Positive Impact

RYAN WHITE PART C OUTPATIENT EIS PROGRAM

RYAN WHITE PART C OUTPATIENT EIS PROGRAM

COMPREHENSIVE HIGH-IMPACT HIV PREVENTION PROJECTS FOR COMMUNITY-BASED ORGANIZATIONS

I MATTER (INDIVIDUALIZED MEDICATION ASSISTED TREATMENT AND THERAPY TO EMBRACE RECOVERY) - THE I MATTER (INDIVIDUALIZED MEDICATION ASSISTED TREATMENT AND THERAPY TO EMBRACE RECOVERY) PROJECT PROPOSES TO EXPAND CURRENT MEDICATION ASSISTED TREATMENT (MAT) SERVICES BY 80% TO ADULTS (18 AND OLDER) CLINICALLY ASSESSED WITH AN OPIOID USE DISORDER (OUD), RESULTING IN 350 UNDUPLICATED PARTICIPANTS SERVED OVER FIVE YEARS. POSITIVE IMPACT HEALTH CENTERS WILL BE ABLE TO ENHANCE CURRENT MAT SERVICES BY USING EXTENDED RELEASE INJECTABLE NALTREXONE (VIVITROL). VIVITROL, GIVEN EVERY 28 DAYS, IS AN OPIOID ANTAGONIST THAT BLOCKS THE EFFECTS OF OPIOIDS. INJECTABLE NALTREXONE IS NOT MONITORED BY THE PRESCRIPTION DRUG MONITORING PROGRAM (PDMP) BECAUSE IT IS NOT A CONTROLLED SUBSTANCE, DOES NOT REQUIRE A DRUG ADDICTION TREATMENT ACT OF 2000 (DATA) WAIVER TO PRESCRIBE AND DISPENSE, AND IT IS LESS SUSCEPTIBLE TO DIVERSION FOR ILLICIT PURPOSES. THE MAT PROGRAM WILL SERVE UNDUPLICATED PARTICIPANTS OF 50 IN YEAR 1 (BEGINNING 3 MONTHS FOLLOWING GRANT AWARD), AND 75 UNDUPLICATED PARTICIPANTS IN YEARS 2-5. THE MAT PROGRAM WILL BE SUPPLEMENTED WITH COMPREHENSIVE, EVIDENCE-BASED SUBSTANCE ABUSE TREATMENT IN GROUP FORMAT; RECOVERY SUPPORT SERVICES (RSS) SUCH AS PEER SUPPORT IN COMPLETING THE WRAP (AN EBP; WELLNESS RECOVERY ACTION PLAN); INDIVIDUAL SUBSTANCE ABUSE AND MENTAL HEALTH COUNSELING; PSYCHIATRY; AND INCORPORATING TECHNOLOGY (I.E., TELEHEALTH AND A RECOVERY-ORIENTED SMARTPHONE APP). ADDITIONAL SERVICES INCLUDE SCREENING, BRIEF INTERVENTION, REFERRAL TO TREATMENT (SBIRT), A COMPREHENSIVE ASSESSMENT USING THE ADDICTION SEVERITY INDEX, TRANSPORTATION, AND HOUSING REFERRALS. BY ENHANCING TREATMENT WITH MOTIVATIONAL ENHANCEMENT THERAPY (AN EBP), THE I MATTER PROJECT WILL ALSO ASSIST PARTICIPANTS IN DECREASING AND/OR ABSTAINING FROM ILLICIT OPIOID USE AT 6-MONTH FOLLOW-UP AND IN REDUCING HIV TRANSMISSION RISKS BY SUSTAINING RECOVERY. AT LEAST 80% OF THE PROJECT PARTICIPANTS WILL RECEIVE A 6- AND 12-MONTH REASSESSMENT INTERVIEW. PARTICIPANTS WILL ENGAGE IN THE CURRENT STATE-LICENSED 9-MONTH DRUG AND ALCOHOL TREATMENT PROGRAM AT PIHC, WHICH IS BASED ON THE MATRIX MODEL, AN EBP AND HAS THREE 90-DAY PHASES OF GROUP-LEVEL ENGAGEMENT: INTENSIVE OUTPATIENT TREATMENT. TRANSITION, AND CONTINUING CARE. IN ADDITION, PARTICIPANTS IN THE PROJECT CAN ACCESS OTHER SERVICES PROVIDED BY PIHC, INCLUDING COGNITIVE PROCESSING THERAPY (AN EBP FOR PTSD), HIV TESTING (CDC-FUNDED), NO-COST PREP (PRE-EXPOSURE PROPHYLAXIS), HIV PRIMARY CARE (RYAN WHITE-FUNDED), HIV HOUSING ASSISTANCE (HOPWA-FUNDED), AND CIS- AND TRANSGENDER WOMEN’S PSYCHOTHERAPY GROUPS (HRSA-FUNDED). PARTICIPANTS THAT ARE UNINSURED OR UNDERINSURED WILL BE LINKED WITH A PIHC INSURANCE NAVIGATOR TO SECURE AN APPROPRIATE LEVEL OF INSURANCE THAT WILL INCLUDE COVERAGE FOR NALTREXONE AND DETOXIFICATION (AS NECESSARY). FOR OUTREACH AND COLLABORATION WITH COMMUNITY PARTNERS, OVER THE COURSE OF YEARS 1 – 5, PIHC STAFF AND PARTNER AGENCIES WILL RECEIVE AN IN-SERVICE PRESENTATION BY THE PROJECT STAFF PROVIDING INFORMATION ON AVAILABLE SERVICES AND EDUCATION ONCE PER YEAR TO ENCOURAGE STIGMA REDUCTION RELATED TO OUD/COD TREATMENT.

PURPOSE: TO IMPLEMENT A NEW PROJECT IN THE 20-COUNTY METRO ATLANTA THAT ELEVATES HOUSING AS AN EFFECTIVE STRUCTURAL INTERVENTION IN ENDING THE HIV EPIDEMIC.; ACTIVITIES TO BE PERFORMED: TENANT-BASED RENTAL ASSISTANCE, SHORT-TERM RENTAL, MORTGAGE AND UTILITY ASSISTANCE, PERMANENT HOUSING PLACEMENT, SUPPORTIVE SERVICES. ; EXPECTED OUTCOMES: TENANT-BASED RENTAL ASSISTANCE - 27 HOUSEHOLDS, SHORT-TERM RENTAL, MORTGAGE AND UTILITY ASSISTANCE- 45 HOUSEHOLDS, PERMANENT HOUSING PLACEMENT - 21 HOUSEHOLDS, SUPPORTIVE SERVICES - 25 HOUSEHOLDS. ; INTENDED BENEFICIARIES: LOW-INCOME PEOPLE WITH HIV; SUBRECIPIENT ACTIVITIES: N/A

HIV PREVENTION SERVICES FOR MEN WHO HAVE SEX WITH MEN - POSITIVE IMPACT HEALTH CENTERS IMPLEMENTS A FIVE YEAR HIV PREVENTION PROJECT THAT PROVIDES TARGETED HIV TESTING SERVICES IN VARIOUS VENUES FOR 12,500 MINORITY MEN WHO HAVE SEX WITH MEN THAT INCLUDES PERSONALIZED COGNITIVE COUNSELING FOR 875 REPEAT TESTERS. LINKAGE TO CARE SERVICES WILL BE PROVIDED WITHIN 30 DAYS FOR ALL NEWLY-IDENTIFIED HIV-POSITIVE PERSONS AND RE-ENGAGEMENT AND LINKAGE TO HIV CARE FOR PREVIOUSLY-IDENTIFIED HIV-POSITIVE PERSONS. INTEGRATED SCREENINGS FOR SEXUALLY TRANSMITTED INFECTIONS AND VIRAL HEPATITIS DURING THE HIV TESTING EVENT WILL BE PROVIDED FOR APPROPRIATE TEST CLIENTS. IMPLEMENTATION OF THE HIGH IMPACT PREVENTION BEHAVIORAL INTERVENTION PROMISE FOR BLACK MEN WHO HAVE SEX WITH MEN WILL INCREASE AWARENESS OF THE BENEFITS OF HIV TREATMENT AND PROMOTE MEDICATION ADHERENCE BY TRAINING 150 PEERS WHO WILL DISSEMINATE AT LEAST 65 ROLE MODEL STORIES. AT LEAST 150,000 CONDOMS WILL BE MADE AVAILABLE THROUGH CONDOM DISTRIBUTION EFFORTS.

FUSE: FACILITATING UNITED SERVICE EFFORTS

HIV PREVENTION FOR YOUNG MEN OF COLOR WHO HAVE SEX WITH MEN

THE GROWTH PROJECT (GAINING RECOVERY BY OBTAINING WHOLISTIC TREATMENT AND HOUSING) - THE GROWTH PROJECT (GAINING RECOVERY BY OBTAINING WHOLISTIC TREATMENT AND HOUSING) PROPOSES TO SCREEN AT LEAST 295 UNDUPLICATED INDIVIDUALS FOR SUD/COD AND ENROLL AT LEAST 195 UNDUPLICATED INDIVIDUALS IN SUD/COD TREATMENT AND RECOVERY SUPPORT SERVICES, INCLUDING STABLE HOUSING OVER THE SPAN OF THE 5-YEAR GRANT. THE PROJECT WILL EXPAND OPPORTUNITIES TO IMPROVE ACCESS TO AND DELIVERY OF COMPREHENSIVE, COORDINATED, AND EVIDENCE-BASED TREATMENT AND SERVICES FOR INDIVIDUALS WITH SUD/COD, INCLUDING THEIR FAMILIES AND YOUTH (18-24), WHO ARE EXPERIENCING HOMELESSNESS. THE PROJECT SUPPORTS THE EXPANSION OF COMMUNITY INFRASTRUCTURE THAT INTEGRATES EVIDENCE-BASED BEHAVIORAL HEALTH (SA/MH) TREATMENT, PEER SUPPORT, RECOVERY SUPPORT SERVICES, HIV/VH TESTING AND TREATMENT, AND LINKAGES TO SUSTAINABLE PERMANENT HOUSING WITH A FOCUS ON PEOPLE THAT IDENTIFY AS A RACIAL/ETHNIC, SEXUAL, AND/OR A GENDER MINORITY.

INDIVIDUALIZED RECOVERY WITH INTEGRATED SUPPORTIVE ELEMENTS (I-RISE) - THE INDIVIDUALIZED RECOVERY WITH INTEGRATED SUPPORTIVE ELEMENTS (I-RISE) PROJECT WILL DECREASE THE POTENTIAL FOR HIV AND VIRAL HEPATITIS (VH) TRANSMISSION FOR INDIVIDUALS ASSESSED WITH SUD/COD AMONG RACIAL/ETHNIC, AND GENDER AND/OR SEXUAL MINORITY INDIVIDUALS WHO ARE HIV POSITIVE OR AT RISK OF HIV, BY PROVIDING HIV/VH TESTING AND TREATMENT, PREP, EVIDENCE-BASED SUD TREATMENT, PEER SUPPORT, CARE COORDINATION, HARM REDUCTION, AND MEDICATION-ASSISTED TREATMENT. THE I-RISE PROJECT WILL RESULT IN AT LEAST 700 UNDUPLICATED INDIVIDUALS SCREENED AND ASSESSED FOR SUD/COD AND HIV/VH (100 IN THE FIRST 9-MONTHS AND 150 IN YEARS 2-5) AND AT LEAST 369 UNDUPLICATED INDIVIDUALS ENROLLED IN SUD/COD TREATMENT 50 IN THE FIRST 9-MONTHS, 63 IN YEAR 2, 78 IN YEAR 3, 86 IN YEAR 4, AND 92 IN YEAR 5). I-RISE WILL FOLLOW A TRAUMA-INFORMED PATIENT-CENTERED MEDICAL HOME (PCMH) MODEL, WHICH STRIVES TO INCREASE EACH INDIVIDUAL'S ADHERENCE TO CARE. ALL OF THE REQUIRED ACTIVITIES WILL OCCUR ON-SITE AT EACH OF PIHC'S THREE LOCATIONS IN DECATUR (DEKALB COUNTY), DULUTH (GWINNETT COUNTY), AND MARIETTA (COBB COUNTY). THE PIHC LOCATIONS ARE LOCATED IN THREE OF THE FOUR COUNTIES WITH THE HIGHEST INCIDENCES OF HIV IN THE STATE OF GEORGIA. THE I-RISE CARE COORDINATOR WILL LINK 100% OF THE PROJECT PARTICIPANTS AND THEIR SIGNIFICANT OTHERS TO ON-SITE HIV TESTING (RAPID AND CONFIRMATORY) AND, FOR THOSE CONFIRMED POSITIVE FOR HIV, WILL HAVE RAPID ENTRY TO PRIMARY CARE WITHIN 72 HOURS; VH TESTING, VH A/B VACCINATION SERIES, AND, FOR THOSE CONFIRMED AS POSITIVE FOR VH, WILL RECEIVE TREATMENT WITHIN ONE WEEK; THOSE CONFIRMED AS NEGATIVE FOR HIV WILL BE OFFERED PRE-EXPOSURE PROPHYLAXIS (PREP) SERVICES WITHIN ONE WEEK; AND WITHIN 48 HOURS, PARTICIPANTS CAN BEGIN OUTPATIENT TREATMENT, PEER SUPPORT SERVICES, AND COORDINATION OF OTHER RECOVERY SUPPORT SERVICES, INCLUDING HARM REDUCTION (E.G., SYRINGE EXCHANGE, ETC.), MEDICATION-ASSISTED TREATMENT USING ORAL AND INJECTABLE NALTREXONE, TRANSPORTATION AND RECOVERY HOUSING ASSISTANCE, AND COMPREHENSIVE CARE COORDINATION. I-RISE WILL USE THE FOLLOWING EVIDENCE-BASED PRACTICES: CONTINGENCY MANAGEMENT (CM), A BEHAVIORAL THERAPY, BASED ON OPERANT CONDITIONING PRINCIPLES, THAT SYSTEMATICALLY REINFORCES DESIRED BEHAVIORS WITH TANGIBLE REINFORCERS ALONG WITH VERBAL PRAISE AND RECOGNITION AND WITHHOLDS PUNISHMENT FOR UNDESIRED BEHAVIORS TO PROMOTE BEHAVIOR CHANGE AND INCREASE RETENTION IN TREATMENT; SOMATIC EXPERIENCING (SE), A RESILIENCY-BASED APPROACH TO TRAUMA TREATMENT, FOCUSING ON WORKING WITH ONE'S INNATE OR INNER RESILIENCE BY INCREASING CAPACITY FOR REGULATION OF EXCELL AUTOMATIC AROUSAL OFTEN FOUND IN THOSE WITH TRAUMA HISTORIES, COMMONLY REPORTED AMONGST THOSE LIVING WITH SUD/COD; AND THE WELLNESS RECOVERY ACTION PLAN (WRAP), A MANUALIZED INTERVENTION FOR SYMPTOM MANAGEMENT FOR PEOPLE WITH SUD/COD, FACILITATED BY TRAINED AND CERTIFIED PEER SUPPORT SPECIALISTS, THAT ASSISTS IN IDENTIFYING AND UNDERSTANDING PERSONAL WELLNESS RESOURCES AND HELPS DEVELOP A PLAN TO USE THESE RESOURCES.

CONNECTED CARE INITIATIVE: EVIDENCE-BASED INTEGRATION OF MENTAL HEALTH/CO-OCCURRING DISORDERS SERVICES AND PRIMARY CARE SERVICES FOR PEOPLE LIVING WITH, OR AT RISK OF, HIV - CONNECTED CARE INITIATIVE (CCI) INTEGRATES MENTAL HEALTH (MH) AND CO-OCCURRING DISORDER (COD) TREATMENT WITH HIV/VIRAL HEPATITIS (VH) MEDICAL CARE AND PREVENTION SERVICES, AT POSITIVE IMPACT HEALTH CENTERS, AN AIDS SERVICE ORGANIZATION WITH A 30-YEAR HISTORY IN THE ATLANTA, GA AREA. DURING THE FOUR-YEAR PROJECT, 376 PEOPLE LIVING WITH, AND AT RISK OF, HIV, WILL ENROLL IN EVIDENCE-BASED SERVICES, INCLUDING TRAUMA TREATMENT, PSYCHIATRY, CASE MANAGEMENT, AND PEER SUPPORT. THE MAJORITY OF CONSUMERS WILL BE AFRICAN AMERICANS WHO IDENTIFY AS GAY MEN OR CIS/TRANS WOMEN. THE OVERARCHING GOALS OF THIS INITIATIVE ARE TO: 1) REDUCE THE INCIDENCE OF HIV 2) IMPROVE HEALTH AND MENTAL HEALTH OUTCOMES FOR PEOPLE WITH MH/COD. THESE COULD NOT BE MORE CRITICAL THAN IN ATLANTA, WHERE, ACCORDING TO THE CDC, HIV IS 16 TIMES MORE PREVALENT THAN THE US PREVALENCE. SERVICE INTEGRATION IS FIRST KEY TO REACHING THESE GOALS. CCI IMPLEMENTS THE EVIDENCE-BASED PRACTICE (EBP) OF PATIENT CENTERED MEDICAL HOME (PCMH), A FORMAL CARE DELIVERY MODEL THAT PROVIDES CARE TO PATIENTS WHEN AND WHERE THEY NEED IT, IN A MANNER THEY CAN UNDERSTAND. MH/COD PROVIDERS, PRIMARY CARE PROVIDERS, AND CASE MANAGERS ARE ASSIGNED TO CARE TEAMS THAT MEET IN DAILY HUDDLES, AND WEEKLY FOR CASE CONSULTATION, ENSURING THAT CARE IS FULLY COORDINATED TO MEET PATIENT NEEDS. THE MODEL ALSO REQUIRES NON-TRADITIONAL HOURS, WALK-IN SERVICES, AND 24-HOUR EMERGENCY PHONE ACCESS TO PROVIDERS. THE SECOND KEY IS THE PROVISION OF ACCESSIBLE, EVIDENCE-BASED, CULTURALLY APPROPRIATE MH/COD TREATMENT. BECAUSE PEOPLE LIVING WITH HIV EXPERIENCE POST-TRAUMATIC STRESS DISORDER (PTSD) AT UP TO EIGHT TIMES THE GENERAL POPULATION RATE, AND UNTREATED MH/COD CAN LEAD TO RISK BEHAVIOR AND NON-ADHERENCE TO CARE, CCI UTILIZES TWO EBPS TO TREAT TRAUMA: COGNITIVE PROCESSING THERAPY (CPT), EYE MOVEMENT DESENSITIZATION AND REPROCESSING (EMDR). CCI ALSO PROVIDES PEER SUPPORT UTILIZING THE WELLNESS RECOVERY ACTION PLAN (WRAP). CCI CONSUMERS CAN ACCESS THE AGENCY'S WRAP-AROUND SERVICES THAT INCLUDE PSYCHIATRY, MEDICATION CO-PAY ASSISTANCE, CASE MANAGEMENT, HIV/VH TESTING, VH VACCINATION/TREATMENT, A LICENSED INTENSIVE OUTPATIENT SUBSTANCE ABUSE TREATMENT PROGRAM, AND MEDICATION ASSISTED TREATMENT FOR OPIOID USE. THE THIRD KEY IS TO REACH THOSE MOST AT NEED OF SERVICES, INCLUDING THE 29% OF PEOPLE LIVING WITH HIV IN ATLANTA WHO ARE NOT IN HIV CARE. CCI DOES THIS THROUGH A SUCCESSFUL PREVENTION STRATEGY: GEO-FENCED SOCIAL MEDIA ADVERTISEMENTS THAT ARE PUSHED WHEN PEOPLE ARE IN SPECIFIC LOCATIONS (SEX CLUBS, GAY BARS, AND BALLROOM SCENE EVENTS). IMPLEMENTATION OF THESE STRATEGIES RESULTS IN MORE INDIVIDUALS RECOVERING FROM MH/COD ISSUES, REDUCING HIV RISK BEHAVIOR AND, REDUCING LAPSES IN CARE.

HUMAN IMMUNODEFICIENCY VIRUS(HIV) PREVENTION PROJECTS FOR COMMUNITY BASED ORGS

FUSE-II (FACILITATING UNITED SERVICE EFFORTS): INTEGRATING MENTAL HEALTH AND CO-OCCURRING DISORDER TREATMENT WITH HIV PRIMARY CARE AND PREVENTION SERVICES.

THE GEORGIA HIV SUBSTANCE ABUSE TREATMENT ENGAGEMENT PROGRAM (GA HIV-STEP)

RYAN WHITE PART C OUTPATIENT EIS PROGRAM

HUMAN IMMUNODEFICIENCY VIRUS(HIV) PREVENTION PROJECTS FOR COMMUNITY BASED ORGS

TRANSFORM-TREATMENT, RECOVERY, & NAVIGATION SRVCS. FOR OVERCOMING RISKS IN MINORITIES

ENHANCED EXPRESS STI AND HIV SERVICES IN THE ATLANTA EMA - THE FUNDING THROUGH THE CDC SUPPORT AND SCALE UP OF HIV PREVENTION SERVICES IN SEXUAL HEALTH CLINICS WILL ENABLE POSITIVE IMPACT HEALTH CENTERS IN PARTNERSHIP WITH THE GWINNETT COUNTY BOARD OF HEALTH TO INCREASE THEIR EFFORT TO END THE HIV EPIDEMIC. POSITIVE IMPACT HEALTH CENTERS WILL IMPROVE THE UPTAKE OF HIV TESTING BY MEN WHO HAVE SEX WITH MEN AND AFRICAN AMERICAN WOMEN BY IMPROVING ITS EXISTING EXPRESS STI SCREENING SERVICES. OVER THE FIVE YEAR GRANT PERIOD IT WILL DOUBLE ITS CAPACITY TO PROVIDE HIV TESTING AND EXPRESS STI SCREENING SERVICES IN THE ATLANTA EMA. GWINNETT COUNTY BOARD OF HEALTH WILL ESTABLISH EXPRESS STI SCREENING SERVICES WITHIN THEIR PUBLIC HEALTH CENTERS INCREASING ACCESS TO THESE SERVICES FOR MEMBERS OF THE PRIORITY POPULATIONS, MEN WHO HAVE SEX WITH MEN AND AFRICAN AMERICAN WOMEN. OVER THE FIVE YEAR PERIOD THE PROJECT SEEKS TO PROVIDE OVER 38,000 PERSONS WITH HIV/STI SCREENING SERVICES, HEPATITIS VACCINATIONS, AND OTHER RELATED VACCINATIONS. ACCESS TO NEEDED TREATMENT SERVICES AND INCREASED ACCESS TO CONDOMS WILL BE AVAILABLE. LINKAGE TO CARE SERVICES WILL BE PROVIDED WITHIN 7 DAYS FOR ALL NEWLY-IDENTIFIED HIV-POSITIVE PERSONS AND RE-ENGAGEMENT AND LINKAGE TO HIV CARE FOR PREVIOUSLY-IDENTIFIED HIV-POSITIVE PERSONS. REFERRALS AND LINKAGE TO PREP AND PEP SERVICES WILL BE MADE FOR PERSONS DIAGNOSED AS HIV NEGATIVE TO FURTHER REDUCE THE TRANSMISSION OF HIV. PROJECT STAFF WILL ENGAGE 15 ADDITIONAL COLLABORATIONS WITH OTHER AGENCIES DURING THE PROJECT PERIOD TO STREAMLINE THE REFERRAL PROCESS AND PROMOTE THE AVAILABLE HIV/STI EXPRESS SERVICES AT BOTH POSITIVE IMPACT HEALTH CENTERS AND GWINNETT COUNTY BOARD OF HEALTH.

POSITIVE IMPACT HIV PREVENTION AND RISK REDUCTION PROJECT

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE - MINORITY HIV/AIDS FUND - PROJECT TITLE: CASHA: COLLABORATIVE APPROACH TO SYNDEMIC HEALTH IN ATLANTA – DEMONSTRATION SITE APPLICANT ORGANIZATION NAME: POSITIVE IMPACT HEALTH CENTERS (PIHC) ADDRESS: 2800 CENTURY PARKWAY, NE, SUITE 550, ATLANTA, GA 30345 PROJECT INVESTIGATOR: JUSTIN SMITH, MS, MPH PROJECT DIRECTOR: MICHELLE ALLEN, MPH EVALUATOR: DR. JAMILA EASLEY, DRPH, MPH CONTACT: 404.600.2420 EMAIL: JUSTIN.SMITH@PIHCGA.ORG AND MICHELLE.ALLEN@PIHCGA.ORG WEBSITE: WWW.POSITIVEIMPACTHEALTHCENTERS.ORG SUMMARY OF PROJECT: CASHA: COLLABORATIVE APPROACH TO SYNDEMIC HEALTH IN ATLANTA IS A PROJECT THAT AIMS TO IMPROVE HIV CARE AND TREATMENT FOR PEOPLE FROM RACIAL AND ETHNIC MINORITY GROUPS THROUGH A SYSTEM-LEVEL SYNDEMIC APPROACH. THE APPROACH ADDRESSES THE FOLLOWING FACTORS: 1) ENGAGEMENT AND RETENTION IN PRIMARY HIV CARE, 2) CARE AND TREATMENT FOR CO-OCCURRING AND INTERACTING CONDITIONS, INCLUDING MENTAL HEALTH (MH) AND/OR SUBSTANCE ABUSE (SA) CONDITIONS, AND 3) ADDRESSING SOCIAL DETERMINANTS OF HEALTH (SDOH), INCLUDING ACCESS TO CARE, INTIMATE PARTNER VIOLENCE (IPV), FOOD INSECURITY, UNSTABLE HOUSING, AND GENDER-AFFIRMING CARE. PIHC WILL INTEGRATE A SYSTEM-LEVEL APPROACH WITH COMMUNITY-BASED NAVIGATION SERVICES AND A CAPACITY-BUILDING COMPONENT TO MENTOR AND GUIDE SMALL COMMUNITY-BASED ORGANIZATIONS (CBOS) THAT PRIORITIZE SERVING RACIAL/ETHNIC MINORITY POPULATIONS AND ARE ALSO LED BY MEMBERS OF THESE COMMUNITIES. THIS INTERVENTION AIMS TO EXPAND THE COMMUNITY'S REACH, FACILITATE A SMOOTH TRANSITION, AND ACCELERATE THE PROCESS OF CONNECTING INDIVIDUALS NEWLY DIAGNOSED WITH HIV, OUT OF CARE, OR AT GREATEST RISK OF BEING LOST TO CARE IN METRO ATLANTA. THIS EFFORT IS INTENDED TO CONTRIBUTE TO ENDING THE HIV EPIDEMIC. PRIORITY POPULATION(S): BLACK AND LATINO GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WITH MEN (MSM), BLACK CISGENDER WOMEN, BLACK TRANSGENDER WOMEN, AND YOUNG BLACK MSM 18-24. GOALS AND OBJECTIVES: OVERALL - 90% OF CASHA CLIENTS WILL BE RETAINE D IN HIV CARE, WITH 90% OF RETAINED CLIENTS ACHIEVING VIRAL SUPPRESSION AND: CLIENT LEVEL OUTCOMES: 200 NEWLY DIAGNOSED INDIVIDUALS WITH HIV OR INDIVIDUALS WHO ARE NOT RECEIVING HIV CARE WILL BE CONNECTED TO RAPID ENTRY/SAME-DAY CARE AND TREATMENT AND MH/SA SERVICES, AND SDOH SUPPORT AT PIHC. THIS WILL BE DONE THROUGH NAVIGATORS AT FOUR RACIAL/ETHNIC MINORITY-FOCUSED CBOS: 1) THRIVE SS, 2) LATINO LINQ, 3) H.Y.P.E TO EMPOWER, AND 4) A BLACK CIS/TRANSGENDER WOMEN'S CBO (YEAR 2). • REDUCED DISEASE BURDEN • ENHANCED TREATMENT EFFECTIVENESS • REDUCED HEALTHCARE COSTS SYSTEM-LEVEL OUTCOMES: • INCREASED ACCESS TO CARE • EMPOWERMENT AND SOCIAL SUPPORT • REDUCED HEALTH DISPARITIES • IMPROVED DATA COLLECTION AND ANALYSIS • DEVELOPMENT OF BEST PRACTICES • MORE EFFECTIVE RESOURCE ALLOCATION SUMMARY OF FUNDING: PIHC REQUESTS $500,000 FOR THE FIRST YEAR AND $700,000 FOR YEARS 2-4

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

THE SUBSTANCE USE AND HIV NAVIGATION PROJECT (SUHN) - THE SUBSTANCE USE AND HIV NAVIGATION PROJECT (SUHN) WILL REDUCE HEALTH DISPARITIES FOR RACIAL/ETHNIC MINORITY ADULTS FROM SUBPOPULATIONS (MSM, MSMW, LGBTQ+) BY PROVIDING SUBSTANCE USE PREVENTION (25 UNDUPLICATED IN YEAR 1, INCREASING TO 55 IN YEAR 5) AND HIV PREVENTION (30 UNDUPLICATED IN YEAR 1, INCREASING TO 85 IN YEAR 5) FOR INDIVIDUALS AT HIGH-RISK FOR SUBSTANCE USE DISORDERS (SUDS) AND HIV INFECTION, WHO ARE NOT IN STABLE HOUSING AND/OR RESIDE IN COMMUNITIES WITH HIGH RATES OF HIV, VIRAL HEPATITIS (VH), AND/OR SEXUALLY TRANSMITTED INFECTIONS (STIS). BY USING EVIDENCE-BASED PRACTICES FOR SUDS AND HIV PREVENTION STRATEGIES, EXPECTED OUTCOMES FOR THE POPULATIONS OF FOCUS INCLUDE DECREASED USE OF SUBSTANCES THROUGH SUD/COD TREATMENT; INCREASED HIV TESTING AND DIAGNOSIS OF HIV FOR INDIVIDUALS WITH OR AT RISK FOR SUD/COD; AN INCREASE IN THESE INDIVIDUALS LINKED TO AND RETAINED IN HIV MEDICAL CARE TOWARD SUSTAINED VIRAL SUPPRESSION; AND LINKAGE TO STABLE HOUSING. THE SUHN PROJECT WILL BE BASED ON THE STRATEGIC PREVENTION FRAMEWORK (SPF) BY DESIGNING AND IMPLEMENTING A COMPREHENSIVE STRATEGIC PLAN TO ADDRESS SUD/COD AND HIV/VH/STI AMONG THE POPULATION OF FOCUS BY CONDUCTING AN INITIAL NEEDS ASSESSMENT, BUILDING CAPACITY, AND ASSESSING PROJECT PERFORMANCE.

REALISTIC ALTERNATIVES PREVENTION PROJECT (RAPP)

COMPREHENSIVE HIGH-IMPACT HIV PREVENTION PROJECTS FOR COMMUNITY-BASED ORGANIZATIONS

REALISTIC ALTERNATIVES PREVENTION PROJECT (RAPP)

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

RYAN WHITE PART C OUTPATIENT EIS PROGRAM

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS - PIHC WILL PURCHASE DENTAL EQUIPMENT FOR $150,000 TO DEVELOP AN ON-SITE DENTAL CLINIC AT ITS MARIETTA CENTER. THE GOALS OF THIS INITIATIVE ARE TO INCREASE ACCESS TO AND RETENTION IN CARE, IMPROVE OUTCOMES FOR ORAL HEALTH, ACHIEVE A MORE COORDINATED RESPONSE IN PATIENT CARE, AND STANDARDIZE FOLLOW-UP AND DATA TRACKING THROUGH THE ELECTRONIC DENTAL RECORD (EDR), WHICH INTERFACES WITH THE ELECTRONIC MEDICAL RECORD (EMR); AND DEVELOP A PRIMARY CARE AND ORAL HEALTH TEAM AT THE MARIETTA CENTER. PIHC IS SEEKING FUNDING THROUGH THE RYAN WHITE HIV/AIDS PROGRAM PART C CAPACITY DEVELOPMENT PROGRAM UNDER THE PROPOSED ACTIVITY CATEGORY OF INFRASTRUCTURE DEVELOPMENT.

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS - PIHC PROPOSES TO HIRE TWO CONSULTANTS TO PROVIDE ASSESSMENT, TRAINING AND EDUCATION ON INCLUSIVE MEDICAL INTAKE AND REGISTRATION FORMS, TAKING A GENDER-AFFIRMING HISTORY, CONDUCTING A GENDER-AFFIRMING PHYSICAL ASSESSMENT, AND IMPLEMENTING ANATOMICALLY APPROPRIATE PREVENTIVE HEALTH SCREENINGS AND GENDER-AFFIRMING CULTURAL COMPETENCY TRAINING. THE GOALS OF THIS INITIATIVE ARE TO PROVIDE EDUCATION AND TRAINING FOR THE PIHC CLINICAL AND BEHAVIORAL HEALTH SETTINGS, ENHANCE THE COLLABORATIVE NETWORK WITH THE PIHC GENDER INCLUSIVE DEPARTMENT, AND DEVELOP A MODEL OF CARE INFRASTRUCTURE AND CLINICAL APPLICATION. PIHC'S GENDER INCLUSIVE DEPARTMENT AND THE VARIOUS PROGRAMS AND SERVICES ENHANCE PATIENT CARE FOR THE GENDER NON-CONFORMING PERSONS AND/OR PERSONS OF TRANSGENDER EXPERIENCE AND DECREASE BARRIERS TO CARE, SUCH AS STIGMA AND TRANSPORTATION. ALTHOUGH THE PROGRAMS AND SERVICES FOR GENDER-AFFIRMING CARE HAVE EXPANDED, A COMPREHENSIVE MODEL OF CARE INFRASTRUCTURE AND CLINICAL APPLICATION HAS YET TO BE FULLY ACHIEVED. INCREASED EDUCATION AND TRAINING IN PIHC’S CLINICAL AND BEHAVIORAL HEALTH SETTINGS WILL ASSIST IN BUILDING CAPACITY. IN ADDITION, INCREASED SUPPORT FOR A COLLABORATIVE NETWORK OF THE GENDER-INCLUSIVE, CLINICAL, AND BEHAVIORAL HEALTH TEAMS WILL ASSIST IN ACHIEVING OPTIMAL POSITIVE HEALTH OUTCOMES FOR THIS POPULATION. EXPECTED OUTCOMES FROM PROVIDING TRAINING AND EDUCATION ON INCLUSIVE MEDICAL INTAKE AND REGISTRATION FORMS, TAKING A GENDER-AFFIRMING HISTORY, CONDUCTING A GENDER-AFFIRMING PHYSICAL ASSESSMENT, AND IMPLEMENTING ANATOMICALLY APPROPRIATE PREVENTIVE HEALTH SCREENINGS, AND GENDER-AFFIRMING CULTURAL COMPETENCY TRAINING WILL BENEFIT GENDER NON-CONFORMING PERSONS AND/OR PERSONS OF TRANSGENDER EXPERIENCE AT PIHC ACROSS THE AGENCY AND BUILD CAPACITY IN KNOWLEDGE, UNDERSTATING, AND PRACTICE. THE EXPECTED OUTCOMES OF THIS EXPANSION WILL BENEFIT PATIENT HEALTH AND INCREASE ACCESS TO AND RETENTION IN CARE. AREAS TO FURTHER BE IMPROV ED ARE (1) CREATING A SAFE ENVIRONMENT THAT BUILDS TRUST WITH HEALTH CARE PROVIDERS; (2) SUPPORTING DISCLOSING RELEVANT ASPECTS OF GENDER IDENTITY; (3) IMPLEMENTING INTERVENTIONS THAT IMPROVE MENTAL HEALTH OUTCOMES OF GENDER DIVERSE CLIENTS THROUGH SELF-ESTEEM BUILDING AND RESILIENCE; AND (4) IMPROVING THE AGENCY'S POLICIES, PROCEDURES AND COORDINATION PRACTICES SURROUNDING GENDER-AFFIRMING CARE.

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS

RYAN WHITE HIV/AIDS PROGRAM PART C EIS COVID-19 RESPONSE

POSITIVE IMPACT HIV PREVENTION AND RISK REDUCTION PROJECT

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS - THE ATLANTA AREA CONTINUES TO HAVE ONE OF THE WORST HIV EPIDEMICS IN THE COUNTRY, WHETHER MEASURED BY TOTAL PLWH, NEW DIAGNOSES, POOR HEALTH OUTCOMES, OR MINORITY HEALTH DISPARITIES. IN 2020, POSITIVE IMPACT HEALTH CENTERS (PIHC) RECEIVED FUNDING FROM RYAN WHITE HIV/AIDS PROGRAM PART C CAPACITY DEVELOPMENT GRANT TO PURCHASE DENTAL EQUIPMENT RESULTING IN THE DEVELOPMENT OF AN ON-SITE DENTAL CLINIC AT ITS DULUTH CENTER. FOR 2022, PIHC PROPOSES TO PURCHASE AND IMPLEMENT AN ELECTRONIC DENTAL RECORD (EDR) TO ENHANCE PRACTICE MANAGEMENT MODULES FOR THE ON-SITE DENTAL CLINIC AT THE DULUTH CENTER. THE GOALS OF THIS INITIATIVE ARE TO INCREASE ACCESS TO AND RETENTION IN CARE, IMPROVE OUTCOMES FOR ORAL HEALTH, ACHIEVE A MORE COORDINATED RESPONSE IN PATIENT CARE, STANDARDIZE FOLLOW-UP AND DATA TRACKING THROUGH AN ELECTRONIC DENTAL RECORD (EDR), WHICH WILL INTERFACE WITH THE AGENCY ELECTRONIC HEALTH RECORD (EHR), AND FOSTER THE INTEGRATION OF HIV PRIMARY CARE WITH ORAL HEALTH. PIHC IS SEEKING FUNDING THROUGH THE RYAN WHITE HIV/AIDS PROGRAM PART C CAPACITY DEVELOPMENT PROGRAM UNDER THE PROPOSED ACTIVITY CATEGORY OF HIV CARE INNOVATION. PIHC'S ON-SITE DENTAL CLINIC ENHANCES THE PATIENT CARE EXPERIENCE AND DECREASES BARRIERS TO CARE, SUCH AS STIGMA AND TRANSPORTATION. CURRENTLY, MAINTAINING ORAL HEALTH DATA AND OUTCOMES WHICH INTERFACE WITH THE AGENCY'S EHR HAS NOT BEEN ACHIEVED. AN EDR IS IMPORTANT, BUT THE NEED FOR THE EDR TO INTERFACE WITH THE AGENCY'S EHR IS CRITICAL FOR INTEGRATING AND COORDINATING PATIENT CARE AND ACHIEVING OPTIMAL POSITIVE HEALTH OUTCOMES. EXPECTED OUTCOMES FROM PURCHASING AND IMPLEMENTING THE EDR TO INTERFACE WITH THE AGENCY'S EHR WILL BENEFIT EVERY SERVICE AREA AND ADMINISTRATIVE RESPONSIBILITIES ACROSS THE AGENCY AND BUILD CAPACITY. IN AREAS THAT PROVIDE DIRECT PATIENT CARE, THE EXPECTED OUTCOMES OF THIS EXPANSION WILL BENEFIT PATIENT HEALTH AND INCREASE ACCESS TO AND RETENTION IN CARE. AREAS TO FURTHER BE IMPROVED ARE: (1) STANDARDIZING THE REFERRAL PROCESS TO INCREASE COMPLIANCE WITH SCHEDULING APPOINTMENTS; (2) DECREASING NO SHOWS BY ESTABLISHING A ONE-STOP-SHOP FOR PRIMARY AND ORAL HEALTH CARE; (3) DATA SHARING ACROSS PRIMARY CARE AND ORAL HEALTH TO PROMOTE CONSISTENCY WITH PATIENT CARE AND HEALTH MANAGEMENT; AND (4) DEVELOPING PERFORMANCE METRICS TO TRACK OUTCOMES WITH THE GOAL OF INCREASED PATIENT ACCESS BY 40-50% ATTENDING APPOINTMENTS. IN ADDITION, ADDING THE EDR, WHICH INTERFACES WITH THE AGENCY'S EHR, WILL IMPROVE THE AGENCY'S POLICIES AND PROCEDURES SURROUNDING CONTRACT INVOICING, BILLING, AND DATA COLLECTION AND REPORTING. PIHC CURRENTLY SERVES 3,800 PLWH WITH MEDICAL CARE, 490 WITH ORAL HEALTH CARE, 930 WITH MENTAL HEALTH AND/OR SUBSTANCE ABUSE (MH/SA) SERVICES, AND 1,000 PATIENTS ARE ENROLLED IN PREP. THE ORGANIZATION TESTS OVER 9,000 INDIVIDUALS EACH YEAR (MANY OF WHOM ARE AT HIGH RISK FOR HIV/HEPATITIS). THE TESTING DEPARTMENT IDENTIFIES NEARLY 200 NEW HIV DIAGNOSES PER YEAR, WITH MOST BECOMING PIHC CLIENTS. THE ORGANIZATION CONTINUES TO EXPERIENCE AN INCREASED DEMAND FOR SERVICES DUE TO THE OVERALL UNMET NEEDS FOR PLWH IN THE ATLANTA EMA. SERVING MORE PATIENTS, ESPECIALLY THOSE OUT OF CARE, IS A PRIORITY.

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

HUMAN IMMUNODEFICIENCY VIRUS(HIV) PREVENTION PROJECTS FOR COMMUNITY BASED ORGS

TRANSFORM-TREATMENT, RECOVERY, & NAVIGATION SRVCS. FOR OVERCOMING RISKS IN MINORI

FUSE: FACILITATING UNITED SERVICE EFFORTS