Encouraging the Development of Statewide HIV/AIDS Plans
Posted Apr 18 2011 5:28pm
By Ronald Valdiserri, M.D., M.P.H., Deputy Assistant Secretary for Health, Infectious Diseases, U.S. Department of Health and Human Services
On Tuesday, April 12, the Department of Health and Human Services ( HHS ) convened a consultation to explore the principles and practices that should be considered as we move forward in our efforts to encourage the development of state HIV/AIDS plans as recommended in the National HIV/AIDS Strategy ( NHAS ).
The Strategy’s Federal Implementation Plan directs HHS to “work with States to encourage the development of statewide HIV/AIDS plans.” In recommending that the States develop individual HIV/AIDS plans, the Strategy suggests: “The purpose of State plans would be to enhance coordination between planning and resource allocation activities, which are often siloed in a way that separates prevention and care…In developing their plans, States will also be encouraged to identify all Federal, State, and local resources, and to the extent feasible, private and nonprofit resources to ensure that all HIV/AIDS resources are allocated in the most efficient manner to address the full range of prevention, care, and social service needs.”
The consultation involved a large group of representatives voicing multiple perspectives from the Federal government, state and local health departments, academia, and policy, provider, and non-governmental organizations. Colleagues from the Centers for Disease Control and Prevention ( CDC ), Centers for Medicare and Medicaid Services ( CMS ), Health Services Administration’s HIV/AIDS Bureau ( HAB ) and Bureau of Primary Health Care ( BPHC ), Substance Abuse and Mental Health Services Administration ( SAMHSA ), and the Department of Housing and Urban Development’s Housing Opportunities for Persons with AIDS ( HOPWA ) program participated in the discussion and shared information about current Federal requirements for HIV/AIDS planning, whether legislatively mandated or required as a condition of grant award. Representatives from the White House Office of National AIDS Policy ( ONAP ) and the Presidential Advisory Council on HIV/AIDS ( PACHA ) were also actively engaged in our conversation. (View list of participants [PDF]).
As we explored the idea of state plans we were mindful that these plans should build on, complement and extend current required HIV/AIDS planning activities. The investments of time and thought in those planning activities are valuable platforms on which even more comprehensive HIV/AIDS plans can be developed to help States better coordinate HIV prevention and care efforts and, ultimately, improve outcomes—thus moving us closer toward achieving the strategy’s goals.
Over the course of the meeting, there were several areas where perspectives appeared to converge, including:
Avoid a complex, highly standardized process
Concentrate on principles, not on process
State Plans must relate to the NHAS
State Plans should include and reflect meaningful community input
State Plans should provide "value added" to all stakeholders
Planning is not a budget-neutral activity; we must be mindful of the costs involved
Given competing demands and environmental constraints, it’s critical to be realistic about capacity and timelines
In addition, a number of issues were also raised. These included:
How can we apply lessons learned from the 12 Cities Project to better inform our thinking about the development of statewide plans?
Should plans be broadly comprehensive or focus on a few significant “game changers” that would advance a state’s HIV/AIDS response from “good to great?”
To what extent should mapping of epidemiology and resources be considered as a standard element of state plans?
Can modeling help States in the process of determining how best to utilize resources for maximum impact?
What are your thoughts on how state HIV/AIDS plans should be structured to support a statewide HIV/AIDS planning processes that cuts across categorical, programmatic, and jurisdictional lines and improves HIV/AIDS outcomes?