Quality assessment of Ryan White funded substance abuse services provided to persons living with HIV/AIDS in the Baltimore metropolitan area

Baltimore City Health Department (BCHD) administers a Quality Improvement Program (QIP) that reviews service categories across all Ryan White Title I funded agencies on a 4-year cycle to ensure quality HIV services that adhere to local standards of care. Substance Abuse was reviewed for the second time in Fiscal Year 2006 (FY06). Reviews were conducted at 14 agencies providing Substance Abuse services to 915 clients in FY05. QIP reviewed 393 charts utilizing data abstraction tools developed from local standards of care. The sample was 52% male, 67% fell between 40-59 years of age, largely African American (77%), and urban with 78% residing in Baltimore City. One-third (33%) showed IVDU as the risk factor for HIV and 31% documented no insurance. CD4 and Viral Loads were documented in 51% and 47% of records respectively and 33% of clients were on HAART. Documentation of residency and financial status were in less than one-fifth of the records sampled and agency policies are shared with clients approximately half of the time. Substance Abuse Indicators assessed included rates of completed intakes, ASI completion, treatment plan development, treatment plan updates, and HIV education with areas for improvement identified. Upon completion of this session, participants can plan to evaluate Substance Abuse service delivery across agencies and identify improvement projects that target weaknesses in a system of care.