FLORIDA HIV/AIDS Community Planning
Local Community Prevention Planning Group
Assessment Tool
The primary purpose of this assessment tool is to provide the Bureau of HIV/AIDS with additional insight into the structure, function, and activities of your local planning group. The information provided will allow the bureau to provide better services, technical assistance, and offer suggestions that will help support your local planning group. This assessment tool addresses the area’s priority populations, planning group make-up, local area resources and gaps, and technical assistance needs. The local community planning group (CPG) representative for the statewide body will be responsible for ensuring that this tool is completed and submitted. The assessment tool will serve as your area’s contribution to the Statewide Comprehensive HIV Prevention Plan. Some parts of this tool may be used in the plan. Please answer the questions to your best of your ability.
Please identify the local planning group chair, co-chair and contact person for the area.
Chair: _________________________________________________________________
Telephone: _____________________________________________________________
Address: _______________________________________________________________
E-mail address: __________________________________________________________
Co-chair: _______________________________________________________________
Telephone: _____________________________________________________________
Address: _______________________________________________________________
E-mail address: __________________________________________________________
Contact Person: _________________________________________________________
Telephone: _____________________________________________________________
Address: _______________________________________________________________
E-mail address: __________________________________________________________
Who is responsible for the meeting minutes?
Contact Person: _________________________________________________________
Telephone: _____________________________________________________________
Address: _______________________________________________________________
E-mail address: __________________________________________________________
Planning Group Structure
1. Please describe your community planning group structure.
2. Does the planning group have a committee structure for prevention activities?
Yes No
If yes, please explain:
3. Does the planning group have a sub-committee or working group structure through which specific planning tasks are accomplished?
Yes No
If yes, please indicate how these are organized:
By Target Populations By Intervention Type
By Planning Tasks Combination
Other:_________________
Please provide a list or description of these sub‑committees:
4. How many members does your planning group have?
5. Please provide a breakdown of the demographic make-up of the planning group by race/ethnicity.
6. Does the planning group operate under bylaws or formal group guidance?
Yes No
7. Please explain the process used for decision making by the planning group.
8. Please explain how non-voting members are heard.
9. Is your planning group combined with the HIV/AIDS Care CPG?
Yes No
If yes, please explain how prevention activities are handled within the group.
10. Where are the Community Planning meetings held?
11. Do the locations change or rotate?
Yes No
If yes, please explain.
12. How do you ensure that meeting locations are easily accessible to everyone in the area?
Yes No
13. Is each county health department in the area represented?
Yes No
RECRUITMENT
1. How often does the planning group recruit for new members?
2. During the recruit, are members of the area’s priority populations or at-risk group recruited for membership?
Yes No
If no, please explain why they are not recruited.
3. Is new member orientation provided to newly recruited members of the planning group?
Yes No
If yes, please describe the orientation process.
4. Are the community planning meetings advertised?
Yes No
If yes, please explain the methods used for advertising meetings.
5. Do all counties in the area participate in community planning meetings?
Yes No
6. If no, please list the counties represented in the area’s CPG.
7. During the past year, has the local planning group undertaken other activities beyond those stipulated in the CDC community planning guidance (e.g., development of the comprehensive plan)?
Yes No
If yes, please check all that apply:
Public Relations Allocating Resources
Media Outreach Participating in Program Implementation
Community Mobilization Program Evaluation
RFP Development Other _____________
8. Please provide a brief description of any current projects that the local planning group is involved with.
PRIORITIES
1. Please list the area’s current priority populations.
1.
2.
3.
4.
5.
6.
7.
2. How does the makeup of the planning group compare to the local epidemic and priority populations?
3. Describe how all priority populations are represented in the planning process?
4. What activities are currently taking place to address the area’s priority populations?
5. Briefly describe how each priority population is being addressed?
LINKAGE AND COORDINATION
1. Is your planning group currently coordinating with substance abuse prevention service providers?
Yes No
If yes, please describe your efforts:
If no, why not?
2. Is your local planning group currently coordinating with STD prevention service providers?
Yes No
If yes, please describe your efforts:
If no, why not?
3. Is your local planning group currently coordinating with corrections agencies?
Yes No
If yes, please describe your efforts:
If no, why not?
4. Is your local planning group currently coordinating with hepatitis prevention services?
Yes No
If yes, please describe your efforts:
If no, why not?
5. Is your local planning group currently coordinating with HIV/AIDS care providers?
Yes No
If yes, please describe your efforts:
If no, why not?
6. Please describe how your planning group promotes community planning to the broader community.
Use of Media Brochure on Planning Process
Fax/Phone Trees Newsletter
Community Events/Forums Special Packaging of Prevention Plan
Other_______________
7. Does the planning group have or use a web page to communicate about the planning process?
8. How does the health department work with the planning group to communicate about the area’s HIV prevention program?
SUSTAINING INVOLVEMENT PARITY, INCLUSION & REPRESENTATION (PIR)
1. What mechanisms have the planning group established to ensure that all members can fully and meaningfully participate in the planning process?
Check all that apply:
Orientation Sessions/Meetings Annual Conferences
Mentoring Trainings on Epidemiology, Social Science, etc.
Subcommittee on PIR Glossary of Planning/Prevention Terms
Provision of Technical Assistance Retreats
Requiring Members to sit on at least one Operating Subcommittee
Ongoing Review/Revisiting of Operating Principles / By-Laws
Other:___________________
2. Does the planning group or health department utilize other mechanisms to obtain community input for the determination of HIV prevention priorities identified in the local prevention plan or in the planning process?
Yes No
If yes, please describe the process:
Please check all that apply:
Public Hearing Focus Groups
Open Forums Written Testimony
Teleconferences Other:______________
3. Please note any strengths and/or weaknesses you would like to share related to sustaining appropriate parity, inclusion and representation (PIR) in the CPG.
Strengths:
Weaknesses:
RESOURCE INVENTORIES
1. Has your planning group completed a resource inventory for the area?
Yes No
2. What method(s) were used to compile the area’s most recent resource inventory?
Check all that apply:
Survey of Current Health Department Review of Administrative Documents
Survey of all Prevention Providers in Jurisdiction Interviews with Providers
Survey of Consumers Interviews with Consumers
Other:_____________
3. Who completed the most recent resource inventory?
Check all that apply:
Health Department Staff Contractor
Local Planning Group Members Health Department & LPG
Other:_____________
4. Has the planning group completed a gap analysis for the area?
Yes No
Planning Groups Technical Assistance Needs
1. Please indicate whether any of the following issues are being discussed and addressed by the planning group in your area.
Check any that apply:
Counseling, Testing, and Linkage Needle Exchange Programs
Harm Reduction New Testing Technologies Secondary Prevention
Perinatal Transmission Use of Social Marketing DEBI Interventions
Corrections Substance Abuse Community Mobilization
Other:______________ Partner Services
2. Please describe any technical assistance needs that the CPG currently has.
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