Ryan White Medical Case Management

1. Program Purpose

Since 1991, the Kansas Department of Health and Environment (KDHE) HIV/AIDS Section has been providing Case Management services to those infected by HIV/AIDS in Kansas through funds provided by the United States Health Resources Services Administration (HRSA) of the Federal Government. These funds are available under the Ryan White Emergency CARE Act of 1990. The historical funding streams for HIV case management were state general funds (10%), CDC HIV Prevention funds (10%), and HRSA Ryan White base award funding, which was approximately 80%. The current funding stream will be 100% from the HRSA Ryan White base award funding.

The following application guidance is for Kansas Ryan White Part B HIV Medical Case Management services for 2010-2013. Funds are only available to current Ryan White Part B HIV Medical Case Management Agencies as awarded on July 1, 2010. Eligible agencies must develop and maintain a case management delivery system capable of meeting the requirements of the Kansas Ryan White Part B Standards of Care for Medical Case Management.

Ryan White services are intended to reduce the use of more costly inpatient care, increase access to care for underserved populations, and improve the quality of life for those affected by the epidemic. The Ryan White Program works toward these goals by funding local and State programs that provide primary medical care and support services; healthcare provider training; and technical assistance to help funded programs address implementation and emerging HIV care issues.

For more information on the Ryan White CARE Act and the specifics of each Part, please visit the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau website at http://hab.hrsa.gov.

For more information on the history of the Ryan White Part B (Title II) CARE Program in Kansas, please visit http://www.kdheks.gov/hiv/ryan_white_care.html.

2. Funding

Continuation Grants – The amount of funding the local agency requests in this grant application should be based on the amount of funding received for the 2012 fiscal year. In the event additional funds are received at the state level for Medical Case Management, they will be distributed to local agencies based on performance/need data. The State Agency reserves the right to modify, in its sole discretion, the funds awarded.
New Grants – At this time, funding is only available to support those projects currently in existence.

3. Specific Program Information

Application - Follow the KDHE "SYF2013 Grant Application Guidance" instructions.
Agency Requirements –

(1) CERTIFICATION OF MEDICAL CASE MANAGEMENT
Case managers must be adequately and appropriately experienced and trained in providing vital service linkages for people living with HIV/AIDS. In order to ensure these high standards, certification criteria required of case managers has become the benchmark of providing these services. To achieve this end, the Ryan White Part B Program has established defined criteria to ensure the accuracy and creditability of the training and certification process:
Minimum education and/or experience requirements of a case manager shall be:

(a) An RN with BSN or Social Worker with BSW or other related health or human services degree from an accredited college or university. (Current case managers that do not meet the education requirement will be grandfathered in as long as all other requirements are met).

(b) Completion of the Medical Case Management Training with a passing score on exam

(c) Completion of the current KDHE HIV/AIDS testing and counseling certification program, educators certification program and update trainings; and

(d) All case managers must attend all statewide mandatory case management meeting/education updates provided by KDHE and have a designated representative that attends all Kansas Advisory Council on HIV/AIDS (KACHA) meetings.
NOTE: Additional Certification Requirements can be found in the Kansas Ryan White Part B Standards of Care for Medical Case Management.

(2) HIV CASE MANAGEMENT REPORTING REQUIREMENTS
Site visits will be conducted by the Ryan White Part B Grants Manager, Ryan White Part B Quality Manager and/or Ryan White Part B/ADAP Director before the annual objective review audit. All agencies are required to complete the following reports:

(a) Contractor Quarterly Reporting Form:
The Contractor Reporting Form includes information on clients served by your agency during a given quarter. Specific report to be submitted will be run from the SCOUT Database. A narrative report is also required quarterly from each contracted agency. All report templates will be provided to the agencies upon contract award.

(b) Affidavits of Expenditures:
The Affidavits of Expenditure are submitted quarterly with the Contracting Reporting Form. This information includes, but is not limited to, a budgetary breakdown of funds to be received for continuation of grant funding. These line items include salaries, materials, transportation and indirect costs. Specific documentation to support expenditures must be sent with the Affidavit. Examples include, but are not limited to, time and leave reporting documentation and travel logs to support budgeted items. The Ryan White Grants Manager will work with each agency upon contract award to assess what documentation should be sent and what will be acceptable.

i. All agencies must ensure their performance through an annual client satisfaction survey tool provided by the Ryan White Program. Agencies may also introduce additional evaluation criteria exceeding the recommendations provided by the Ryan White Program. Results of the surveys will be submitted to the Ryan White Quality Manager.

(d) Quality Management:
Self-Reporting of quality management activities are encouraged and will appear on Case Management Site Visit Reports. All agency quality management initiatives will have the support of KDHE´s Quality Manager and/or the Kansas Quality Management Committee.

(e) Technical Assistance:
Requests for technical assistance on reporting requirements may be addressed by the Ryan White Part B Grants Manager, Ryan White Part B Quality Manager and/or the Ryan White Part B/ADAP Director by email or phone. On-site technical assistance is available for all contractors by appointment.

(3) Budget

(a) Budget Narrative – Applicants should prepare a detailed annual budget using the Detail Budget Form AND supply a detailed budget narrative as an attachment with the items below. The narrative should be split into the categories as listed as well as differentiate what costs are administrative and what costs are direct services. The budget narrative is where the detail and calculation will be documented. The totals for each category will then be translated onto the Detail Budget Form:

i. Personnel Costs:
Personnel costs should be explained by listing each staff member who will be supported from funds, name (if possible), position title, percent full time equivalency, annual salary, and the exact amount requested for each project year.

ii. Fringe Benefits:
List the components that comprise the fringe benefit rate; for example: health insurance, taxes, unemployment insurance, life insurance, retirement plans, and tuition reimbursement. The fringe benefits should be directly proportional to that portion of the personnel costs allocated for the project.

iii. Travel:
List travel costs according to local and long distance travel. For local travel, the mileage rate, number of miles, reason for travel and staff member/consumers completing the travel should be outlined. The budget should also reflect the travel expenses associated KACHA meetings and other proposed trainings or workshops. KDHE will pay for travel and hotel for the Annual Medical Case Management training, but per diem for food will be the responsibility of the agency. Note: Ryan White Part B funds may not be used for international travel.

iv. Equipment:
*All equipment purchases must be approved prior to purchase*
List equipment costs and provide justification for the need of the equipment to carry out the program’s goals. Extensive justification and a detailed status of current equipment must be provided when requesting funds for the purchase of computers and furniture items.

v. Supplies:
List the items that the project will use. In this category, separate office supplies from educational purchases. Office supplies could include pagers, internet access, postage, copies, telephone etc. and the like; educational supplies may be pamphlets and educational videos. Remember, they must be listed separately and explain the cost breakdown.

vi. Administrative Cost:
Detail administrative cost limited to 10% of the grant amount. This category could include supervision salary, overhead and general administration, supplies, and travel for meetings. For line items that contain both administrative and direct service, be sure to separate into two lines. An example would be a case manager that does direct client care and supervision. In this example you would need one line under salaries that indicates Administration and the percentage worked as Administration and another line for the same position that indicates Direct Service and the percentage worked as direct service. Case Manager salaries do not count toward the administrative cost as it can be considered direct client care.

(b) Special Conditions
The Federal Government (HRSA) provides funding for this grant application. All funded contractors and subcontractors must be in compliance with all administrative requirements and programmatic policies of the funding agencies. The following requirements and restrictions apply to all agencies and proposals:

i. No funds may be used to purchase or improve land, or to purchase, construct, or make permanent improvement to any building.

ii. Funds may not be used to make payments to recipients of services.

iii. All providers must participate in the region's HIV-related community based continuum of prevention and care.

iv. Services must be provided by the project sponsor in facilities that are accessible to people with physical disabilities in accordance with the Americans with Disabilities Act.

v. No funds may be used to support services that are reimbursable under any other program.

vi. HIV/AIDS services shall be provided free of charge.

vii. HIV health and support services provided must be made without regard to the individual´s ability to pay, the individual´s past or present health condition, and in a setting accessible to low-income individuals.

viii. Special efforts must be undertaken by all recipients of grant funds to reach out to low-income individuals to make them aware of the availability of services.

i. Copy of your agency Contraband/Illicit Drug Policy.

ii. Detailed budget narrative. This document is in addition to the budget form.

iii. Copies of your agency Security and Confidentiality Policy for your agency.

iv. Copy of your agency Sexual Harassment Policy.

v. Copy of your agency Internal Grievance Policy.

vi. Job descriptions and resumes of all those employees being paid out of the grant award. These would include your current and/or proposed case managers, executive director, administrative support, etc.

vii. Copy of your agency organizational chart.

viii. Copy of your agency´s most recent audit.

ix. Proof of non-profit status such as 501 (c) 3 letter.

x. Board of Directors List.

(4) Monitoring, Evaluation, and Reporting
KDHE is responsible for program monitoring, evaluation, and reporting on contractors. This process is ongoing through regular interactions between the Program Directors, Grants Manager and community partners working together on behalf of the persons targeted to receive these services. The goal of these activities is to assure the efficient, timely, and appropriate delivery of high quality HIV services.

(5) Required Forms
Some of the information below may require additional paperwork that you will have to submit as supporting documentation or as an attachment to your proposal.

(a) Program Narrative

(b) Detailed Budget
The applicant must complete a detailed budget and budget narrative along with their proposal as outlined in Section B.

(c) Application Checklist
Applicants are required to submit the Application Checklist form to ensure that all parts of the application are complete.

(d) Cover Sheet

(e) Cultural Competency Checklist
Applicants are required to submit the Cultural Competency Checklist to ensure that the agency has policies and procedures that meet the provisions for quality services to Gay, Lesbian, Bisexual, and Transgendered clients.

4. Program Contact Persons

Jeni Mulqueen, Director, Ryan White Part B/ADAP
785-368-8218
jmulqueen@kdheks.gov

Sandra Springer, Director HIV/AIDS Program
785-296-1037
sspringer@kdheks.gov

Form Required: |

Cover Sheet, Application Checklist, Program Narrative and Detail Budget forms have been combined |

Reference Document:

Detailed Budget Sample

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