ALAMEDA COUNTY PUBLIC HEALTH DEPARTMENT OFFICE OF AIDS ADMINISTRATION AND OAKLAND EMA COLLABORATIVE COMMUNITY PLANNING COUNCIL OAKLAND, CALIFORNIA ELIGIBLE METROPOLITAN AREA 2006 – 2009 COMPREHENSIVE HIV SERVICES PLAN SUBMITTED TO THE US HEALTH RESOURCES AND SERVICES ADMINISTRATION DECEMBER 28, 2005 Oakland Eligible Metropolitan Area (EMA) 2006 - 2009 Comprehensive HIV Services Plan OAKLAND EMA 2006 – 2009 COMPREHENSIVE HIV SERVICES PLAN TABLE OF CONTENTS Table of Contents 1 Letter of Concurrence 2 Introduction & Acknowledgments 3 Executive Summary 6 Section I: Where Are We Now? What is Our Current System of Care? 8 Section II: Where Do We Want to Go? What System of Care Do We Want? 46 Section III: How Will We Get There? How Will Our System Need to Change to Assure Availability and Accessibility to Core Services? 47 Section IV: How Will We Monitor Our Progress? How Will We Evaluate Our Progress in Meeting? Our Short and Long-Term Goals? 60 Endnotes 63 December 28, 2005 Page 1 of 64 Oakland Eligible Metropolitan Area (EMA) 2006 - 2009 Comprehensive HIV Services Plan December 28, 2005 Page 2 of 64 Oakland Eligible Metropolitan Area (EMA) 2006 - 2009 Comprehensive HIV Services Plan INTRODUCTION & ACKNOWLEDGMENTS The 2006 - 2009 three-year Comprehensive Plan for HIV service delivery in the Oakland Eligible Metropolitan Area (EMA) is the product of an intensive planning and development process spearheaded by a diverse group of consumers, providers, and HIV specialists from both Alameda and Contra Costa Counties. Together, these individuals worked during the second half of 2005 to chart a course for the future of HIV services in the Oakland EMA that will allow our region to utilize Title I funds to make the greatest possible impact on the continually escalating crisis of HIV and AIDS. Work on the comprehensive planning process began in early 2005 with an effort by the Services Planning Council of the Oakland EMA Collaborative Community Planning Council to thoroughly evaluate progress made toward goals and objectives contained in the 2002 Comprehensive Plan. Staff of both the Alameda and Contra Costa County AIDS programs prepared a report on progress made and successes achieved in implementing the previous Plan, and summarized ongoing initiatives to put remaining Plan provisions in place. In turn, these documents were utilized by the Services Planning Committee to provide a starting point for development of this year’s new three-year goals, objectives, and action steps. Beginning in mid-2005, the Oakland EMA Planning Council also formed a Comprehensive Plan Task Force specifically to oversee the development of the three- year Plan. While functioning as an ad hoc subcommittee of the Services Planning Committee, membership on the Task Force was open to all Council members, as well as to interested community members and consumers. Chaired by Sheila Hall, the Task Force met regularly throughout the planning process, including in a special three-hour meeting in September 2005 to develop Plan objectives and action steps. At the same time, the Planning Council and its Steering Committee reviewed documents produced by the Task Force and approved key components of the Plan. On October 26, for example, the Council reviewed and approved the Plan’s integrated set of three-year objectives. At its meeting of November 30, the Council reviewed and revised the Plan’s three-year action steps designed to aggressively move our EMA forward in continuing to respond effectively to local HIV care needs. And on December 13, the Planning Council Steering Committee met to review and revise the entire Comprehensive Plan document in preparation for submission to HRSA. The following is a listing of current Planning Council members. The list includes Planning Council members who participated in the Comprehensive Plan Task Force process: December 28, 2005 Page 3 of 64 Oakland Eligible Metropolitan Area (EMA) 2006 - 2009 Comprehensive HIV Services Plan Oakland Eligible Metropolitan Area Collaborative Community Planning Council James Taylor, Chair Gale Brown, Vice Chair Maria Aguilar Paulette Hogan Anthony Shearer Kenneth Arrington Arthur Hollister Bill Stewart Dan Barba Teree Jerome Keith Thompson Amity Balbutin-Burnham AJ King James Walker Maria Camacho Gloria Lockett Norvell Wallace Kathleen Clanon Roosevelt Mosby John Ward Cseneca Greenwood Roy Quintana Hazel Weiss Carla Goad Frederica Robinson Sylvia Young Sheila Hall Joaquin Sanchez Jim Zuber Lorenzo Hinojosa Pauline Sanger Staff of the Alameda County Office of AIDS participated in the preparation of the Comprehensive Plan document through the submission of progress reports, attendance at Comprehensive Plan Task Force meetings, and review and revision of key Plan sections. The following is a listing of Alameda County AIDS Office staff members: Alameda County Public Health Department Office of AIDS Administration Ron Person, Director Lori Williams, Director Care & Prevention Maria Aguilar, Director Data & Quality LaKisha Brents Venna Doijode Tom Mosmiller Ivory Butler Lorenzo Hinojosa Shelley Stinson Patricia Calloway Deborah Jones Beverly Wayne Dolly Cruse Michael Lee Kimberly Wilson Elenetia DeLeon Al Lugtu Staff of the Contra Costa County Office of AIDS Administration also provided continual support to the planning process, and helped formulate key Plan sections. Carla Goad of the Office was a dedicated Task Force member. The following is a listing of Office of AIDS Administration staff: Contra Costa County Health Department AIDS Program Christine Leivermann, MPH, AIDS Program Director Carmen Beyer Rhonda Choi Carla Goad December 28, 2005 Page 4 of 64 Oakland Eligible Metropolitan Area (EMA) 2006 - 2009 Comprehensive HIV Services Plan Marlina Hartley Peter Ordaz The Contra Costa HIV/AIDS Consortium provides ongoing advice, support, and input to the Contra Costa County Office of AIDS Administration. Consortium members include unaffiliated consumers and representatives of a broad range of local agencies. Consortium members helped provide input into Contra Costa County’s recommendations for the current Comprehensive Plan. The members of the Consortium are as follows: Contra Costa HIV/AIDS Consortium Mario Balcita Doris Glasper William Roby Carmen Beyer Robert Hamilton Graciele Salinas Betty Blackmore-Gee Lorena Huerta Sunny Solomon Gale Brown Desiree Jackson Jeri Stegman Mario Camacho Sandra Johnson Corrine Stuart Carlos Carvajal Julie Levin John Sturr Kelly Dunn Margaret Madams Junie Tate Dick Eastwood Cally Martin William Washington Sam Erwin Francisco Nanclares Larry Wilson Alicia Garcia Patrick O’Leary Staff of All Health Care / Imanis - the Oakland EMA’s contracted Planning Council support agency - provided valuable assistance throughout the planning process. We are grateful to Shirley Manly-Lampkin PhD, RN, Norma Del Toro, Patrice Lee, and Priscilla Banks of All Health for their support. Robert Whirry, an independent Program Development Consultant, provided contracted support throughout the planning process, helping facilitate meetings and preparing successive draft versions of the Plan document. We are grateful to all of those involved in making the 2006 - 2009 Comprehensive Plan for the Oakland EMA a reality. December 28, 2005 Page 5 of 64 Oakland Eligible Metropolitan Area (EMA) 2006 - 2009 Comprehensive HIV Services Plan EXECUTIVE SUMMARY The 2006 - 2009 Oakland EMA Comprehensive HIV Services Plan is designed to serve as a working blueprint to guide the growth and development of HIV/AIDS care and services in Alameda and Contra Costa Counties over the next three years of the HIV epidemic. Developed through a collaborative process involving the local Planning Council and our region’s two County AIDS programs, the Plan offers an assertive, coordinated plan of action designed to improve local HIV outreach, service linkage, and support, while developing effective strategies to better link HIV prevention and care. The Plan is designed to serve as a living document that is continually reviewed, revisited, and improved in order to respond to changing HIV needs and populations, and to incorporate new strategies for improving care and increasing parity of service access. The need for a thoughtful roadmap to guide the continued development of our local HIV continuum is particularly critical at a time when increasing HIV-infected populations coincide with diminishing financial resources to meet these individuals’ needs. In the Oakland EMA, such financial challenges are particularly daunting given the exploding rates of HIV infection among underserved and hard-to-reach groups such as young gay men of color, transgendered people, active substance users, women, and the homeless - populations that require assertive, coordinated efforts in order to involve and retain them in care. The progress our EMA has made in reducing the percentage of individuals who have an unmet need for HIV medical care is continually being challenged by the growing complexity of newly-diagnosed populations, and the need for evolving systems that can affectively meet the needs of multiply-diagnosed individuals, persons in poverty, and sexual minorities. A critical step in realizing our goal of a more unified approach to HIV prevention and care was initiated in 2004, when the Oakland EMA began to implement a long- contemplated strategy of merging the region’s HIV service and prevention planning councils into one unified body whose members could work together to address HIV care and prevention needs in a coordinated manner. The process