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Ryan White Client Demographic Summary and Quality Management
Report
Lisa KrullProgram and Quality Manager
1
Ryan White Client Demographic Summary
2
1508 (34.3%)
2873 (65.4%)
13 (0.3%)
FemaleMaleTransgender
2012 Ryan White Client Gender
N = 4,394
Ryan White Client Demographic Summary
3
2012 Ryan White Client Age
2-13 3-24 25-44 45-64 65+0
500
1000
1500
2000
2500
25
274
2196
1786
113
N = 4,394
Ryan White Client Demographic Summary
4
2012 Ryan White Client Race
N = 4,394
Black or A
frica
n American
White
More
than one ra
ce
Asian /
Pacific I
slander
American In
dian or Alaska
Native
Unknown
0500
1000150020002500300035004000 3693
454126 18 5 98
Ryan White Client Demographic Summary
5
2012 Ryan White Client Ethnicity
N = 4,394
4286 (97.5%)
108 (2.5%)
Not HispanicHispanic
6
Ryan White Client Demographic Summary2012 Ryan White Client Annual Income
N = 4,394
Less than or equal to 100%
FPL
101-200% FPL 201-300% FPL More than 300% FPL
Unknown0
500
1000
1500
2000
2500
3000
3500
4000
3356
659256
70 53
7
Ryan White Client Demographic Summary
2012 Ryan White Client Housing Status
N = 4,394
3892(88.6%)
308(7%)
153(3.5%)
41 (0.9%) Stable/Permanent
Non-Permanent/Unstable
Institution
Unknown
8
Ryan White Client Demographic Summary
2012 Ryan White Client Insurance Status
N = 4,394
Private Medicare Medicaid No Insurance Unknown 0
200
400
600
800
1000
1200
1400
1600
1800
2000
520
772
1109
1883
110
Ryan White Client Demographic SummaryClient Insurance Status – at or below 100% FPL
N = 3,356 (clients with at or below 100% FPL)
Private Medicare Medicaid No Insurance Unknown0
200
400
600
800
1000
1200
1400
1600
154
604
1042
1506
50
Ryan White Client Demographic Summary
10
2012 Ryan White Client HIV Status
N = 4,394
1141(26%)
1151(26.2%)
2102(47.8%)
CDC-Defined AIDS
HIV-positive (AIDS Status Unknown)
HIV-positive (Not AIDS)
11
Medical C
are
Loca
l ADAP
Oral Health EIS
Mental Health
Nutrition
MCM
SA Treatment
0
500
1000
1500
2000
2500
3000
3500
4000
1663
204
643
2136
274
1180
3477
41
2012 Ryan White Unduplicated Clients: Core Services
N = 4,394
12
2012 Ryan White Unduplicated Clients: Support Services
N = 4,394
NMCM EFAFood
HERR
Transporta
tion
Psychoso
cial
Housing
0
200
400
600
800
1000
1200
1400
1600
1084
146
1339
3
1424
320
6
13
Ryan White Core ServicesNumber Unduplicated Clients Served
2011 - 2012
Medical Care Local ADAP Oral Health EIS Mental Health Nutrition MCM SA Treatment0
500
1000
1500
2000
2500
3000
3500
4000
1662
162
646
2167
256
777
3353
16
1663
204
643
2136
274
1180
3477
41
2011 2012
14
Ryan White Support ServicesNumber Unduplicated Clients Served
2011 - 2012
*Outreach clients NOT unduplicated
NMCM EFAFood
HERR
Transporta
tion
Psychoso
cial
Housing
Outreach
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
1098
147
1266
3
1142
336
7
4411
1084
146
1339
3
1424
320
6
3838
2011 2012
15
2012 Performance Measure Data: Medical Providers
Provider 1
Provider 2
Provider 3
Provider 4
Provider 5
0%
20%
40%
60%
80%
100%
120%
% with 2 or more visits% with 2 or more CD4% with PCP prophylaxis (CD4 <200)% of AIDS patients on HAART
2012 In + Care Campaign
Measures 9/30/12 11/30/12 1/31/13 Part A National
Benchmark
Measure 1: Gap Measure% of patients who did not have a medical visit in last 6 months
35% 11% 12% 14%
Measure 2: Visit Frequency% of patients with at least 1 visit in each 6 month period of the 24 month measurement period
26% 70% 71% 67%
Measure 3: New Patients% of newly enrolled patients who had a visit in each 4 month period of the measurement year
48% 63% 60% 70%
Measure 4: Viral Load Suppression% of patients with a viral load <200 at last VL test in the measurement year
60% 64% 64% 72%
Survey of Consumers*Consumer Input Meeting 5-30-13
Service Category Reduce or Eliminate Keep or Increase
Substance Abuse Treatment
10/22 (45%) NA
Psychosocial Support 10/22 (45%) 7/10 (32%)
EFA Utility Assistance 7/10 (32%) 5/22 (23%)
Non Medical Case Management
5/22 (23%) NA
Outreach 5/22 (23%) NA
Food 22/22 (100%) NA
N=22
FY 2012 Cost Utilization Data
Service Category Expenditures # Clients Cost/Client # Services # Services/Client
Outpatient $2,389,778 1,663 $1,437 8,585 OP visits 5.2
Local Pharmacy $61,833 204 $303 518 prescriptions 2.5
Oral Health $608,732 643 $947 1,445 visits 2.2
Mental Health $92,286 274 $337 1,164 visits 4.7
Medical Nutrition Therapy $100,685 1,180 $85 1,948 encounters, 606 cases supplements 1.7
Medical Case Management $883,596 3,477 $254 32,431 encounters 9.3
Early Intervention Services $405,398 2,136 $190 8,218 encounters 3.8
Substance Abuse Treatment $25,149 41 $613 423 encounters 10
Case Management (Non-medical) $196,864 1,084 $182 3,736 encounters 3.4
EFA $66,659 146 $457 189 payments 1.3
Food Bank $277,274 1,339 $207 5,773 bags/1,815 vouchers 5.7
Housing $23,730 6 $3,955 55 rent/deposit payments 9.2
Medical Transportation $62,856 1,424 $44 9,432 bus passes, 3,044 gas cards, 265 cab trips, 108 client transport 9.0
Psychosocial Support $97,092 320 $303 644 individual/244 group encounters 2.8
Referral for Health Care/Support $48,480 252 $192 298 referrals for care, 578 referrals for testing 3.5
Outreach $38,398 3,838 $10 5,164 website visits, 15,656 page views 1.3
Non-Ryan White and Other Funding Sources
Martha MontgomeryData Analyst
Ryan White Part A Program
PSRA Data Presentation June 26, 2013 19
Other Funding Sources for PLWHA in the Memphis TGA
• Ryan White Funding• Part B, Part C, and Part D
• Medicaid• Centers for Disease Control and Prevention• Veterans Administration• Food and Nutrition Services
• Services for Women, Infants, and Children (WIC)• Food Stamp Programs
• Substance Abuse Prevention and Treatment• Housing and Financial Assistance
• Housing Opportunities for People with AIDS (HOPWA) • Community Sources for Emergency Financial/Rent Assistance
• Mid-South AIDS Fund
20PSRA Data Presentation June 26, 2013
Overview of Ryan White Part B• Part B funding is distributed to states for specific programs
• States may provide services directly, contract with agencies, or work through subcontracts with Part B HIV Care Consortia
• TN funds five regional Consortia (Southwest, West, Middle, East, Southeast) with Lead Agencies who contract with agencies to provide services
• State Programs offered in Tennessee– Outpatient medical services– Medical case management– AIDS Drug Assistance Program (ADAP)
• Insurance Assistance Program (IAP)• HIV Drug Assistance Program (HDAP)
21PSRA Data Presentation June 26, 2013
Tennessee ADAP (TGA)
22
FY11 FY12 FY130
200
400
600
800
1000
1200
1400
1600
1199
14001448
482
538 500
ADAP Number Served
HDAP IAP
Num
ber S
erve
d
FY11 FY12 FY13$0
$2,000,000
$4,000,000
$6,000,000
$8,000,000
$10,000,000
$12,000,000
$14,000,000
$10,514,282 $8,277,702 $8,190,721
$1,944,336
$1,739,511 $1,770,936
ADAP Expenditures
HDAP IAP
$12,458,618
$10,017,213 $9,961,657
PSRA Data Presentation June 26, 2013Source: State of Tennessee Department of Health.
In the past two years, the number of ADAP clients in TN has increased by 16%; total expenditures have decreased by 20%.
23
Overview of Part B Funding in Tennessee in TGA
Service
FY 2011 (4/1/10 – 3/31/11) FY 2012 (4/1/11 – 3/31/12) FY 2012 (4/1/11 – 3/31/12)
Number Served Expenditure
Average Cost Per Person
Number Served Expenditure
Average Cost Per Person
Number Served Expenditure
Average Cost Per Person
ADAP 1681 $12,458,618 $7,411 1938 $10,017,213 $5,169 1948 $9,961,657 $5,114
OMS NA NA NA 44 $12,483 $284 29 $13,566 $468
MCM 706 $188,350 $267 180 $50,004 $278 204 $61,712 $303
TOTAL 2,387 12,646,968 7,678 2,178 10,079,700 5,708 2,181 10,036,935 5,884
PSRA Data Presentation June 26, 2013
Source: State of Tennessee Department of Health.
Mississippi & Arkansas ADAP (TGA)
24
FY11 FY12 FY130
10
20
30
40
50
60
70
4047
58
Number Served in MS
FY11 FY12 FY13$0
$50,000
$100,000
$150,000
$200,000
$250,000
$300,000
$278,462 $294,576 $314,638
ADAP Expenditures in MS
FY11 FY12 FY1305
101520253035404550
32 2732
Number Served in AR
FY11 FY12 FY13$0
$50,000 $100,000 $150,000 $200,000 $250,000 $300,000 $350,000
$244,148 $239,820 $324,000
ADAP Expenditures in AR
PSRA Data Presentation June 26, 2013
In the past two years, the number of ADAP clients in MS has increased while the number in AR has remained relatively stable; MS expenditures increased 13% and AR expenditures increased 33%.
Part C Requirements
25
Part C funds comprehensive primary health care in outpatient settings for PLWHA
No more than 10% of the budget can be allocated to administrative costs
At least 75% of the balance remaining after subtracting administrative costs, must be used for core medical services
PSRA Data Presentation June 26, 2013
Overview of Ryan White Part C
• Part C provides grants to service providers to support EIS and ambulatory care for PLWHA
• Part C funds go to– East Arkansas Family Health Center
• Outpatient/Ambulatory Medical Care, Dental, Medical Case Management, Medical Transportation, Mental Health, Nutritional Counseling & Supplements, and HIV Testing
– Adult Special Care Clinic at the Regional Medical Center• Outpatient/Ambulatory Medical Care, Mental Health
26PSRA Data Presentation June 26, 2013
27
Note: Part C fiscal year is January 1 to December 31.
PSRA Data Presentation June 26, 2013
Ryan White Part C Funding in TGA
2011 20120
500
1000
1500
2000
2500
3000
3500
4000
204 182
31932925
Number of Clients Served
EAFHC ASCC
2011 2012 $-
$200,000
$400,000
$600,000
$800,000
$1,000,000
$1,200,000
$1,400,000
$299,384 $299,384
$813,705 $974,325
Part C Budget
EAFHC ASCC
$1,113,089$1,273,709
In the last year, the total Part C budget in the Memphis TGA has increased by 14%. The total number of clients served has decreased by 9%.
Overview of Ryan White Part D• Part D funding is for women, infants, children, youth
and their families• Part D funds are provided through networks in
regional areas• Community HIV Network serves– Tennessee: Shelby, Fayette, and Tipton counties– Mississippi: DeSoto county– Arkansas: Crittenden county
• Any eligible consumer can receive services in those counties, even if they are from another county
28PSRA Data Presentation June 26, 2013
Part D Programs• Previous year (8/1/11–7/31/12)
– $353,153 to MAYAH– $777,888 to Memphis HIV
Family Care Program
• Current year (8/1/12–7/31/13)– All MAYAH funding was cut– Memphis HIV FCP was cut to
$500,000• A 6-7% cut is anticipated for the
next grant year
29
2011-2012 2012-2013 2013-2014$0
$200,000
$400,000
$600,000
$800,000
$1,000,000
$1,200,000
$777,888 $500,000 $467,500
$353,133
Part D Programs
Memphis HIV Family Care Program (FCP)Memphis Adolescent/Young Adult HIV Program (MAYAH)
PSRA Data Presentation June 26, 2013
Part D funding in the Memphis TGA has been cut by 60% in the last two years.
Part D Programs• Changes to services in the 2012 – 2013 grant year
– All Part D youth initiatives were pooled with standard Part D funding, resulting in the loss of $353,133 for the MAYAH program
– Medical case management and social work services provided by ASCC and St. Jude were cut• Medical Case Management is no longer a core medical service
– All Hope House services (psychosocial support and social work) were cut
• Funded services for 2012 – 2013– Le Bonheur Infectious Disease Clinic provides social work and advocacy by Le
Bonheur FCP staff– Adult Special Care Center provides outpatient/ambulatory medical– St. Jude provides outpatient/ambulatory medical– UTMG provides social work and advocacy by Le Bonheur FCP staff and
obstetrical care– Oral health care is provided by two dental practices
30PSRA Data Presentation June 26, 2013
Part D Programs
31PSRA Data Presentation June 26, 2013
HIV Family Care Program 8/1/11-4/30/12 3/1/12-2/28/13Medical case management
(women) 1041 138Outpatient
(pregnant women/infants) 156 168Psychosocial support services
(women/families) 63 5Non-medical case management
(women/families) 63 22
Youth served by MAYAH 8/1/11-4/30/12 3/1/12-2/28/13Medical case management (youth) 201 0
Outpatient (youth) 248 0Psychosocial support services (youth) 57 0
Mental health (youth) 21 0
In the next year, the majority of Part D funds will likely be used for medical services; MCM and support services will not be funded.
Tennessee Medicaid (TennCare)
PSRA Data Presentation June 26, 2013 32
Source: Bureau of TennCare. Data include only PLWHA; totals are based on the county where the recipient lived.
In the last year, Tennessee’s Medicaid expenditures in the Memphis TGA have decreased by 6%. The total number of clients served has decreased by 25%.
2010 (N=1,987)2011 (N=1,887)
2012 (N=1,501)
$- $2,000,000 $4,000,000 $6,000,000 $8,000,000
$10,000,000 $12,000,000 $14,000,000 $16,000,000 $18,000,000
$6,071,679 $5,375,250
$4,469,966
$9,823,105 $11,179,129
$10,533,770
TennCare Expenditures and Number Served in Shelby, Fayette, & Tipton Counties
Medical Expenditure Pharmacy Expenditure
Mississippi Medicaid
33
Source: Mississippi Division of Medicaid. Note: Data includes only PLWHA. Medicaid coverage in Mississippi requires that a person have proof of income eligibility and be determined disabled. Most PLWHA do not qualify for Medicaid until they are in advanced stages of illness and meet the disability requirements. PSRA Data Presentation June 26, 2013
2010 (N=67)2011 (N=79)
2012 (N=73)
$-
$100,000
$200,000
$300,000
$400,000
$500,000
$600,000
$700,000
$800,000
$900,000
$252,167 $425,554 $643,694
$265,692 $199,925
$176,308.83
MS Medicaid Expenditures and Number Served in DeSoto, Marshall, Tate, & Tunica CountiesMedical Expenditure Pharmacy Expenditure
In the last year, Mississippi’s Medicaid expenditures in the Memphis TGA have increased by 58%. The total number of clients served has increased by 9%.
Arkansas Medicaid
34
Source: Arkansas Department of Health. Data includes only PLWHA. Fiscal Year 12-13 is June 1, 2012 – May 31, 2013. Medicaid services in Crittenden county include Medical Care, Private Duty Nurse, Medical Services, Outpatient Services, Surgery, and Home Health PSRA Data Presentation June 26, 2013
FY 10-11 (N=44)FY 11-12 (N=61)
FY 12-13 (N=61)
$-
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
$140,000
$92,471
$125,917 $133,605
AR Medicaid Expenditures and Number Served in Crittenden County
In the last year, Arkansas’ Medicaid expenditures in the Memphis TGA have increased by 44%. The total number of clients served has increased by 39%.
Centers for Disease Control and Prevention (CDC)
• Provides funds to states for HIV Prevention and testing programs
• States distribute the funds to local programs via the state Department of Health or via Consortia
35PSRA Data Presentation June 26, 2013
Tennessee Department of Health Projects (CDC) Funding
15 HIV testing sites, 5 prevention/outreach programs in TGA in 2012
36
CY 2010 CY 2011 CY 20120
10,000
20,000
30,000
40,000
50,000
60,000
33,58039,204
50,935
15,795 14,890
24,386
CDC Testing/Prevention in TN in TGA
Number of HIV Tests conductedNumber Served with Prevention/Outreach Programs
2010 2011 2012$0
$200,000
$400,000
$600,000
$800,000
$1,000,000
$1,200,000
$1,000,000 $1,000,000 $1,000,000
$417,000 $478,000
$407,800
CDC Funding for Prevention/Outreach in TN in TGA
HIV Testing Prevention and Outreach
PSRA Data Presentation June 26, 2013
In the last two years, TN CDC funding in the Memphis TGA has been relatively stable. Both the numbers of HIV tests conducted and clients served with outreach/prevention has increased by more than 50%.
Mississippi Department of Health Projects (CDC) Funding
• Testing sites in DeSoto, Marshall, Tate and Tunica• DeSoto County Health Department• Marshall County Health Department• Tate County Health Department• Tunica County Health Department• Aaron E. Henry Health Services Center
37
Source: State of Mississippi Department of Health.
CY 2011 CY 2012Number of HIV Prevention Activities
and Outreach Programs/Agencies 7 6
CDC Cooperative Agreement for Prevention $2,023,284 $1,090,150
CDC Expanded Testing Initiative $821,152 $320,577
Table 9: HIV Prevention and Testing in MS in TGA
PSRA Data Presentation June 26, 2013
Over the past two years, MS CDC funding in the Memphis TGA has decreased by more than 50%.
Arkansas Department of Health Projects (CDC) Funding
• Crittenden County is not covered in the scope of work for any funded grantees– However, the grantees are not limited to serving only clients that
reside in their scope of work
• Testing events occur in Crittenden County
38
Source: State of Arkansas Department of Health
CY 2011 CY 2012Number of Community Based
organizations for HIV prevention 6 7
CDC Funding for Community Based organizations $329,409 > $300,000
Table 10: HIV Prevention and Testing in AR in TGA
PSRA Data Presentation June 26, 2013
Over the past two years, AR CDC funding in the Memphis TGA has been relatively stable.
U.S. Dept. of Veteran Affairs• VA claims to be the largest provider of HIV care in the U.S.
– 21 Veterans Integrated Service Networks (VISNs), consisting of over 1,100 medical centers, community-based outpatient clinics, and other providers
– TN is in VISN 9, MS and AR are in VISN 16– Nationwide, the number of Veterans living with HIV has been stable
(about 1 / 250); information specific to the Memphis TGA is limited
39PSRA Data Presentation June 26, 2013
2009 2010 2011Arkansas 245 253 258Mississippi 438 372 425Tennessee 636 646 681
Number HIV Infected Veterans in Care
Note: The number of Veterans in Veterans Health Administration (VHA) care who filled a VHA outpatient prescription for a HIV antiviral medication (ARV) during the calendar year, and/or who ever had Clinical AIDS based on an AIDS-defining opportunistic infection prior to or during the calendar year. There is limited data available specific to the Memphis TGA.
Source: HIV Infected Veterans in VHA Care by State. http://www.publichealth.va.gov/quality/reports/hiv-in-care-by-state-2009.asphttp://www.publichealth.va.gov/quality/reports/hiv-in-care-by-state-2010.asphttp://www.publichealth.va.gov/quality/reports/hiv-in-care-by-state-2011.asp
U.S. Dept. of Veteran Affairs• HIV Testing Rates in the VA
– Historically low due to restrictions• As of 2009, <10% of Veterans in VA care had ever tested for HIV • Over 50% of HIV patients at the VA had AIDS at time of diagnosis
• August 2009: Policy changes allowed for widespread testing in the VA
• July 2010: VA was designated as one of the lead Federal agencies for the National HIV/AIDS Strategy (NHAS); primary goals include: – Reducing HIV incidence – Increasing access to care and optimizing health outcomes – Reducing HIV-related health disparities
40
Sources: http://www.publichealth.va.gov/quality/reports/index.asp; http://aids.gov/federal-resources/national-hiv-aids-strategy/nhas-operational-plan-va.pdf
PSRA Data Presentation June 26, 2013
U.S. Dept. of Veteran Affairs• VA HIV providers adhere to HHS guidelines for HIV health care
– 98% of Veterans living with HIV had hepatitis C screening; 80% receive hepatitis B screening and vaccination
– 93% have routine CD4+ lymphocyte count– 86% who require PCP prophylaxis are on the recommended medications– 80% receive antiviral medications for treatment
42
Sources: Department of Veterans Affairs (2009). The State of Care for Veterans for HIV/AIDS (http://www.hiv.va.gov/provider/state-of-care/index.asp). Department of Veterans Affairs National HIV/AIDS Strategy Operational Plan (http://aids.gov/federal-resources/national-hiv-aids-strategy/nhas-operational-plan-va.pdf).
2009 2010 2011Veterans with an outpatient visit 5,713,265 5,888,599 6,114,034
Veterans ever tested for HIV 524,267 795,126 1,221,328Veterans ever tested for HIV (%) 9.2% 13.5% 20.0%
National VA Testing Rates
PSRA Data Presentation June 26, 2013
Nationally and in each VISN, the percentage of Veterans ever tested for HIV more than doubled in two years (2009-2011).
Services for Women, Infants, and Children (WIC)• Administered by the U.S. Department of Agriculture, WIC provides
federal grants to states • Serves low-income pregnant / postpartum women and infants and
children up to age five who are at nutritional risk• WIC Special Supplemental Nutrition Program (SNP)
– Provides nutritious supplemental foods, nutrition education, breastfeeding support, and health/social services referrals
• WIC Commodity Supplemental Food Program (CSFP)– Similar to SNP, but CSFP also serves elderly people and provides food
rather than food vouchers
• Eligible people cannot participate in SNP and CSFP at the same time
43PSRA Data Presentation June 26, 2013
WIC Services in Memphis TGA
44
Sources: WIC Program Grant Levels by State. http://www.fns.usda.gov/wic/fundingandprogramdata; WIC Program Monthly Data - Participation. http://www.fns.usda.gov/pd/wicmain.htm
FFY 2010 FFY 2011 FFY 2012 FFY 2013$0
$20,000,000
$40,000,000
$60,000,000
$80,000,000
$100,000,000
$120,000,000
$140,000,000 $127,115,461 $126,150,085 $128,479,260 $122,716,796
$98,986,082 $91,444,337 $88,188,725 $84,577,473
$73,448,817 $74,733,382 $71,575,020 $69,734,786
WIC Program Grant Levels by State
Tennessee Mississippi Arkansas
PSRA Data Presentation June 26, 2013
WIC Services in Memphis TGA
45
Sources: WIC Program Grant Levels by State. http://www.fns.usda.gov/wic/fundingandprogramdata; WIC Program Monthly Data - Participation. http://www.fns.usda.gov/pd/wicmain.htmNote: Federal Fiscal Year (FFY) 2013 is October 1, 2012 through September 30, 2013; number of participants for WIC programs in FFY 2013 is not yet available.
PSRA Data Presentation June 26, 2013
FFY 2010 FFY 2011 FFY 20120
25,000
50,000
75,000
100,000
125,000
150,000
175,000 170,588 161,578 162,775
102,224 97,277 94,773
98,963 93,461 94,293
Participants in WIC Program by State
Tennessee Mississippi Arkansas
WIC Services in Memphis TGA
46PSRA Data Presentation June 26, 2013
FFY 2011 FFY 2012 FFY 2013 $-
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
$7,000,000
$8,000,000
$4,783,199 $6,164,700
$6,791,084
$673,372
$600,352 $681,773
WIC Funding Available in the Memphis TGA
Tennessee (Shelby, Tipton, Fayette) Mississippi (DeSoto, Marshall, Tate, Tunica)
Approximately $70 million is available for WIC in Arkansas; allocations specific to Crittenden County are not available.
In the last two years, WIC funding in the Memphis TGA has increased by 37%.
Food Stamp Programs• Food Stamp programs are financed 100% by Federal funds and
administered in the Memphis TGA by the Departments of Human Services in TN, MS, and AR
• Client benefits can be redeemed at participating stores, farmers’ markets, direct marketing farmers, homeless meal providers, treatment centers, group homes, and others authorized to accept SNAP (“authorized firms”)
• To improve access to healthy foods, USDA has developed a strategic plan to increase farmers’ market participation in SNAP
– The number of authorized firms increased by >40% in the past five years
– The number of farmers’ markets and direct marketing farmers increased 327% in the past five years
47PSRA Data Presentation June 26, 2013
Source: United States Department of Agriculture (USDA) Food and Nutrition Service (FNS)
Food Stamp Programs
48PSRA Data Presentation June 26, 2013
Source: United States Department of Agriculture (USDA) Food and Nutrition Service (FNS)
In the past decade, food stamp benefits have more than quadrupled nationally from $18,256,200,000 to $74,619,460,000
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012$0.0
$10.0
$20.0
$30.0
$40.0
$50.0
$60.0
$70.0
$80.0
$18.3 $21.4
$24.6 $28.6 $30.2 $30.4
$34.6
$50.4
$64.7
$71.8 $74.6
Client Benefits (in Billions)
Federal Fiscal Year
Food Stamp Programs
49PSRA Data Presentation June 26, 2013
In the past decade, the number of clients receiving food stamp benefits has more than doubled nationally from 19 million to 46 million.
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
50.0
19.121.3
23.825.6 26.5 26.3
28.2
33.5
40.3
44.746.6
Number of Clients (in Millions)
Federal Fiscal Year
Source: United States Department of Agriculture (USDA) Food and Nutrition Service (FNS)
Food Stamp Programs
50PSRA Data Presentation June 26, 2013
For the Memphis TGA, Shelby County is in Tennessee’s 9th congressional district; Mississippi’s 1st congressional district includes all of DeSoto, Marshall, Tate Counties and Tunica County is in the 2nd congressional district; Crittenden County is in Arkansas's 1st congressional district. Source: United States Department of Agriculture (USDA) Food and Nutrition Service (FNS)
TN (Shelby) MS (DeSoto, Tate, Tunica) AR (Crittenden)
Households Receiving Benefits 46,217 (19.6%) 35,263 (13.9%) 42,884 (18.7%)
Median Income $15,684 $13,328 $13,191
Percent with Children <18 56.7% 60.4% 58.0%
Overview of Households Receiving Benefits in Memphis TGA (2010)
Tennessee Mississippi ArkansasMonthly Benefit $133.86 $122.54 $122.59
Average Monthly Benefits by State (per person)
Across all three states in the Memphis TGA, 17% of households receive food stamps. On average, annual household income of food stamp recipients is $14,000 and more than half have children under age 18.
Substance Abuse Prevention and Treatment
51
Allocations for Shelby, Tipton and Fayette counties
FY 09-10 FY 10-11 FY 11-12$0
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
$7,000,000
$8,000,000
$9,000,000
$10,000,000
$2,231,659 $3,311,727
$4,484,289
$3,274,954
$4,224,066
$3,992,518 $898,321
$839,490 $721,547
Federal Preven-tion
Federal Treatment
State Treatment
PSRA Data Presentation June 26, 2013
Source: Tennessee Department Mental Health, Division of Alcohol and Drug Abuse Services. State Fiscal Year 2011-2012 is July 1, 2011 - June 30, 2012.
Substance Abuse Prevention and Treatment
52
Source: Tennessee Department Mental Health, Division of Alcohol and Drug Abuse Services. State Fiscal Year 2011-2012 is July 1, 2011 - June 30, 2012.
Allocations for Shelby, Tipton and Fayette counties
PSRA Data Presentation June 26, 2013
FY 09-10 FY 10-11 FY 11-12$0
$1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 $6,000,000 $7,000,000 $8,000,000 $9,000,000
$10,000,000
$6,404,934
$8,375,283 $9,198,354
Allocations for substance abuse prevention and treatment have increased about 44% in the past two years.
Housing Opportunities forPeople with AIDS (HOPWA)
• The U.S. Dept. of Housing and Urban Development manages the HOPWA program for low-income persons living with HIV/AIDS
• Serves PLWHA living in Fayette, Shelby and Tipton counties in TN, DeSoto, Marshall, Tate and Tunica counties in MS, and Crittenden county, AR
• Services include– Tenant-Based Rental Assistance (TBRA)– Short-term Rent, Mortgage & Utility Assistance (STRMU)– Permanent Housing Facility– Short-term Housing Facility– Permanent housing placement (e.g., first month’s rent, utility deposits)– Housing information (e.g., flyers, pamphlets)– Support Services (e.g., case management, life skills management,
employment assistance/training)
53PSRA Data Presentation June 26, 2013
54
Source: City of Memphis, Division of Housing and Community Development, Annual Action Plans.
PSRA Data Presentation June 26, 2013
FY11 FY12 FY13 FY14$0.00
$500,000.00
$1,000,000.00
$1,500,000.00
$2,000,000.00
$2,500,000.00 $2,279,322.50 $2,044,449.
00 $1,835,799.
50 $1,620,183.39
HOPWA Budget
Housing Opportunities forPeople with AIDS (HOPWA)
Over four years (FY11-FY14) HOPWA funding in the Memphis TGA decreased 30%.
55
Source: City of Memphis, Division of Housing and Community Development.
FY10 FY11 FY12 $-
$500,000
$1,000,000
$1,500,000
$2,000,000
$2,500,000
$3,000,000
$2,385,365
$2,177,710
$1,544,651
HOPWA Expenditures
PSRA Data Presentation June 26, 2013
Housing Opportunities forPeople with AIDS (HOPWA)
The number of households served in FY 2012 is down 12% from FY 2010.
FY10 FY11 FY120
200
400
600
800
1000
1200
725
997
821
Number Served by HOPWA
Num
ber
of H
ouse
hold
sSe
rved
56
Source: City of Memphis, Division of Housing and Community Development.
HOPWA Expenditures by Agency
Services Provided by HOPWA Agencies1. Tenant-Based Rental Assistance (TBRA); Short-Term Rent, Mortgage & Utility Assistance (STRMU); Permanent Housing Facility-Operating; Permanent housing placement (first month’s rent, rent/utility deposits); Support Services (case management, Wellness University, etc.)
2. Short-Term Housing Facility; Support Services (mental health, A&D); Housing Information (flyers, pamphlets)3. Homemaker Services; Support Services (case management)4. Tenant-Based Rental Assistance (TBRA); Support Services (case management, life skills management, employment assistance/training)
5. Tenant-Based Rental Assistance (TBRA); Support Services (case management, transportation)
FY 2010 (7/1/09 - 6/30/10) FY 2011 (7/1/10 - 6/30/11) FY 2012 (7/1/11 - 6/30/12)
Number Served Expenditure
Average Cost Per Person
Number Served Expenditure
Average Cost Per Person
Number Served Expenditure
Average Cost Per Person
Friends For Life 470 $1,393,765 $2,965 883 $1,391,529 $1,576 712 $828,830 $1,164
Peabody House 116 $306,992 $2,646
55 $281,236 $5,113 49 $229,440
$4,682
Meritan 35 $96,059 $2,745 38 $173,136 $4,556 35 $134,095 $3,831
Hope House 10 $202,012 $20,201 13 $182,870 $14,067 17 $171,643 $10,097
Urban Family Ministries 9 $159,828 $17,759 8 $148,939 $18,617 8 $180,643 $22,580
Family Services of the
Mid-South 85 $226,709 $2,667 - - - - - -
TOTAL 725 $2,385,365 $3,290 997 $2,177,710 $2,184 821 $1,544,651 $1,881
PSRA Data Presentation June 26, 2013
Other Community Sources for Emergency Financial or Rental Assistance
• Metropolitan Inter-Faith Association (MIFA)– Provides food, rent/mortgage, transportation, and utility assistance to eligible individuals
• MLG&W Utility Service Payment Assistance Programs– Pay the utility bills of people whose utilities have been or are at risk of being shut off– Includes the Federal Low Income Home Energy Assistance Program (LIHEAP), a non-
emergency program that provides utility assistance in the form of a credit once per calendar year
– Utility bill payment assistance programs have age, income, disability, need and other eligibility requirements
57PSRA Data Presentation June 26, 2013
Transportation 642 clients 37,359 tripsFood 3,210 clients 447,976 meals
Utility Assistance 1,601 households $502,876 on utility bills
Mid South AIDS Fund A Community Partner of AIDS United Housed at the Methodist Healthcare Foundation Funding decisions made by the Board of Directors Awards grants to local programs for education, stigma reduction,
prevention and access to care regarding HIV/AIDS 2012 Grantees include: Memphis Center for Reproductive Health (CHOICES); Christ
Community Health Services; Church Health Center; St. Paul Baptist Church; Planned Parenthood of the Greater Memphis Region
58
2011 Budget 2012 Budget$0
$20,000
$40,000
$60,000
$80,000
$100,000 $92,000
$82,000
PSRA Data Presentation June 26, 2013