Field Placement: Los Angeles County Department of Health Services Office of AIDS Programs and Policy (OAPP)
Location: Torrance, CA
Preceptor: Marcy Fenton, MS, RD
Student Name: Elaine Kok
Year: 2004

As one of the seven divisions in the Los Angeles County Department of Health Services Office of AIDS Programs and Policy (OAPP), the Division of Care Services strives to promote the overall health outcomes of indigent persons living with HIV/AIDS (PLWH/A) by providing adequate and timely care services. This includes social services in fields such as case management and mental health; client services such as transportation, housing, and alcohol and substance abuse; medical outpatient services. During my tenure with OAPP (June 29 to September 8, 2004), I worked with Marcy Fenton, MS, RD, who is well-known for her pioneering work in improving the nutrition of PLWH/A. I was assigned to assist in the development of two types of evaluation mechanisms.

There has been a history of integrating the operations of the Divisions of Care and Prevention Services at OAPP. One of my goals was to develop cohesive monitoring instruments (MIs) that integrate data collected by these two divisions. This project included the development of a programmatic review tool for at least one of the five new Care service contracts and an administrative review tool. These MIs are used by OAPP’s program managers (PMs) to evaluate an agency’s operations and how well an agency is providing services according to the contract. Using this tool, PMs provide constructive feedback and technical assistance to help improve the service through a monitoring report. Creating the MIs involved examining the service contracts, conducting focus groups with PMs, meeting with PMs individually, and participating in a site visit to learn how the PMs utilize the MIs. I also conducted a brief needs assessment of the staff’s computer skills. Because the PMs will need to re-create these MIs, I held a series of training sessions to demonstrate the new monitoring report format and review the skills they would need for the report and MIs.

The second goal was to assist in developing a series of best practices symposia in HIV/AIDS care services. As a forerunner in innovative responses to the AIDS epidemic, Los Angeles County seeks to bring service providers across the County together through these symposia to share and uncover inventive ways of delivering optimal service to PLWH/A. Because the County has a good set of standards of care for case management, this service was chosen to be the first highlighted category. This project involved conducting a literature review on case management and best practices, researching Ryan White CARE Act funding, learning about quality management, investigating what has been done in best practices and/or in case management across the country, interviewing key individuals knowledgeable in best practices, gathering feedback from community providers, and facilitating workgroup meetings with the PMs and Section Manager involved in case management. At this time, OAPP is not ready to implement the symposia, but I created a template replete with information on the formative steps I took and drafted copies of an agenda, brochure, and calendar to assist staff when they arrive at the implementation stages.

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