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Quality Management Program

The Ryan White HIV/AIDS Treatment Modernization Act of 2006 requires clinical quality management (QM) programs as a condition of grant awards. The QM expectations for Ryan White Program Part B grantees include:

  1. Assist direct service medical providers funded through the CARE Act in assuring that funded services adhere to established HIV clinical practice standards and Public Health Services Guidelines to the extent possible;
  2. Ensure that strategies for improvements to quality medical care include vital health-related supportive services in achieving appropriate access and adherence with HIV medical care; and
  3. Ensure that available demographic, clinical and health care utilization information is used to monitor the spectrum of HIV-related illnesses and trends in the local epidemic.

2013-14 Goals and Objectives

Goal 1: Continuously implement a statewide RW Part B quality management plan, which is updated at least annually. Objectives include:

  • 1.a. Provide at least two quality improvement (QI) /quality management (QM) training workshops based on identified needs.
  • .b. Assure that at least two quality improvement projects occur at the state and local level during the year.
  • 1.c. Assure that at least two quality improvement activities occur in each district during the year.
  • 1.d. Communicate findings to key stakeholders at least biannually.
  • 1.e. Update the QM plan at least annually and the QM work plan at least quarterly.
  • 1.f. Require that all districts revise written QM plans annually, and submit quarterly QM progress reports. 

Goal 2: Improve efficiency of the Georgia AIDS Drug Assistance Program (ADAP). 
Objectives include:

  • 2.a.Increase the percentage of Georgia ADAP clients recertified for ADAP eligibility criteria at least semi-annually to 95% or greater.
  • 2.b.Increase the percentage of new Georgia ADAP applicants placed on the waiting list or denied for ADAP services within two weeks of ADAP receiving a complete application to 95% or greater.
  • 2.c.Increase the percentage of correctly completed waiting list ADAP applications submitted to ADAP to 95% or greater.
  • 2.d.Conduct an internal audit of up to 5% of ADAP recertification forms annually.
  • 2.e.Monitor programmatic compliance and adherence to antiretroviral regimens from the PBM.
  • 2.f.Systematically review data collected by the ADAP to identify inappropriate antiretroviral regimens or components.

Goal 3: Improve efficiency of the Georgia Healthcare Insurance Continuation Program (HICP). 
Objectives include:

  • 3.a.Increase the percentage of active HICP clients recertifying before the 6 month due date to prevent delays in payments for health insurance premiums to 95% or greater.
  • 3.b.Increase the percentage of correctly completed new HICP applications submitted to HICP to 95% or greater.
  • 3.c. Conduct an internal audit quarterly of up to 5% of HICP new client applications and/or recertification forms.

Goal 4: Improve the quality of health care and supportive services.
Objectives include:

  • 4.a. Monitor performance measures in all 16 Part B funded sites at least annually.
  • 4.b. Increase the percentage of HIV-infected clients who have a dental examination at least annually from 26% to 50%.*
  • 4.c.Increase the percentage of HIV-infected female clients > 18 years old who have a PAP smear at least annually from 78% to 90%.*
  • 4.d. Monitor the implementation of the Acuity Scale and Self Management Model.
  • 4.e. Revise the Georgia HIV/AIDS Case Management Standards by March 31, 2014.
  • 4.f. Coordinate quality-related activities across Ryan White Programs (Parts A, B, C, and D) in Georgia.
  • 4.g. The percentage of HIV-infected pregnant women prescribed antiretroviral therapy will be 95% or greater.
  • 4.h. Revise the Georgia Medical Guidelines for the Care of HIV- Infected Adults and Adolescents by December 31, 2013.
  • 4.i. Collaborate with partners to monitor the implementation of the Affordable Care Act (ACA).
  • 4.j. Monitor In+Care Campaign Measures and utilize data to facilitate quality improvement.

*Data from 2009 clinical chart review

Publications/Guidelines

Georgia Ryan White Program Part B Quality Management Plan April 2013-March 2014 PDF

HIV Medical Guidelines for the Care of HIV-Infected Adults and Adolescents PDF
Guidelines for medical, nursing, and nutrition therapy providers delivering care services to HIV infected adults and adolescents in Ryan White funded public health clinics in Georgia.

Georgia HIV/AIDS Case Management Standards July 2008 PDF

AIDSInfo
Guidelines for the Treatment of HIV/AIDS, U.S. Department of Health and Human Services

Training

Part B QM staff members provide quality improvement related training and technical assistance for Ryan White funded providers throughout Georgia. To date they have conducted training on the following topics: how to develop a quality management plan, the fundamentals of quality management, and performance measurement.

The National Quality Center (NQC) developed internet-based quality improvement learning modules, which are free and readily available for self-paced learning. These tutorials are online at the NQC, Quality Academy. The Part B QM staff highly recommends that all persons working with Ryan White funded programs complete these tutorials.

Links

AIDS Education and Training Centers (AETC)
Training and education programs for healthcare providers treating persons living with HIV/AIDS

AIDSInfo
Guidelines for the Treatment of HIV/AIDS, U.S. Department of Health and Human Services

HIV/AIDS Bureau (HAB), Performance Measures
Core performance measures for adult and adolescent HIV care

National HIVQual Project
Quality improvement capacity building for HIV ambulatory care clinics, including annual submission of computerized data on quality indicators

National Quality Center
Quality improvement technical assistance, tools, measures, and training.

Contact: Quality Management Team Lead, (404 )657-3113