At the April meeting of the Comprehensive Planning and Needs Assessment Committees, Jessica Brown of AACO presented on Ryan White service categories. She also reviewed changes enacted by PCN 16-02.

1. RWHAP Services and
PCN 16-02
Jessica Browne
AACO Information Services Unit
April 20, 2017

2. Objectives
• Review service definitions for Ryan
White Part A Core and Support services
in EMA
• Discuss how services are rendered in
EMA
• Understand impact of PCN 16-02 on
service names and definitions

3. Policy Clarification Notice (PCN) 16-02
• Goes into effect 3/1/2017
• Replaces PCN 10-02
• Provides clarification on:
oEligible Individuals
oAllowable/Unallowable Uses of Funds
oService Category Descriptions and Program
Guidance
• Changes highlighted in purple throughout
slides

4. Services Funded in EMA
Core Services Support Services
• AIDS Pharmaceutical
Assistance
• Medical Case Management
• Medical Nutritional Therapy
• Mental Health Services
• Oral Health Care Services
• Outpatient/Ambulatory
Health Services
• Substance Abuse
Outpatient Care
• Emergency Financial Assistance
• Food Bank/Home Delivered
Meals
• Housing
• Medical Transportation Services
• Other Professional Services
(formerly Legal Services)
• Referral for Health Care and
Support Services

5. Core: AIDS Pharmaceutical Assistance
Service Definition
• Local pharmacy assistance programs
• Supplemental means of providing medication
assistance
• Detailed requirements (see handout)
• Cannot be used for Emergency Financial
Assistance
• ADAP funds cannot be used for LPAP support
(only RWHAP Part A grant award or Part B base
award funds)

6. Core: AIDS Pharmaceutical Assistance
Implementation in EMA
• Offered by 1 provider
• One unit = 30 day prescription

7. Core: Medical Case Management
Service Definition
• Focused on improving health outcomes
in support of HIV care continuum
• Medical Case Management vs. Non-
Medical Case Management

8. Core: Medical Case Management
Service Definition
• Includes all types of case management
encounters (e.g. face-to-face, phone
contact, and any other forms of
communication)
• Treatment Adherence no longer exists as a
separate funded service (now all TA under
OAHS/MCM)

9. Core: Medical Case Management
Key Activities
• Initial assessment of service needs
• Comprehensive, individualized care plan
• Access to health and support services
• Ongoing assessment of needs
• Treatment adherence counseling
• Advocacy and/or review of utilization of services

10. Core: Medical Case Management
Implementation in EMA
• Medical vs. CBO
• AACO Workgroup made
recommendations for more flexible
system
• Focus groups with providers and other
stakeholders
• Will be incorporated in upcoming RFP

11. Core: Medical Case Management
Implementation in EMA
• Offered by 22 providers
• One unit = 15 minutes of service

12. Core: Medical Nutritional Therapy
Service Definition
• Nutrition assessment, screening, and evaluation
• Food and nutritional supplements
• Nutrition education and counseling
• Individual or group settings
• Must be referred by medical provider
• Based on a nutritional plan developed by the
registered dietitian or other licensed nutrition
professional

13. Core: Medical Nutritional Therapy
Implementation in EMA
• Offered by 2 providers
• One provider offers more group, one
offers more individual
• One Unit = One Hour

14. Core: Mental Health
Service Definition
• Outpatient psychological and psychiatric
screening, assessment, diagnosis,
treatment, and counseling services
• Outpatient group or individual session
• Provided by a licensed mental health
professional
• Allowable only for clients with HIV

15. Core: Mental Health
Implementation in EMA
• Offered by 9 providers
• Added BHCs at several sites last year
• Group and individual sessions
• One Unit = One Hour (Individual Session)
• One Unit = One Hour per Person (Group
Session)

16. Core: Oral Health Care Services
Service Definition
• Outpatient diagnostic, preventive, and
therapeutic services
• Provided by dental health care
professionals

17. Core: Oral Health Care Services
Implementation in EMA
• Offered by 6 providers
• One Unit = One Visit

18. Core: Outpatient/Ambulatory
Health Services
Service Definition
• Outpatient diagnostic/therapeutic
services
• Provided by licensed healthcare
provider
• Consistent with the Public Health
Service's guidelines

19. Core: Outpatient/Ambulatory
Health Services
Service Definition
• Renamed Outpatient/Ambulatory
Health Services (previously
Outpatient/Ambulatory Medical Care)
• Treatment Adherence no longer exists
as a separate funded service (now all TA
under OAHS/MCM)

20. Core: Outpatient/Ambulatory
Health Services
Implementation in EMA
• Offered by 26 providers
• Variety in type of provider from small
clinics to large hospital-based systems
• One unit = One visit

21. Core: Substance Abuse
Service Definition
• Outpatient services for the treatment of
drug or alcohol use disorders
• Includes screening, assessment,
diagnosis and/or treatment
• May include syringe access services if
allowed by current law and applicable
HHS guidance

22. Core: Substance Abuse
Implementation in EMA
• Offered by 4 providers
• One unit = 15 min.

23. Support: Emergency Financial Assistance
Service Definition
• Limited one-time or short-term payments for:
• essential utilities
• housing
• food (including groceries and food vouchers)
• transportation
• medication
• Direct payment to agency (no cash to clients)
• Payer of last resort, and for limited amounts, uses,
and periods of time

24. Implementation in EMA
• Primarily short-term rental and utility
payments
• Units vary widely (see handout)
Support: Emergency Financial Assistance

25. Support: Food Bank/Home Delivered Meals
Service Definition
• Food items, hot meals, and/or voucher
program to purchase food
• Essential non-food items: personal hygiene
products, household cleaning supplies, and
water filtration or purification systems

26. Support: Food Bank/Home Delivered Meals
Service Definition
• Unallowable costs: household
appliances, pet foods, and other non-
essential products.
• Nutritional services and nutritional
supplements provided by a registered
dietitian are considered Medical
Nutrition Therapy

27. Support: Food Bank/Home Delivered Meals
Implementation in EMA
• Offered by 9 providers
• Home-Delivered Meals: 1 Unit = 1 Meal
• Congregate Meals: 1 Unit = 1 Meal
• Food Bank: 1 Unit = 1 Visit
• Food Voucher: 1 Unit = 1 Voucher

28. Support: Housing
Service Definition
• Limited short-term assistance
• Must provide medical/supportive services OR
enable client to access services
• New clients must have access to housing
services
• Cannot be in the form of direct cash payments
• Cannot be used for mortgage payments

29. Support: Housing
Implementation in EMA
• Offered by 5 providers
• Emergency Rental Assistance: 1 Unit = 1 Voucher
• Transitional Group Residential Housing: 1 Unit = 1 Day
• Housing Assistance – Legal Representation: 1 Unit =
15 min.
• Housing Support – RW Only: 1 Unit = 15 min.

30. Support: Medical Transportation
Service Definition
• Non-emergency transportation services
to core medical and support services
• Payer of last resort (must use Logisticare
first)
• See handout for allowable and
unallowable uses

31. Support: Medical Transportation
Implementation in EMA
• Offered by 4 providers
• Client Transportation
• Bus Pass, Train Token, Taxi Voucher
• 1 Unit = 1 Way Trip or Round Trip
• Agency Staff Member
• 1 Unit = 1 Way Trip or Round Trip

32. Support: Other Professional Services
Service Definition
• Legal Services is now under this
category
• Provision of legal services related
client’s HIV
• Includes assistance with benefits, power
of attorney, and living will

33. Support: Other Professional Services
Implementation in EMA
• Offered by 1 provider
• 1 Unit = 15 min.

34. Support: Referral for Health Care and
Support Services
Service Definition
• Directs client to needed core medical or
support services
• Referrals to public and/or private programs
• Referrals provided by OAHS providers
reported under OAHS
• Referrals provided by MCMs reported under
MCM

35. Support: Referral for Health Care
and Support Services
Implementation in EMA
• Offered by 3 providers (including AACO
CSU)
• Hotline calls: 1 unit = 1 call
• Computer classes/access: 1 unit = 15 min.
• Benefits Counseling: 1 unit = 15 min.

36. Questions?

37. Resources
• aacoisu@phila.gov
• jessica.browne@phila.gov
• Electronic version of PCN 16-02:
• https://hab.hrsa.gov/sites/default/files/ha
b/program-grants-
management/ServiceCategoryPCN_16-
02Final.pdf