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County and Regional Services FY 2015-2016 Required Reports

The Oregon HIV Community Services Program (HCS) is committed to developing, evaluating and continually improving a statewide, quality continuum of HIV care, treatment and supportive services that meets the identified needs of persons living with HIV and their families, ensures equitable access and decreases health disparities.  The HCS Program supports this mission by gathering data and information about the services delivered by HCS and it's contractors, analyzing this information to measure outcomes and quality of services, reporting this analysis in order to identify areas requiring needed planning, and implementing improvement activities in order to meet program goals.

As part of the HCS's quality management plan, HIV case management provider agencies submit program reports which provide a written evaluation of the services delivered, and includes partnership and referral activities undertaken, staffing changes, and targeted quality improvement activities the agency has undertaken.  The HCS team reviews required reports and HCS Quality and Compliance Coordinator identifies items requiring follow-up.  Technical assistance is provided to the contractor as requested.

County and Regional Services Reporting Package and Instructions

Fiscal Year 2014-2015 Package

Quarterly 2014-2015 Package


Required Reports

Description

Reporting dates

Due Date

Form

For printing

Fillable

County and Regional Based Programs:

1. Quarterly Progress Report Form

 

 

Quarterly Progress Report Form Sections:

Section I: Data--

Includes a “Non-Client Specific Units of Service” summary form.

Section II: Narrative-- written evaluation of the agency’s performance.

1. 7/1/15 - 9/30/15

2. 10/1/15 - 12/31/15

3. 1/1/16 - 03/31/16

4. 4/1/16 - 06/30/16

 

1. October 31, 2015

2. January 31, 2016

3. April 30, 2016

4. July 31, 2016

 





PDF link to Intake/Eligibility Review 





Intake/Eligibility Review - Word document link 

Section III:  Narrative for the Contract Year--
a written summary of the agency’s performance for the entire contract year

1.  7/1/15 – 6/30/15

 

1. July 31, 2016

County and Regional Based Programs:

2. Administrative Fiscal Form

 

Administrative Fiscal Form includes:

Administrative and service expenditures.

 

1. 7/1/15-9/30/15

2. 10/1/15-12/31/15

3. 1/1/16 - 03/31/16

4. 4/1/16 - 06/30/16

 

1. October 31, 2015

2. January 31, 2016

3. April 30, 2016

4. July 31, 2016

 



PDF link to Intake/Eligibility Review 



Intake/Eligibility Review - Word document link 

County Based Programs only:

3. LPHA Chart Review Summary

 

 

LPHA Chart Review Summary includes:

 LPHA review of documentation in the client chart and data entry in CAREWare.

1. Chart and data entry review of services and documentation for the preceding 12 months.

1. October 31, 2015

 



PDF link to Intake/Eligibility Review



Intake/Eligibility Review - Word document link

For printed forms, once printed and completed, scan and save to your computer, and email as an attachment.

For fillable forms, once download and completed, save to your computer, and email as an attachment.

Submit all reports by e-mail only to:
DeAnna P. Kreidler, M.S.
HIV Care and Treatment Program
Quality and Compliance Coordinator
deanna.p.kreidler@state.or.us​

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