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“Proxy” Needs Assessment Questions for PLWH/A Now in Care Who Have Been Out of Care

The following document is a set of proxy questions to add to your PLWH/A needs assessment to identify PLWH/A who are currently in care using the Unmet Need Framework definition, but were out of care for at least a year during the past 3-5 years, to ask about service gaps and barriers to care during the time they were out of care.

A Practical Guide to Measuring Unmet Need for HIV-Related Primary Medical Care -- Using the Unmet Need Framework

A Practical Guide to Measuring Unmet Need for HIV-Related Primary Medical Care -- Using the Unmet Need Framework was developed by the University of California-San Francisco. This document was prepared to help CARE Act grantees and planning bodies, particularly Title I and Title II jurisdictions, estimate the number of individuals in your jurisdiction who know they are HIV-positive but are not receiving regular HIV-related primary medical care. The Guide explains the reasons you need to estimate unmet need, describes the Unmet Need Framework, and provides practical steps and examples to help you use it in your State or eligible metropolitan area (EMA). The first two sections will help you understand the Unmet Need Framework and why it is important. The other sections will help you use the Framework to estimate unmet need in your jurisdiction.

To obtain TA: Grantees may access on site technical assistance through their HRSA/HAB project officer, using the regular TAC process. For more limited advice or assistance that does not require a site visit, contact the Center by e-mail or telephone:

· By e-mail at unmetneedta@mosaica.org
· By telephone at 1-877-UNMNEED (1-877-866-6333)

After the Estimate of Unmet Need –What Comes Next? Assessing and Addressing Unmet Need

This updated document provides an overview of next steps for grantees after developing their initial estimate of unmet need – including roles for grantees from all Titles and programs and how Project Officers can help. The next steps include carrying out demographic analysis, assessing service needs and gaps and barriers to care, and using the resulting information in planning and decision making about priorities, resource allocations, and the system of care.

Aviso sobre “Guía práctica para medir las necesidades no satisfechas de atención médica primaria relacionada con el VIH: Cómo utilizar el marco de trabajo de las necesidades no satisfechas”

La Universidad de California en San Francisco desarollo la Guía práctica para medir las necesidades no satisfechas de atención médica primaria relacionada con el VIH: Cómo utilizar el marco de trabajo de las necesidades no satisfechas. Este documento fue preparado para asistir los grantees del Ryan White CARE Act y sus entidades de pleaneamiento, particularmente los de los Titulos I y II, estimar los numeros de individuos en sus jurisdicciones que saben que son VIH-positivas pero que no están recibiendo regularmente, la apropriada atención médica primaria para la infección con el VIH. La Guía explica las razones porque necesitan estimar las necesidades no satisfechas, describe el marco de trabajo (o, “Framework,” en ingles) de las necesidades no satisfechas, y provee pasos practicos y ejemplos para ayudarles usarlo en su estado o área metropolitana elegible (EMA). Las primeras dos secciones les ayudaran comprender el “Framework” de necesidades no satisfechas y porque es importante. Las otras secciones les ayudaran a usar el “Framework” para estimar las necesidades no satisfechas en sus jurisdicciones. Para obtener asistencia técnica: Los grantees pueden tener aceso a la asistencia técnica a través de sus “project officers” de HRSA/HAB, usando el proceso regular del TAC. Para consejo o asistencia limitada que no requiere una visita, contactan al centro por e-mail or telefono:

Estimating Unmet Need for HIV Primary Medical Care FAQs (Frequently Asked Questions):

This document provides a listing of the most frequently asked questions related to estimating unmet need, including information on getting started, selecting data sources, working with your data sources, and deciding on next steps.

Estimating Unmet Need for HIV-Related Primary Medical Care: Summary of Preliminary Findings from FY 2006 Ryan White Title I and II Applications:

This document provides a brief, preliminary overview of the estimates of unmet need provided by Title I and Title II grantees in their funding applications for FY 2006.

Estimating Unmet Need for HIV-Related Primary Medical Care: The Basics:

This summary provides a brief plain language introduction to the legislative and administrative requirements and expectations related to estimating unmet need, defines some key terms, and presents and describes the Unmet Need Framework developed by the University of California at San Francisco (UCSF) and used by the HIV/AIDS Bureau.

Estimating, Assessing and Addressing Unmet Need for HIV Primary Medical Care: What Planning Bodies Need to Know

This PowerPoint Presentation will provide you with the basic information that planning bodies need to know about unmet need, including the definition of “unmet need,” legislative requirements and HRSA expectations for Title I programs, and overviews on estimating unmet need (grantee responsibility), assessing unmet need, and decision making to address unmet need – to help PLWH/A get into care and stay in care. This is an idea presentation for a planning body meeting.

Medicaid Algorithm

This document provides an explanation for the shift in focus away from using the Medicaid Algorith developed by the University of California at San Francisco to estimate care inputs for the estimation of unmet need.

Mini-Survey on Unmet Need Carried out Year-Round by Early Intervention Services Outreach Staff

The following document is a sample mini-survey based on an approach used by the Dutchess County, NY, EMA that is carried out throughout the year by early intervention services outreach staff, to assist in assessing unmet need.

Probable FY 2006 Application Requirements for Section on Unmet Need for HIV-Related Primary Care

This document lists the probable requirements for the unmet need section of the FY 2006 application guidance, as listed by Douglas H. Morgan, Director of the HIV/AIDS Bureau’s Division of Service Systems (HAB/DSS), in a letter to Title I and Title II grantees on June 3, 2005.

Sample EMA Unmet Need Estimate and Narrative

This document is a made-up unmet need estimate and narrative for an EMA in a large State with several EMAs that used linked databases for its estimate. In addition to the narrative, the document also includes some hints to guide you in the development of your own estimate and narrative.

Summary of Approaches Used for Assessing Unmet Need: Ideas from the FY 2006 Ryan White Title I and Title II Applications

The following chart provides ideas taken from FY 2006 Ryan White Title I and Title II applications on approaches used to assess unmet need, including demographic analyses, PLWH/A surveys, and other special needs assessment activities.

Summary of Cross-Title Collaboration to Estimate, Assess, and Address Unmet Need: Ideas from the FY 2006 Ryan White Title I and Title II Applications

The following chart provides ideas taken from FY 2006 Ryan White Title I and Title II applications on cross-title activities to estimate, assess, and address unmet need, including estimating unmet need, planning, training, assessing unmet need, task forces, addressing unmet need

Summary of Grantee and Provider Activities to Address Unmet Need: Ideas from the FY 2006 Ryan White Title I and Title II Applications

The following chart provides ideas taken from FY 2006 Ryan White Title I and Title II applications on grantee and provider activities to address unmet need, including standards of care, quality management, and evaluation, contracts and contract monitoring, and provider initiatives.

Summary of Planning Body and Joint Grantee-Planning Body Decision Making to Address Unmet Need: Ideas from the FY 2006 Ryan White Title I and Title II Applications

The following chart provides ideas taken from FY 2006 Ryan White Title I and Title II applications on planning body or joint grantee-planning body decision-making activities to address unmet need, including planning, priority setting, resource allocations, directives, and new initiatives.

Summary of Prevention-Care Collaboration to Assess and Address Unmet Need: Ideas from the FY 2006 Ryan White Title I and Title II Applications

The following chart provides ideas taken from FY 2006 Ryan White Title I and Title II applications on unmet need prevention-care collaborative activities, including joint planning, training, and other activities to assess and address unmet need.

Ten Questions for Reviewing and Refining Your Unmet Need Methodology

This document lists ten essential questions for grantees and planning bodies to ask while reviewing and/or refining their methodology for estimating unmet need in their jurisdictions. Answering these questions will contribute to a sound methodology for estimating unmet need – and will help you prepare a clear and understandable unmet need section in your application narrative.

Unmet Need Case Studies: Best Practices in the Estimation Process:

This summary describes how three jurisdictions prepared and presented unmet need estimates in their FY 2005 grant applications. The case studies highlight sound practices these Title I and Title II programs used in their methods of estimating unmet need. Their submissions include some components that go beyond Program Guidance requirements.

Unmet Need Estimates: Dos and Don’ts for Title I and Title II Grantees

This updated document provides suggested “Dos” and “Don’ts” for grantees to consider in developing their unmet need estimates. The suggestions may be particularly useful if reviewed along with the individual grantee unmet need estimate reports and consultant comments.

Unmet Need Framework Table: Calculating Unmet Need for HIV Primary Medical Care

For the FY 2007 application, Title I and Title II grantees will be asked to provide an updated or refined estimate of unmet need in their jurisdictions. This Microsoft Excel spreadsheet has built in formulas to help you calculate the unmet need in your jurisdiction. The spreadsheet includes the unmet need Framework table instructions, a template, and an example.

Unmet Need: Roles for Planning Bodies in Assessment and Decision Making

Much of the responsibility for assessing unmet need, and a considerable amount of the decision making about how to address unmet need, typically falls to planning bodies. This document provides a brief overview of next steps for planning bodies, working with grantees, in meeting these other responsibilities – including roles for groups from all Titles.

What Comes Next on Unmet Need: Five Steps for Title I and Title II Project Officers:

This document provides Project Officers with information on five basic steps they should take with their grantees after reviewing grantee unmet need estimates and consultant reports on these estimates. The steps include how Project Officers can help grantees refine their estimates, and assess and address unmet need.