Fy 2012 Public Health Master Agreement Annex

Annex 2

FY 2014 PUBLIC HEALTH MASTER AGREEMENT ANNEX

Program Descriptions and Reporting Requirements

Cooperative Agreement: 1U62PS003689-01

PROGRAM NAME: “Test, Link, and Care” Network

PROGRAM CODE: 104(HIV Prevention)

PURPOSE:

The purpose of this program is to implement the “Test-Link-Care” Network. This model will identify and promptly link to care persons who are living with HIV but not receiving treatment (including those who are unaware of as well as, those who are aware of their HIV-positive status) and improve patient retention in HIV primary care, through the use of trained Linkage Coordinators and systemic networking among HIV care providers, HIV testing providers and the health department.

FUNDING REQUIREMENTS:

In collaboration with Office of HIV/AIDS Staff, recipient is responsible for developing an outcome driven program implementation work plan outlining the specific tasks and activities to be accomplished, time-line for completion of each task, and key performance indicators to evaluate its success, which will include, how the health district will successfully implement the Anti-retroviral Treatment Access Study (ARTAS) strategy for individuals newly diagnosed or lost to care.

Recipient will ensure that ARTAS is being implemented to fidelity.

Recipient will ensure ongoing performance assessment and continuous training and development of all staff positions funded by this annex.

Recipient will establish a protocol for documenting and confirming linkage to care.

Recipient will actively participate in all “Test, Link, and Care” Network meetings, and conference calls.

Recipient will establish a formal agreement with at least two Community Based Organizations to provide HIV Counseling, Testing, and Linkage services targeting individuals with recent high-risk behaviors. A memorandum of agreement (MOA) must be signed annually by each collaborative partner (including sites to which clients are referred for HIV care, STD testing, mental health services, etc.) and a copy submitted to the Office of HIV/AIDS.

Recipient will establish a formal agreement with at least one HIV Primary Care provider to facilitate linkages to care services.

Recipient will maintain appropriate staff for effective planning, oversight and delivery of the services.

Recipient will ensure that staff receives appropriate training in compliance with the Office of HIV/AIDS and CDC Guidelines.

Recipient will collect and report data consistent with the requirements set forth by DPH and CDC for ARTAS, as well as any additional data requested by the Office of HIV/AIDS..

Recipient must perform quality assurance for all service throughout the duration of the program to ensure that appropriate standards for HIV prevention services are being met and that all services are being delivered in an appropriate, competent, and sensitive manner (e.g. observation of service providers); and HIV prevention services meet the needs of the population.

Recipientmust develop and maintain systems for managing client records and program data related to the services, including assuring client confidentiality and adhering to policies and practices for data security.

Recipient is required to comply with the Office of HIV/AIDS List of Minimum Quality Standards for HIV Prevention and HIV Testing Programs (Form HIV-900), as applicable.

Recipient must cooperate with the contract monitoring process set forth by the Office of HIV/AIDS to ensure the appropriate use of federal awards and in compliance with the specifications of the annex agreement.

All clients who receive an HIV test must also receive pre and post test counseling and linkage services.

All clients who receive a preliminary positive test result will receive confirmatory testing.

All clients who are identified as HIV infected must be linked to HIV care, partner services (PS), STD, Hepatitis, and TB screening, and other supportive services. Documentation oflinkage is required for each confirmed HIV-positive client.

A copy of the Georgia Adult HIV/AIDS Confidential Case Report Form must be completed and attached to the test form of all confirmed HIV-positive clients. The original copy must be mailed to: Georgia Division of Public Health, EPI Section, PO Box 2107, Atlanta, GA 30301. All case report forms for HIV/AIDS must be completed within seven (7) days of patient diagnosis. At a minimum, sections 2 through 6 and sections 8 through 9 of the Confidential Case Report Form must be completed. Submitting a copy of this form with the CDC Test form does not replace any district or local procedures for Confidential Case Reporting.

All clients who are identified as HIV negative with high risk behaviors must be linked to prevention services.

All newly identified HIV infected individuals will be screened for mental health and substance abuse treatment, (using a Substance Abuse and Mental Health Services Administration (SAMHSA) standardized screening tool) and receive appropriate linkage.

Restrictions:

Recipient may only expend funds for reasonable program purposes, including personnel, travel, supplies and services such as laboratory fees.

Funds may not be used to purchase medications

Funds may not be used for research purposes. (As defined in the Code of federal regulations (title 45, Part 46) the term “research” means, “a systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge.”

Administrative costs may not be charged to this program unless the Department’s Office of Financial Services has approved a cost allocation plan.

A portion of funds may be used for client incentives (such as for participation awards to facilitate client recruitment and retention) in accordance with the Office of HIV/AIDS List of Minimum Quality Standards for HIV Prevention and HIV Testing Programs (Form HIV-900). Awards to be used should be outlined in a plan submitted with the first monthly programmatic and data reports. All participation awards purchased must be inventoried and reported on monthly programmatic report.

Funds may be used to develop, purchase or distribute health education materials only with the approval of each item by the Office of HIV/AIDS Materials Review Committee.

Deliverables:

Within 14 days of grant execution, grantee will provide a final work plan, time line, budget and budget narrative for the duration of the grant period.

Follow current DPH requirements and guidelines for data reporting and submit monthly data by the 15th calendar day of each successive month.

Monthly progress reports must be submitted to the Office of HIV/AIDS that reflect progress made toward accomplishing program goals and objectives reflecting achievement of milestones within the defined timeframes. These reports must include quantitative and qualitative data on clients served (new client assessments (unduplicated in the last 12 months) as well as total number of encounters by service type and should be submitted by the 15th calendar day of each month.

Submit quarterly financial reports to DPH in accordance with the grant agreement for payment of services rendered which detail expenditures made against the grant for program activities.

Recipient must submit final program and financial reports to DPH Office of HIV/AIDS no later than 45 calendar days following the grant termination date (12/31).

Within 30 calendar days of notice of award, recipient must meet with an assigned DPH Contract Monitor for a "Readiness to Work Site Visit" and to develop a tailored contract monitoring plan. This tailored plan serves two purposes. First, it serves as formal documentation of baseline performance indicators and performance expectations. Second, it provides a systematic schedule for monitoring and assessing progress toward deliverables throughout the contract period. This document will be completed by DPH in collaboration with the contractor and tailored for specific aspects of the program. A list of the specific mandatory forms for process monitoring will be included as part of this Tailored Contract Monitoring Plan.

For compliance with contract monitoring, recipient must do the following:

Office of HIV/AIDS Responsibilities:

Provide ongoing guidance, consultation and technical assistance, as related to the recipient training opportunities and grant activities or as needed on grant related issues.

Prepare and disseminate for the general public annual reports of aggregate data from all projects.

Provide contract monitoring and audits (programmatic and financial) for quality assurance and grant compliance.

Identify and link recipient with any departmental or other technical resources that may be available to assist in fulfilling the grant objectives.

The most recent revision of reporting forms can be downloaded at or by contacting Michael Seabolt at .

PROGRAMMATIC CONTACT:

Posted to website 2/8/12