If you haven't had many opportunities to attend HIV-related conferences, you might wonder just what happens at these gatherings. Four women in our community wrote about their experiences at various conferences over the past year, and shared some of the information they gathered. This is one of those accounts.
I was greatly honored to attend and be a panelist in this year's African-American Institute on "Tools for Survival: Staying Relevant and Viable" at the 2011 United States Conference on AIDS in Chicago. The focus of the Institute is on African-American organizations and health centers, and those that serve African Americans.
Kimberleigh J. Smith, M.P.A., senior director for state and local policy of Harlem United Community AIDS Center, was given the objective of showcasing AIDS service organizations and community-based organizations that have adapted (or are currently adapting) to the changing health care and HIV service landscape -- finding creative innovations in integrating medical care and prevention models, strategic partnerships, diversified funding, and/or innovative programming that extends beyond HIV.
Ms. Smith provided a powerful opportunity for discussion, with participation by Cornelius Baker (national policy advisor at the National Black Gay Men's Advocacy Coalition and senior communications advisor at the Academy for Educational Development) and administrative heavy hitters such as Steve Bussey (CEO, Whitman-Walker Clinic in Washington, D.C.), Don Blanchon (CEO, Harlem United), Bambi Gaddist (executive director, South Carolina HIV/AIDS Council) and myself, as a humble representative from the provider side of the equation of sustainability, from St. Hope Foundation. Panelists worked hard to address such themes as integrated care models, diversified funding, strategic and sustainable partnerships, accountability, adaptability, mentality of leadership and solution-building to a smaller-than-I-would-have-liked audience. This is a topic that needs to fill ballrooms to overflowing as creative solutions are crucial in this changing economic time.
As Don Blanchard stated at a pharmaceutical-sponsored dinner program the night before: "Houston, we have a problem!" Although we have a problem with health care reform and sustainability, that was a passionate plea from the panelists before this track of the conference as well as the evening before. Frank Beadle De Palomo -- current senior vice president and director of the Global Health, Population and Nutrition Group at FHI 360 and past president of Academy of Educational Development -- passionately reiterated that the time for action is now! Organizational paralysis will kill us! But don't be scared to CHANGE! Realize that HIV is not the disease du jour any longer. There is not enough funding to keep health care going at its present rate of utilization. Health care reform is not tomorrow! It's now! Reimbursement state by state has always been different for Medicaid and Medicare. Look at my home state of Texas -- one of the lowest states for Medicaid reimbursement. What they reimburse and predict for future reimbursement may not keep the doors open to provide quality care.
Mr. Bussey and Ms. Gaddist shared their agencies' stories, which were diametrically opposed but illuminated why this topic is so relevant.
Tips from the panel on staying relevant and viable:
- Health care institutions have learned (I hope) that chasing every grant known to man is not feasible for viability.
- Creating strategic partnerships in this time of shrinking dollars (oh yes, Houston!) is a must. Less competition and more collaboration are needed. Linking patients to care through other agencies that provide that service. Do what you do best and not everything. Know the resources in your community.
- Diversify your payer source and do not be dependent on public sources.
- Clinical research dollars.
- Electronic Health Records.
- Patient Centered Medical Homes Certification.
- Know your political representation intimately. They should know your name.
- Apply for Federally Qualified Health Center (FQHC) status -- although awards are very small.
- Make structural changes and not incremental changes in your organization. Be innovative.
- Have a reserve fund.
- Embrace change.
- Do right for your patients. It's not about what the agency thinks about how well they do.
- Patient-centered quality outcomes are needed and not the grantee check-off lists of units.
- Creative models of health care and prevention integration.
Agencies need to stop the paralysis and despondency, now! There need to be sustainable models and strategic collaborations in planning for the care of HIV-positive people. The future is now!
Bethsheba Johnson, G.N.P.-B.C., A.A.H.I.V.S., is an associate medical director of St. Hope Foundation in Houston, Texas. She is a frequent contributor to HIV Care Today, a blog by and for HIV health professionals, on TheBodyPRO.com.
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