% to supportive services

75% of funds must be spent on Core Medical Services:

Outpatient and ambulatory health services AIDS Drug Assistance Program treatments in

accordance with the minimum drug list Drug Reimbursement Oral health care Early intervention services Health insurance premium and cost sharing assistance

for low income individuals Home health care Home and community-based health services Medical nutrition therapy Medical case management, including treatment

adherence service Hospice services Mental health services Substance abuse outpatient care

Blue= Not Currently Funded

2011 Core Services Allocations Ambulatory Care $6,038,080 Drug Reimbursement Program $1,758,904 Case Management $5,929,364 Substance Abuse Treatment-Outpatient

$340,198 Mental Health Therapy/Counseling 279,665 Medical Nutrition Therapy $50,000 Oral Health Care $701,312 Early Intervention Services $1,229,262

2010 Supportive Service Allocations

Transportation $705,254Food Bank/Home-Delivered Meals $246,934Housing Assistance $556,632Legal Services $312,760Care Outreach $709,642Emergency Financial Assistance $66,858Treatment Adherence $248,257

Another $3 million is allocated to system-wide categories like Administration (AACO), Planning Council Support (OHP), Capacity Building, Information and Referral (AACO Hotline),etc.

Additional Funding Changes

Two categories were allocated $5 to allow the Council to move money into them, if the need arises and there is additional money to do so› ADAP› Health Insurance Premium/Cost Sharing

Assistance

How is the money divided per region?

Region 2008 PLWHAs

Philadelphia 18,634 75.84%

PA 3,270 13.31%

NJ 2,666 10.85%

Our EMA uses living HIV and AIDS cases to decide how to divide the funding for each region. Each region receives a portion of funding equal to the number of living HIV/AIDS cases.

FY2010 was the first year funding was been divided using both HIV and AIDS numbers.

What happens at the regional meetings?

OHP staff provide background information and facilitate the process.

Finance Committee members chair the meeting

Handouts are provided with relevant information.

Everyone has the opportunity to speak to offer ideas and suggestions at the appropriate time

3 budgets are drafted: Level Funding (exactly the same amount) 5% Decrease 10% IncreaseOnly Planning Council members present can vote on the region’s

drafts

How are the budgets approved? Each region’s budgets are presented to the

Planning Council for final approval (August meeting)

Planning Council may make changes to these drafts before final approval

These regional budgets are combined into an EMA budget and included in the Part A grant application

AACO is federally mandated to follow the allocations as approved by the Planning Council

Any changes to the allocations must be presented to the Planning Council by AACO

How are changes made? Re-allocations over 5% for a category must be

presented by AACO to the Planning Council for approval

Re-allocations under 5% for a category can be carried out by AACO, but they must be presented to the Planning Council as soon as possible

Once the grant award is received, any necessary changes to service category allocations will be made by the Planning Council as soon as possible (usually in March)

How are PLWHA involved? Some PLWHA are Planning Council members

Comments from Town Hall meetings and other needs assessment activities are used in decision-making

All allocation meetings are open to the public

Comments, suggestions and ideas are taken at the meeting from guests

Final Thoughts Planning is done for the funding year that begins

in the March of the next year (This summer we are planning for March 2013)

Only Planning Council members can vote on budgets

Come to allocations meetings – check meeting calendar for your area› Pa Counties – July 10th

› NJ Counties – July 19th

› Philadelphia – July 26