Transcript Ryan White Needs Assessment

2010 Client Survey Synopsis
Southeast Tennessee Region
RYAN WHITE NEEDS ASSESSMENT
Response Rates
 268 Surveys were distributed
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99 to Chattanooga CARES clients
108 to Ryan White Dental /Nancy’s House clients
50 to Channels of Love clients
10 to Chattanooga CARES Healthy Relationships
 13 were “Returned to Sender”
 Net of 255 sent and received
 79 responded…and they are still coming in!
 30.98 % response rate…so far
What did the survey measure?
 Who we are serving (aka demographics)
 Their situation in re: housing, finances, health
 What services they need and are receiving
 What services they need and do not receive
 What services are not needed
 Access to services
 Barriers to service
 Satisfaction with services
Demographics

2 were filled out by mothers of clients
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(and yes, it was for their grown sons)
Males = 48 (60.8%)
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Females = 29 (36.7%)
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13-24: 1 ( 2.1%)
25-44: 14 (29.2%)
45-64: 32 (66.6%)
≥ 65: 1 (2.1%)
13-24: 1 (3.4%)
25-44: 15 (51.7%)
45-64: 10 (34.5%)
≥ 65: 2 (6.9%)
No response: 1 (I guess she holds fast to that “Never ask a woman her age!”)
Transgendered = 0
No response = 2 ( 2.5%)

No response on age either
Demographics
 Age:
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0-12:
13-24:
25-44:
45-64:
65-?:
0
2
29
42
3
(0.00%) YES!!!
( 2.5%)
(36.7%)
(53.2%)
( 3.8%)
 No response: 3 (3.8%)
Demographics
 Race
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African American: 36 (45.6%)
Caucasian:
39 (49.4%)
Multiracial:
3 ( 3.8%)
No response:
1 ( 1.2%)
• Ethnicity
 Non-Hispanic: 47 (59.5%)
 Hispanic:
2 ( 2.5%)
 No Response: 30 (38.0%)
Demographics
 Sexual Orientation
 Heterosexual/ Straight: 37 (46.8%)
 Gay or Lesbian:
 Bisexual:
 Not Applicable:
 No Response:
30 (38.0%)
6 (7.6%)
3 (3.8%) 1 A-Sexual
3 (3.8%)
Primary Language:
• English: 78 (98.7%)
•Spanish: 0 (0.00%)
• Other: 1 (1.3%) (American Sign Language)
Demographics
 Counties:
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Hamilton: 61 (77.2%)
Bradley: 7 ( 8.9%)
Marion: 2 ( 2.5%)
Polk: 2 ( 2.5%)
Bledsoe : 2 ( 2.5%)
McMinn: 1 ( 1.3%)
Georgia (Whitfield, Catoosa: 1 each): 2 (2.5%)
Collin, TX: 1 (1.3%)
No Response: 1 (1.3%)
Where do you live?
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30721: 1
30736: 1
37303: 2
37311: 3
37312: 2
37323: 2
37341: 1
37343: 3
37367: 1
37373: 1
37379: 5
37380: 2
37381: 1
37391: 1
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37402: 4
37403: 2
37404: 4
37405: 4
37406: 12
37407: 3
37408: 3
37410: 3
37411: 7
37412: 1
37415: 4
37416: 1
37419: 2
37421: 1
GA:
2 ( 2.5%)
TX:
1 ( 1.3%)
TN (Rural):
24 (30.4%)
Athens:
2 ( 2.5%)
Cleveland:
7 ( 8.9%)
Harrison:
1 ( 1.3%)
Hixson:
3 ( 3.8%)
Sale Creek:
1 ( 1.3%)
Soddy Daisy:
5 ( 6.3%)
South Pittsburg: 2 ( 2.5%)
Spring City:
1 ( 1.3%)
Turtletown:
1 ( 1.3%)
Chattanooga: 51 (64.5%)
37406 is 15.2% alone
No Response:
1 ( 1.3%)
Now that we have broken them down, let us put
them back together…
 Men:
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4 Bisexual African American Men, aged 25-44, living in Hamilton County
8 African American MSM, 1 aged 13-24, 5 aged 45-64, 7 living in Hamilton
County, 1 in Bradley County
2 Multiracial MSM living in Hamilton County
9 Caucasian MSM living in Hamilton County, 1 aged 65 and over
6 Caucasian MSM living in Bradley County
5 Caucasian MSM living in the Rural TN (Bledsoe,Marion, McMinn, Polk)
area and GA
4 African American Heterosexual living in Hamilton County
4 Caucasian Heterosexual living in Hamilton County
1 Caucasian Heterosexual living in Catoosa County, GA
1 Bisexual Caucasian Man, aged 45-64, living in Hamilton County
1 Caucasian A-sexual, aged 45-64, living in Hamilton County
1 African American Heterosexual living in TX
Now that we have broken them down, let us put
them back together…
 Women
 18 African American, Heterosexual, living in Hamilton
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County, 1 aged 65 and over
5 Caucasian, Heterosexual, living in Hamilton County,
1 aged 65 and over
3 Caucasian, Heterosexual, living in Rural TN (Bledsoe,
Marion, Polk)
1 African American, No orientation given, age 25-44
1 Multiracial, Heterosexual, living in Hamilton County,
age 25-44
1 Caucasian, Bisexual, living in Hamilton County , age
25-44
Household Size
1 Person: 27 (34.2%)
2 People: 28 (35.4%)
3 People: 10 (12.6%)
4 People: 7 (8.9%)
5 People: 2 (2.5%)
6 People: 4 (5.1%)
No response: 1 (1.3%)
Monthly Income
 $903 or less: 42 (53.2%)
 $904-$1805: 26 (32.9%)
 $1806-$2708: 3 (3.8%)
 $2709 & over: 1 (1.3%)
 Don’t know: 5 (6.3%)
 No response: 2 (2.5%)
Source of Income
(More than 1 response)
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SSI/SSDI: 50 (63.3%)
Employment: 15 (19.0%)
AFDC: 6 (7.6%)
Food Stamps: 6 (7.6%)
No response: 4 (5.1%)
Parent supports me: 2 (2.5%)
VA Widow’s Pension: 1 (1.3%)
Child support/ Alimony: 1 (1.3%)
Unemployment: 1 (stated “retired”) (1.3%)
No Income: 1 (1.3%)
HIV Care Paid By…
 Ryan White: 54 (68.3%)
 Medicare: 32 (40.5%)
 TennCare: 24 (30.4%)
 Private Insurance: 6 (7.6%)
 Veterans’ Administration: 2 (2.5%)
 Other (Mom or boyfriend; myself; health
department; BBBC; QMB; Healthnet; Humana: 7
(8.9%)
Need but cannot access these services:
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Vision: 43
Legal Services: 22
Low Income Housing: 21
Dental: 20
Alternative/Complementary treatment: 20
Food basket/food vouchers/food pantry: 14
Voluntary Support Person/Buddy system: 13
Medical Insurance Assistance: 13
Support Group: 13
Nutritional Supplements: 11
Budgeting Assistance: 11
Transportation to medical appointments: 11
Need but cannot access these services:
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Case management: 10
Rent/Mortgage Assistance: 10
Utility Assistance: 10
Health Care Service Referrals: 10
Transportation to social service appointments: 9
Employment Counseling/vocational rehabilitation: 9
Non-medical supplies: 8
Transportation to Pharmacy: 6
Individual Counseling: 6
Psychiatric/ Mental Health Care (Outpatient): 5
Nutritional guidance/ counseling: 4
Prescription Drug Assistance: 4
Need but cannot access these services:
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Emergency/ Transitional Housing: 4
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Independent Living Skills Training: 4
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Medical Equipment: 3
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Clinical Trial Referrals: 3
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Visiting Nurse/Home healthcare: 3
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Specialist: 3
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Home delivered meals: 3
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Representative Payee/ financial management/ guardianship: 3
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Adult Daycare: 2
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Adherence Counseling: 2
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Psychiatric/Mental Health Care (Inpatient): 2
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Help understanding medications/treatment education: 2
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Hospice Care: 2
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Alcohol/ drug treatment (Outpatient): 1
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Respite Care: 1
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Child Daycare: 1
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Temporary Child Placement: 1
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Primary/ HIV Doctor: 0
Need and Receive These Services:
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Primary/HIV Doctor: 47
Dental Care: 38
Prescription Drug Assistance: 37
Food basket/food vouchers/food pantry: 27
Case Management: 27
Utility Assistance: 19
Psychiatric/ Mental Health (Outpatient): 16
Nutritional guidance/ counseling: 16
Medical Insurance Assistance: 16
Health care service referrals: 15
Nutritional Supplements: 14
Support Group: 14
Rent/Mortgage Assistance: 14
Eye Care: 12
Need and Receive These Services:
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Individual Counseling: 10
Specialist: 10
Help understanding medications/treatment education: 9
Transportation to medical appointments: 7
Low Income Housing: 6
Budgeting assistance: 6
Legal Services: 5
Voluntary Support/Buddy system: 5
Employment Counseling/ vocational rehabilitation: 5
Psychiatric/ Mental Health (Inpatient): 5
Medical Equipment: 5
Clinical Trial Referrals: 4
Transportation to Social Service appointments: 4
Emergency/ Transitional Housing: 4
Need and Receive These Services:
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Home delivered meals: 4
Transportation to Pharmacy: 4
Non-Medical Supplies: 3
Hospice Care: 3
Visiting Nurse/Home healthcare: 3
Representative Payee/Financial
Management/Guardianship: 2
 Adherence Counseling: 2
 Independent Living Skills Training: 1
 Adult Daycare: 1
Most Important Services:
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Dental: 25
Medical Care: 21
Food: 21 (1 stated food stamps) + 1 Ensure
Rental Assistance/Low income housing: 21
Prescriptions: 16
Utilities:15
Transportation: 11
Financial Assistance for gas, moving*, copays, other necessities: 7
Counseling: 5
Household goods/ cleaning supplies: 3
Support Group: 3
Job/Employment: 2
Health Insurance: 2
Legal: 2
Vision: 2
Case management: 1
Barriers to Service
30
25
20
15
10
5
0
Don’t know Didn’t think the
I have no
Told that
Lack of
where to get
service was
trouble getting
service was
transportation
needed services available (20)
services (16) unavailable (16)
(10)
(28)
17 “Other” Barriers to Service
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RW doesn't cover eye exams
It just that I have foot surgery April 24, 2009 and it hard to walk that long time to get to appt PS:
But I still work and I
Told I didn't qualify
Need someone to sit w/family member while I go out.
Haven't been contacted from RW to know if I have come off the waiting list for dental care.
Hate Chattanooga CARES
Case management @Health Dept. was not consistent w/ asst. and her "stories" changed until I
contacted her
No insurance
Due to NH closing
I live in GA ; I live in TX
Lack of $$
Income qualifications
Money!
Don Ellis is my case manager He has been very helpful at Chattanooga CARES
Have gotten rental asst. several times
Because of past criminal record
-2
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Can't remember
No response
When Diagnosed
10
8
6
4
2
0
Where Diagnosed
50
49
45
40
35
30
25
20
15
10
5
0
4
4
2
1
1
1
1
1
CD4 Count
25
22
20
18
17
15
13
10
5
0
0
4
5
Viral Load
50
45
40
35
30
25
20
15
10
5
0
43
20
9
5
1
1
0
Last Labs Drawn
40
36
35
30
25
20
15
17
17
10
7
5
0
2
< ONE MONTH 1-3 MONTHS 3-6 MONTHS > 6 MONTHS NO RESPONSE
AGO
AGO
AGO
AGO
I CONTRACTED HIV/AIDS THROUGH
1
1 1 1 1
1 1
Man to Man Sexual Contact
2
Heterosexual Contact
4
Undetermined/Unknown
Recipient of Blood/Blood products
4
32, 40%
Other
No Response
4
Occupational Exposure
IV Drug Use
Heterosexual/IDU
8
Undetermined/MSM
Heterosexual/Blood products
Heterosexual /IDU
19, 24%
Heterosexual/IDU/Blood Products
Heterosexual/MSM
Current Physical Health vs. 1
Year Ago
35
30
25
20
15
10
5
0
31
27
10
5
4
2
Current Mental Health
vs. 1 Year Ago
33
35
Other =
Diabetes
30
25
19
18
20
15
10
5
5
1
3
0
Improved
Stayed the
Same
Deteriorated
Not Sure
Other
No
Response
In the past 12 months, I stayed…
Own house/apartment
With Friend/Family member
1
2
1111
Own home/With
Family/Friend
14, 18%
In a shelter
W/Family or Friend/On
Streets
58, 74%
W/Family or Friend/In Prison
Own home/With
Family/Friend/On streets/In
Prison
None
Currently, I live…
111
Own house/apt
1
With friend/family
member
14, 18%
On the Streets
Own house/apt/ with
Friend/Family Member
61, 77%
Own home/will have to
move
No response
I have trouble taking my HIV medications…
2, 2%
10, 13%
NO
YES
NO RESPONSE
67, 85%
Why it is difficult for me
to take my HIV medications
6
5
5
4
3
3
2
2
2
2
1
1
0
1
1
1
1
I was receiving RW services, but stopped
getting them because…
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I don't know if I 'm receiving RW services: 14
I didn't qualify for the service: 4
Didn't need the service anymore: 3
Other: 7
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Have not been in b/c of foot surgery
They cancel my last appt. b/c the dentist quit
Don't know anything about RW services- I'd like to
Funding for dental was not available
I let go of b/c of the SSI medication part, unless necessary
I got Medicaid and didn't qualify
Because of jail time
Still receive housing, but too many restrictions apply now.
Who provides your HIV medical care?
35
30
25
20
15
10
5
0
Who provides your HIV medical care?
 Other:
 Dr. David Barnes (Birmingham, AL)
 Veterans Administration (Murfreesboro, TN)
 Dr. Younger
 Parkland Medical Center, Texas
Does the Medical Staff Treat You with
Dignity and Respect?
“Sometimes” was attributable to :
Chattanooga CARES: 3 times
Dr. Anderson 2 times
CARES + another provider 2 times
0, 0% 0
1
7, 9%
Always
11, 14%
Most of the Time
Sometimes
Rarely
Never
No Response
60, 76%
Comorbidities
Hepatitis C,
Genital Herpes,
Gonorrhea, 1
Other, 2
Hepatitis
A&B, Genital
Herpes, 1
Hepatitis A or B, 3
Hepatitis A or B
Hepatitis C
Genital Herpes
Hepatitis
A,B, and
C, 1
Chlamydia
Gonorrhea
Hepatitis C and Genital Herpes
Hepatitis C
and Genital
Herpes, 2
Hepatitis C, 6
Hepatitis A,B, and C
Hepatitis A&B, Genital Herpes
Hepatitis C, Genital Herpes, Gonorrhea
Other
Gonorrhea
Chlamydia, 1
Genital
Herpes, 2
Other: COPD, Back Problems
I currently receive case management
6, 8%
17, 21%
Yes
No
No Response
56, 71%
CHANNELS OF LOVE (1 SOLELY) AND
WITH CHATTANOOGA CARES (4) OR “NASHVILLE” (1)
I AM AWARE OF THE SERVICES AVAILABLE
FROM MY CASE MANAGER
I FEEL COMFORTABLE ASKING FOR ASSISTANCE
1, 17%
1, 17%
Yes
No
Most of the time
Not very often
1, 16%
Never
4, 67%
5, 83%
CHANNELS OF LOVE (1 SOLELY) AND
WITH CHATTANOOGA CARES (4) OR “NASHVILLE” (1)
MY CASEMANAGER IS KNOWLEDGEABLE ABOUT COMMUNITY
RESOURCES AND IS ABLE TO CONNECT ME TO THESE
RESOURCES
MY CASEMANAGER TREATS ME WITH
DIGNITY AND RESPECT
1, 17%
2, 33%
2, 34%
Most of the time
Always
Sometimes
Most of the time
N/A
5, 83%
2, 33%
CHANNELS OF LOVE (1 SOLELY) AND
WITH CHATTANOOGA CARES (4) OR “NASHVILLE” (1)
MY CASEMANAGER UNDERSTANDS MY NEEDS
MY CASEMANAGER IS ACCESSIBLE
1, 17%
1, 17%
Always
3, 50%
Most of the time
Always
Most of the time
3, 50%
Sometimes
2, 33%
Sometimes
2, 33%
CHANNELS OF LOVE (1 SOLELY) AND
WITH CHATTANOOGA CARES (4) OR “NASHVILLE” (1)
Last year, my case manager contacted me…
1, 17%
2, 33%
> 1x per month
1x per month
Every 3 months
1, 17%
I have not heard from my cm
I CALLED HIM
1, 17%
1, 16%
CHATTANOOGA CARES CASE MANAGEMENT
I
I AM AWARE OF THE SERVICES AVAILABLE FROM
MY CASE MANAGER
I FEEL COMFORTABLE ASKING FOR ASSISTANCE
4
2
Always
21
2
1
9
Always
Most of the time
Most of the time
Sometimes
Sometimes
Not very often
Not very often
Never
Never
11
CHATTANOOGA CARES CASE MANAGEMENT
MY CASEMANAGER IS KNOWLEDGEABLE
ABOUT COMMUNITY RESOURCES AND IS ABLE
TO CONNECT ME TO THESE RESOURCES
2
MY CASEMANAGER TREATS ME WITH
DIGNITY AND RESPECT
Always
1
6
Most of the time
1
1
1
3
Always
Sometimes
Most of the time
Not very often
Sometimes
3
N/A
N/A
10
YET TO BE
DETERMINED
22
CHATTANOOGA CARES CASE MANAGEMENT
MY CASEMANAGER IS ACCESSIBLE
MY CASEMANAGER UNDERSTANDS MY
NEEDS
2
3
8
2
8
12
2
1
Always
Always
Most of the time
Most of the time
Sometimes
Sometimes
Not very often
N/A
N/A
12
CHATTANOOGA CARES CASE MANAGEMENT
Last year, my case manager contacted me…
3
6
2
More than 1xmonth
Once a month
Every 3 months
Every 6 months
Once a year
3
5
5
I have not heard from my CM this year
CHATTANOOGA-HAMILTON COUNTY
HEALTH DEPARTMENT
I AM AWARE OF THE SERVICES AVAILABLE
FROM MY CASE MANAGER
I FEEL COMFORTABLE ASKING FOR ASSISTANCE
2, 22%
4, 44%
Yes
Always
No
Sometimes
5, 56%
7, 78%
CHATTANOOGA-HAMILTON COUNTY
HEALTH DEPARTMENT
MY CASEMANAGER IS KNOWLEDGEABLE ABOUT
COMMUNITY RESOURCES AND IS ABLE TO CONNECT ME TO
THESE RESOURCES
MY CASEMANAGER TREATS ME WITH
DIGNITY AND RESPECT
1, 11%
1, 11%
1, 11%
Always
1, 11%
6, 67%
Most of the Time
Always
Not Very Often
Sometimes
N/A
8, 89%
CHATTANOOGA-HAMILTON COUNTY
HEALTH DEPARTMENT
MY CASEMANAGER UNDERSTANDS MY NEEDS
MY CASEMANAGER IS ACCESSIBLE
1, 11%
1, 11%
1, 11%
Always
Always
Most of the Time
Not Very Often
7, 78%
Most of the Time
3, 33%
5, 56%
Not Very Often
CHATTANOOGA-HAMILTON COUNTY
HEALTH DEPARTMENT
Last year, my case manager contacted me…
2, 25%
> 1x per month
1x per month
4, 50%
Every 3 months
Every 6 months
1, 12%
1, 13%
SERVICE BARRIERS
30
25
20
15
 OTHER=
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10
5
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0
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Nancy's House closing (3)
Funds not available (2)
I didn’t know about these services (2)
EYE CARE, NO SERVICE PROVIDED
I just did things on my own like
finding out things
My appt. was canceled
Negative experiences with multiple
agencies/case managers
Need to update w/manager but don't
have time
Legal Services?
Seems like the guidelines change
quite frequently
TRANSPORTATION SERVICES
25
30
HOW HELPFUL WERE SERVICES ?
ABLE TO ACCESS SERVICES?
20
25
15
20
10
15
5
0
10
5
0
VERY MUCH
SOME
A LITTLE
NOT AT ALL
NOT
APPLICABLE
HOUSING & UTILITY ASSISTANCE
I have received assistance when I needed it
16
14
20
18
16
12
14
10
8
6
12
10
8
6
4
4
2
2
0
0
Assistance received has helped me maintain
stable housing/utility service
Food and Nutritional Services
40
Type of Service Accessed
How often are you able to obtain the
amount of food that you need?
25
35
20
30
25
15
20
15
10
10
5
5
0
0
Food and Nutritional Services
25
Satisfied w/quality of food?
20
18
16
20
14
12
15
10
8
10
6
4
5
2
0
0
Very
Satisfied
Satisfied
Not Satisfied
Very
Unsatisfied
Not
Applicable
How often is the food beneficial to
you during difficult times?
HIV Related information found
at provider agencies
25
35
How often does agency have up to date
information available?
20
How helpful is the information?
30
25
15
20
10
15
5
10
5
0
0
Very Much
Some
A little
Not at all
Not
Applicable
HIV Related information found
at provider agencies
35
Has it helped you reduce or eliminate risk behaviors?
30
25
20
15
10
5
0
Very Much
Some
A little
Not at all
Not Applicable
Impact of Nancy’s House closing
Have you been impacted by the
closing?
11, 14%
If so, please tell us with which
agency/agencies you either have
or intend to make contact .
11, 14%
Chattanooga CARES
1, 7%
1, 7%
Channels Of Love
Yes
6, 43%
No
No Response
4, 29%
Both and other
agency
2, 14%
57, 72%
Both
Neither
COMMENTS

My sincere thanks to CARES, Dept of Health, RW Program, etc and everyone that has helped maintain
good health and quality of life not only to myself but others as well.

Keep CARES staff as it was. Transportation to Dr. visits other than CARES.

I am very satisfied with all of the services in TN and I try to be very understanding when there is a lack of
funds or help b/c I know there are a lot of us out here that need help. I pray everyday that my agency will
always be able to stabilize themselves in order to help me and that RW continues to provide my
medication cause I wouldn't know how else I will get it.

I'm very grateful to have Dr. Hill as my ID doctor.

I really need housing assistance and now the maximum is half what it was last year. I hope it gets better.
Maybe a little note to Elton John would turn things around.

Need to know some places where you can get household and hygiene stuff from when needed

I get good care. Don Ellis has been very helpful to me. I don't attend any support groups. I have a church
family and a lot of personal support. I get fed spiritually so I'm good. I do need my own place to live, but
am working on that, just waiting. I am so thankful for Ryan White. I would have died without them. I
started out with Channels of Love and all the people I used to be in support group with have died. I usually
attend their Christmas Party, but I don't make it to the support groups. I am usually babysitting. It's hard
for me to get there, but I like Channels. They are wonderful people.

I can't get no help from Section 8 housing . I got in touch with the MAC people. I need to know where I
stand in the program of section 8 housing my name is on the front of this letter.
COMMENTS

The only service I need, but don't receive, is eye care exams. If you cannot see it is hard to read and get
around.

I think the RW program is great. It helped me get glasses and getting my dental work done. If it was not
for the program I would not have glasses or get dental work done. They also helped me with rent one
time. Thanks a lot for the program. I hope it stays around to help others in need.

Would like contacts for people, #s to contact in case of need and what services are offered.

SE TN needs more services for HIV/AIDS in the rural areas.

I am very satisfied with my services with CARE and Channels of Love. If it was not so, then a lot of times I
wouldn't make it. The Doctors are great and the staff at both places are the bomb. And I thank Ryan White
foundation for all the help too.

Staff needs to be trained better on services available and more resources available in lobby. Update POZ
magazines available. Spend money wisely. Get a newsletter and send out to keep clients updated. We
need to strive, not just survive.

I don't mind answering questions or asking them. I feel if I need anything or anyone, the agency will help
me.

If it wasn't for the RWF, I wouldn't be able to get my medicine, because my insurance was cut in 2003.

Legal services would be helpful and appreciated . Thank you.

Wish we had assistance w/larger procedures, like colonoscopy to check for colon cancer, etc.

Have gave up on help living in a rural community and this is the way it has been for a long time.

My biggest problem is low income after retirement. Food and supplements could be a problem in the
future if we don't get a S.S. increase soon