Between today and 2014 there will be a total transformation of how HIV/AIDS prevention and care is provided in America. Are You Ready?
These changes include:
1. Affordable Care Act (ACA)
2. National HIV/AIDS Strategy (NHAS)
3. 12 Cities Project
4. Enhanced Comprehensive HIV Prevention Plans (ECHPP)
5. Update of Funding Formula for Housing Opportunities For Persons With AIDS (HOPWA)
6. Ryan White Reauthorization in 2013 (RWCA)
7. HHS Action Plan for the Prevention and Treatment of Viral Hepatitis
8. HHS Action Plan to Reduce Racial and Ethnic Health Disparities
The challenges include:
1. Federal Budget Cuts
2. State Budget Cuts
3. Potential Cuts To Medicaid
4. AIDS Drug Assistance Program (ADAP) Waiting Lists
To survive, organizations must innovate, adapt and change. Are You Ready?
Is "the field" caught up with these important federal initiatives?
The HIV/AIDS community supports the larger visions espoused in these changes, but the implementation plans may also pose challenges. For example, as jurisdictions roll out the specifics of their 12 City and ECHPP programs, it is quite possible that minority-serving community based organizations (CBOs) will face cuts in funding as resources are reallocated or redirected elsewhere. This could exacerbate already tough budgetary times. Is this an outcome we can or should support? What if it's necessary for the implementation of the NHAS/12 City Project/ECHPP?
As part of the ACA, Health Resources and Services Administration (HRSA) will build capacity in community health centers (CHC) and Ryan White grantees to implement HIV/AIDS medical homes. Are you ready to move your clients to HIV/AIDS medical homes? When they move, will you still be funded to provide services?
In other words, are you ready?
CBOs need to consider the following:
1. Educate Yourself
2. Ask Questions & Challenge Assumptions
3. Inventory of Your Agency's Services
4. Review Your Economic Model
5. Change & Grow
Educate Yourself
To know if your agency is on the right track, you need to understand these federal initiatives and how they will be implemented. You need to educate yourself, your staff, your clients and your board. Staff, clients and boards were added because they will also need to adapt and change. This can be very difficult, especially when folks think everything is fine.
Basic Resources
The above resources will give you a basic primer; they do not provide any critical analysis.
It can be overwhelming to stay on top of all this information. So many vital issues are being implemented simultaneously, what's a Queen to do? Keep your sense of humor and prioritize those issues that have the biggest impact on your agency and your clients. If your staff is large enough, you may want to identify different point persons who will monitor each initiative in depth.
Ask Questions & Challenge Assumptions
What do these federal initiatives mean for your agency, staff, clients and board?
As a federal official recently said "we are building the plane at the same time that we have to fly it." Because there isn't a clear blueprint, this is a good time to ask questions, challenge assumptions and clarify priorities.
Some Important Questions to Ask
Inventory of Your Agency's Services
Does your agency provide services that will be funded as these new initiatives are implemented?
First step: Take an inventory of your agency's services.
Then ask hard questions:
This is the hardest part of the equation. You need to be really honest because your agency's survival depends on these answers.
Review Economic Model
Does your economic model sustain your agency? What is your economic model?
Second step: Identify all your sources of revenue.
Then ask hard questions:
You are a business. Like any business, your revenue needs to match your expenses (unless you're the federal government).
Change & Grow
Change can be scary. Adapting to change is an essential life skill.
The community will play an important part in the success of the NHAS, 12 Cities Project, ACA implementation, RWCA reauthorization and other important administration initiatives. However, only the strong will survive.
NMAC will always be there for you. You can always count on me, my Deputy Director Daniel Montoya, my staff and my board. Thanks for everything you do to fight HIV/AIDS.
Yours in the struggle,
Paul Kawata
Executive Director, National Minority AIDS Council
The HIV/AIDS community supports the larger visions espoused in these changes, but the implementation plans may also pose challenges. For example, as jurisdictions roll out the specifics of their 12 City and ECHPP programs, it is quite possible that minority-serving community based organizations (CBOs) will face cuts in funding as resources are reallocated or redirected elsewhere. This could exacerbate already tough budgetary times. Is this an outcome we can or should support? What if it's necessary for the implementation of the NHAS/12 City Project/ECHPP?
As part of the ACA, Health Resources and Services Administration (HRSA) will build capacity in community health centers (CHC) and Ryan White grantees to implement HIV/AIDS medical homes. Are you ready to move your clients to HIV/AIDS medical homes? When they move, will you still be funded to provide services?
In other words, are you ready?
CBOs need to consider the following:
1. Educate Yourself
2. Ask Questions & Challenge Assumptions
3. Inventory of Your Agency's Services
4. Review Your Economic Model
5. Change & Grow
Educate Yourself
To know if your agency is on the right track, you need to understand these federal initiatives and how they will be implemented. You need to educate yourself, your staff, your clients and your board. Staff, clients and boards were added because they will also need to adapt and change. This can be very difficult, especially when folks think everything is fine.
Basic Resources
- Affordable Care Act (ACA)
- National HIV/AIDS Strategy (NHAS)
- 12 Cities Project
- Enhanced Comprehensive HIV Prevention Plans (ECHPP)
- Update of Funding Formula for Housing Opportunities For Persons With AIDS (HOPWA)
- Ryan White Reauthorization in 2013 (RWCA)
- HHS Action Plan for the Prevention and Treatment of Viral Hepatitis (The plan will be released May 12 )
- HHS Action Plan to Reduce Racial and Ethnic Health Disparities
The above resources will give you a basic primer; they do not provide any critical analysis.
It can be overwhelming to stay on top of all this information. So many vital issues are being implemented simultaneously, what's a Queen to do? Keep your sense of humor and prioritize those issues that have the biggest impact on your agency and your clients. If your staff is large enough, you may want to identify different point persons who will monitor each initiative in depth.
Ask Questions & Challenge Assumptions
What do these federal initiatives mean for your agency, staff, clients and board?
As a federal official recently said "we are building the plane at the same time that we have to fly it." Because there isn't a clear blueprint, this is a good time to ask questions, challenge assumptions and clarify priorities.
Some Important Questions to Ask
- What is the role of DEBIs (Diffusion of Effective Behavioral Interventions)? What is the role of community planning? How will they integrate into ECHPP?
- What is the role of directly funded CBOs vis-à-vis NHAS, 12 City Project and/or ECHPP? How will they be integrated into these important initiatives?
- If you don't live in one of the 12 Cities, how will this program impact other cities and states? Is there any new funding for cities/states who reside outside of this initiative?
- Will the Ryan White Care Act be reauthorized in 2013? Will services provided to PWAs under the RWCA be integrated into healthcare reform? Will they be reimbursable?
- Will all HIV medications be covered under AFA? Does this mean the end of ADAP and ADAP waiting lists?
-
How will success be measured? What are the metrics? What if this doesn't work?
Inventory of Your Agency's Services
Does your agency provide services that will be funded as these new initiatives are implemented?
First step: Take an inventory of your agency's services.
Then ask hard questions:
- What services are essential to our mission and our clients?
- What services will be funded under these new initiatives?
- Can you modify any of your existing services to fit within the new funding priorities?
- If you can't modify your services, how will your agency finance them?
- What are the expectations of your board, staff and clients?
This is the hardest part of the equation. You need to be really honest because your agency's survival depends on these answers.
Review Economic Model
Does your economic model sustain your agency? What is your economic model?
Second step: Identify all your sources of revenue.
Then ask hard questions:
- Who supports your agency?
- Is this funding at risk?
- What does your balance sheet say about your organization?
- Are you carrying debt? How much?
- Can you sustain your agency until new revenue streams are identified?
- Are you fundable under any of these new initiatives?
- What other funding options should you consider?
You are a business. Like any business, your revenue needs to match your expenses (unless you're the federal government).
Change & Grow
Change can be scary. Adapting to change is an essential life skill.
The community will play an important part in the success of the NHAS, 12 Cities Project, ACA implementation, RWCA reauthorization and other important administration initiatives. However, only the strong will survive.
NMAC will always be there for you. You can always count on me, my Deputy Director Daniel Montoya, my staff and my board. Thanks for everything you do to fight HIV/AIDS.
Yours in the struggle,
Paul Kawata
Executive Director, National Minority AIDS Council
So frightening, as someone diagnosed earlier this year, and after being aware of all the important breakthroughs and reasons to continue cure research, that what I now have learned is "the field" of hiv 'activists' are more concerned about how to keep their programs and platforms 'new and fresh' instead of the front line of dispersing the Cure.
I've come to know one such career HIV 'activist', who belittles all the news I've shared with him about the cure research and the immediate need to fund these initiatives. I came to realize he had the same interest in a cure as Big Pharma does... if HIV is cured, where would "the field" aka, 'the community' that he strives to advance in professionally, go?
Yes, prevention is important, treatment is important, but what's MOST important is what should have always been the front line of what true HIV + activists seek, which is a cure to this damming disease.
To not even see this newest bloggers introductory post mention the word 'cure' once, is depressing to say the least. I'm 24 years old and recently diagnosed. I do not like much of what I see in the HIV + community, or, "the field". Thankfully some of the activists are truly more concerned with getting funding to the places in which it could do the most good, which is in finding a cure that would free all of the COMMUNITY of POZ people who ARE ALREADY infected of the disease and lifetime of stigma and expense in treating it, as well as the 'PREVENTION' of the disease spreading - a cure is in need of All of our focus and resources, and this is where the real activism is needed.
Thank you for being a kind human being.
I am ingreement with you my friend on the lack of zeal and hope for a cure from our leadership in the field of HIV and AIDS. I look at this problem and poner this quasi science of AIDS for some time and the leadership will not use their political supluss to advocate for the concept of a cure. Yes, they will put fine peices of documents together meeting after meeting and advocate like hell for more money to keep treatment going and moving in all direction for their goals, while saying they are the community and many of these folks are not HIV, but will throw a bone to the HIV person now and then. It will take a new movment of advocates with new concepts with the zeal of the old school folks of the past that got us to this point in HIV care and treatment. Many see the problem and now it is time for solutions, my concern is that the old school folks are going to retirier and new acadimics will see AIDS as a worthie career to follow their old school programs and concepts. It is time for a change in thinking and action will the old school folks in keeping their program funded and the new progress thinkers with faith tofollow their hearts and pressure all to move forward in a do or die stragy. Keep up the advocating and keep up your hopes for a cure, for I believe a cure is out their and wil be unveil to the masses. I believe the begining of any movment it starts with Hope and a goal. You must remember that they only understand what their science has tought them and are torn with past truma and fat and happy to be in the mix to get a piece of the pie and attention, for they will say we are in your stuggle, when realy they have become the prison gaurds. Stay in the battle keep your voice out there, keep writing and keep the pressure on, for it is not over yet, for many are on your side for a cure and have the courage to keep the concept of a Cure for HIV and AIDS on the table and as you meditate or pray each day see the Cure for AIDS and the joy of being healed and released from this prison of hoplessness, that some are tring to substain unkowningly.