Family Health Centers Of San Diego Inc

HEALTH CENTER CLUSTER

HEALTH CENTER CLUSTER

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

AFFORDABLE CARE ACT TEACHING HEALTH CENTER (THC) GRADUATE MEDICAL EDUCATION (GME) PAYMENT PROGRAM

AFFORDABLE CARE ACT - CAPITAL DEVELOPMENT GRANTS

RYAN WHITE PART C OUTPATIENT EIS PROGRAM

AFFORDABLE CARE ACT TEACHING HEALTH CENTER (THC) GRADUATE MEDICAL EDUCATION (GME) PAYMENT PROGRAM

RYAN WHITE PART C OUTPATIENT EIS PROGRAM

TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION PROGRAM

HEALTH CENTER CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY (CARES) ACT FUNDING

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

ARRA - HEALTH INFORMATION TECHNOLOGY IMPLEMENTATION

TEACHING HEALTH CENTER (THC) GRADUATE MEDICAL EDUCATION (GME) PAYMENT PROGRAM

ARRA - CAPITAL IMPROVEMENT PROGRAM

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

HIGH-IMPACT HIV PREVENTION PARTNERSHIP SERVING SAN DIEGO COUNTY - PROJECT ABSTRACT SUMMARYFAMILY HEALTH CENTERS OF SAN DIEGO (FHCSD), THE TENTH LARGEST FEDERALLY QUALIFIED HEALTH CENTER (FQHC) IN THE NATION AND THE LARGEST PROVIDER OF COMPREHENSIVE HIV PREVENTION, OUTREACH, TESTING, AND SUPPORT SERVICES IN SAN DIEGO COUNTY, PROPOSES TO CONTINUE AND ENHANCE OUR CDC COMPREHENSIVE HIGH-IMPACT HIV PREVENTION PROGRAM FOR COMMUNITY-BASED ORGANIZATIONS (CBO HIP PROGRAM), IN PARTNERSHIP WITH VISTA COMMUNITY CLINIC (VCC) AND THE SAN DIEGO LESBIAN, GAY, BISEXUAL AND TRANSGENDER COMMUNITY CENTER (THE CENTER), TO IMPROVE ACCESS TO CULTURALLY AND LINGUISTICALLY COMPETENT HIV NAVIGATION SERVICES, TESTING, MEDICAL CARE, PREVENTION, AND SUPPORTIVE SERVICES FOR MEN WHO HAVE SEX WITH MEN (MSM), WITH AN EMPHASIS ON THE ETHNIC AND RACIAL MINORITIES LOCAL SURVEILLANCE DATA IDENTIFY AS MOST SEVERELY AND DISPROPORTIONATELY AFFECTED BY THE HIV EPIDEMIC IN OUR LOCAL HEALTH JURISDICTION, SAN DIEGO COUNTY. THE PURPOSE OF THIS PROGRAM IS TO CONTINUE AND ENHANCE EXISTING CBO HIP STRATEGIES THAT DIAGNOSE HIV AS EARLY AS POSSIBLE, TREAT HIV QUICKLY AND EFFECTIVELY, PREVENT NEW HIV CASES, AND RESPOND QUICKLY TO HIV CLUSTERS. THIS WILL BE ACHIEVED THROUGH WIDELY AVAILABLE HIV TESTING IN A VARIETY OF SETTINGS THAT ARE ACCESSIBLE AND FAMILIAR TO THE TARGET POPULATION (TP), INTEGRATED HIV AND STD SCREENING, CULTURALLY AND LINGUISTICALLY COMPETENT RAPID LINKAGE TO CARE THROUGH HIV NAVIGATION SERVICES THAT PROVIDE INTENSIVE SUPPORT THROUGHOUT THE LINKAGE-TO-CARE PROCESS FOR BOTH PERSONS WITH HIV AND HIGH-RISK NEGATIVE (HRN) PERSONS, PERSONALIZED COGNITIVE COUNSELING FOR REPEAT TESTERS, REFERRALS TO PARTNER SERVICES (PS), STAY CONNECTED MEDICATION ADHERENCE SERVICES PROVIDED IN AN FQHC SETTING, EXPANDED USE OF SOCIAL NETWORK STRATEGY RECRUITMENT AND COMMUNITY PROMISE FOR HIP BEHAVIORAL INTERVENTION STRATEGIES CONDUCTED BY THE TP FOR THE TP, INNOVATIVE TECHNOLOGY SUPPORTED APPROACHES, CONDOM DISTRIBUTION, LINKAGE AND REFERRALS TO A HOST OF PREVENTIO N AND OTHER ESSENTIAL SERVICES PROVIDED BY PROJECT PARTNERS AND OUR NETWORK OF OVER 400 COMMUNITY PARTNERS, AND COORDINATION AND INTEGRATION OF CBO HIP SERVICES WITH OTHER HIV SERVICES IN SAN DIEGO COUNTY THROUGH PARTICIPATION IN THE SAN DIEGO COUNTY HIV PLANNING GROUP. FHCSD?S CBO HIP PROGRAM PROPOSES TO ACHIEVE THE FOLLOWING PERFORMANCE OUTCOMES BY THE END OF THE 5-YEAR PROJECT PERIOD: DIAGNOSE: INCREASE THE NUMBER OF PERSONS WHO ARE AWARE OF THEIR HIV STATUS TO A MINIMUM OF 7,500 (1,500 PER YEAR) THROUGH TARGETED HIV TESTING, ENSURING THAT 5,625 (1,125 PER YEAR) OR 75% OF THOSE TESTED ARE MEMBERS OF THE TP, AND INCREASE RECEIPT OF INTEGRATED HIV AND STD SCREENINGS, ENSURING THAT A MINIMUM OF 5,680 (1,136 PER YEAR) OR 75% OF ALL HRN CLIENTS AND CLIENTS WITH HIV RECEIVE INTEGRATED SCREENINGS. TREAT: INCREASE RECEIPT OF HIV MEDICAL CARE AND ANTIRETROVIRAL THERAPY (ART) AMONG PERSONS WITH NEWLY DIAGNOSED HIV, ENSURING A MINIMUM OF 90 (18 PER YEAR) OR 90% OF CLIENTS WITH NEWLY DIAGNOSED HIV ARE LINKED TO HIV MEDICAL CARE AND ART WITHIN 30 DAYS OF DIAGNOSIS; INCREASE RECEIPT OF HIV MEDICAL CARE AND ART AMONG PERSONS WITH PREVIOUSLY DIAGNOSED HIV BY ENSURING THAT A MINIMUM OF 55 (11 PER YEAR) OR 75% OF CLIENTS WITH PREVIOUSLY DIAGNOSED HIV WHO ARE NOT-IN-CARE ARE LINKED TO OR RE-ENGAGED IN CARE WITHIN 30 DAYS; AND INCREASE ACCESS TO PS AMONG PERSONS WITH HIV BY ENSURING 175 (35 PER YEAR) OR 100% OF CLIENTS WITH HIV ARE REFERRED TO PS. PREVENT: INCREASE ACCESS TO PRE-EXPOSURE PROPHYLAXIS (PREP) BY ENSURING A MINIMUM OF 6,660 OR 80% (1,332 PER YEAR) OF HRN CLIENTS ARE REFERRED TO PREP; AND INCREASE THE AVAILABILITY OF CONDOMS BY DISTRIBUTING 100,000 (20,000 PER YEAR) CONDOMS TO PERSONS WITH HIV AND HRN PERSONS.

ARRA - INCREASE SERVICES TO HEALTH CENTERS

HEALTH CENTER INFRASTRUCTURE SUPPORT

OPTIMIZING VIRTUAL CARE

COMPREHENSIVE HIGH-IMPACT HIV PREVENTION PROGRAMS FOR YOUNG MEN OF COLOR WHO HAVE SEX WITH MEN (CATEGORY A)

MOBILE HARM REDUCTION TEAM - POPULATIONS SERVED: FAMILY HEALTH CENTERS OF SAN DIEGO’S (FHCSD) MOBILE HARM REDUCTION TEAM (M-HRT) PROGRAM WILL ENGAGE, SCREEN AND ENROLL 350 INDIVIDUALS, YOUTH, AND FAMILIES WHO ARE EXPERIENCING HOMELESSNESS AND SUBSTANCE USE DISORDER (SUD) OR CO-OCCURRING MENTAL HEALTH CONDITIONS (COD) THROUGH FIELD-BASED OUTREACH AND ENGAGEMENT IN M-HRT SERVICES. OPERATING IN CONJUNCTION WITH THE OPERATIONAL HOURS AND VARIOUS SITE LOCATIONS OF FHCSD’S SAFE SYRINGE PROGRAM AND SURROUNDING NEIGHBORHOODS, WE ANTICIPATE THAT OUR POPULATION OF FOCUS (POF) WILL DISPROPORTIONATELY BE EXPERIENCING SUD AND SERIOUS MENTAL ILLNESS (SMI) AND FACE SIGNIFICANT ECONOMIC, SOCIAL AND PHYSICAL BARRIERS TO MAINTAINING STABLE HOUSING, ACHIEVING OPTIMAL SMI AND SUD TREATMENT, AND ACCESSING OTHER SUPPORTIVE SERVICES. EACH YEAR, 20 HIGH-RISK M-HRT PARTICIPANTS WILL ALSO RECEIVE FINANCIAL SUPPORT FOR 3 MONTHS OF RECOVERY RESIDENCY. STRATEGIES AND INTERVENTIONS: M-HRT WILL ESTABLISH A COMPREHENSIVE AND HIGHLY COORDINATED PROGRAM THAT, WITH STRONG CASE MANAGEMENT AND PARTICIPANT SUPPORT, WILL PROVIDE: 1) PROGRAM SERVICES INCLUDING CASE MANAGEMENT, SUBSTANCE ABUSE AND MENTAL HEALTH TREATMENT AND RECOVERY SERVICES, HOMELESS SERVICES NAVIGATION, PEER SUPPORT WITHIN SUD SERVICES, AND HEALTH AND BENEFIT ENROLLMENT ASSISTANCE; 2) INTERNAL SUPPORTED REFERRALS TO WRAP-AROUND FHCSD SERVICES FOR PRIMARY AND DENTAL HEALTHCARE, MEDICATION ASSISTED TREATMENT, PSYCHIATRY, AND OTHER SERVICES PROVIDED BY FHCSD; AND 3) EXTERNAL REFERRALS TO COMMUNITY RESOURCES FOR NEEDS SUCH AS EMPLOYMENT ASSISTANCE, LEGAL AID, RESIDENTIAL TREATMENT, AS WELL AS OTHER SUPPORTIVE SERVICES AS INDICATED. M-HRT WILL EMPLOY EVIDENCE-BASED PRACTICES IN ALL ASPECTS OF THE PROGRAM, INCLUDING HARM REDUCTION (HR), INTENSIVE CASE MANAGEMENT (ICM), TRAUMA INFORMED CARE (TIC), MOTIVATIONAL INTERVIEWING (MI), COGNITIVE BEHAVIORAL THERAPY (CBT), AND RELAPSE PREVENTION (RP). ENHANCED ACCESS TO A HARD-TO-REACH POF THROUGH FIELD-BASED OUTREACH IN COLLABORATION WITH FHCSD’S SYRINGE SERVICES PROGRAM WILL ENHANCE THE SERVICE EXPERIENCE OF M-HRT PARTICIPANTS ACROSS THE CONTINUUM OF CARE BY SYSTEMATICALLY ASSESSING CLIENT NEEDS AND SERVICE GAPS, DEVELOPING STRATEGIC PARTNERSHIPS TO ADDRESS THOSE NEEDS, AND CONDUCTING CAREFUL AND ONGOING REVIEW OF SERVICE COLLABORATIONS TO SECURE THOSE NEEDS. GOALS AND OBJECTIVES: THE OVERARCHING GOAL OF M-HRT IS TO REDUCE SERVICE BARRIERS AND INCREASE ACCESS TO HIGH-INTENSITY SERVICE INTERVENTIONS BY EXPANDING FIELD-BASED SERVICES, INCREASING OUR CAPACITY TO REACH THE POF WITH ROBUST SERVICES THAT IMPACT THEIR HEALTH AND QUALITY OF LIFE. THIS WILL REDUCE INEQUITIES, TRAUMA, AND STIGMATIZATION FOR PARTICIPANTS AS IT IMPROVES THEIR CARE. OFFERING FIELD-BASED SERVICES ALSO INCREASES THE VISIBILITY OF AVAILABLE SERVICES TO, AND HEALTH EDUCATION FOR, THE POF. IT WILL ALSO INCREASE ACCESS TO AGE-APPROPRIATE SERVICES FOR SAN DIEGO’S RAPIDLY GROWING POPULATION OF OLDER ADULTS WITHIN M-HRT’S POF. OBJECTIVES INCLUDE ENROLLING 350 PARTICIPANTS OVER THE COURSE OF THE 5-YEAR PROJECT PERIOD (45 PARTICIPANTS WILL BE ENROLLED IN YEAR 1, AND 75 IN EACH OF YEARS 2-5); AND FUNDAMENTALLY ADDRESSING PARTICIPANT PSYCHOSOCIAL, MENTAL HEALTH, AND MEDICAL NEEDS THROUGH A RANGE OF SERVICES, THE DEVELOPMENT OF INDIVIDUALIZED CARE PLANS, INTERNAL AND EXTERNAL REFERRALS, AND LINKAGES TO CARE.

THE LOTUS PROJECT - FAMILY HEALTH CENTERS OF SAN DIEGO (FHCSD) AND SUBCONTRACTOR, VISTA COMMUNITY CLINIC (VCC), BOTH NON-PROFIT, FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS) LOCATED IN SAN DIEGO COUNTY, CALIFORNIA, WILL ENGAGE IN CARE (OVER THE 5-YEAR PROJECT PERIOD) 480 INDIVIDUALS FROM THE POPULATION OF FOCUS (POF), RACIAL AND ETHNIC UNDERREPRESENTED INDIVIDUALS (PARTICULARLY AFRICAN AMERICANS AND HISPANICS) 18+ YEARS WITH SUBSTANCE USE DISORDERS (SUD) AND/OR CO-OCCURRING DISORDERS (COD) WHO ARE AT HIGH RISK FOR OR LIVING WITH HIV/AIDS. ACCORDING TO LOCAL EPIDEMIOLOGICAL DATA , HIV CONTINUES TO DISPROPORTIONATELY IMPACT AFRICAN AMERICANS AND HISPANICS IN THE COUNTY: AFRICAN AMERICANS WHO CONSTITUTE LESS THAN 6% OF THE COUNTY’S POPULATION, REPRESENT 12% OF ALL RECENT HIV DIAGNOSES, 13% OF ALL PLWH, AND 13.2% OF THOSE UNAWARE OF THEIR INFECTION. HISPANICS CONSTITUTE 34% OF THE POPULATION AND REPRESENT 48% OF ALL RECENT HIV DIAGNOSES, 42.2% OF PLWH, AND 49.6% OF THOSE UNAWARE OF THEIR INFECTION. IN THE PROPOSED LOTUS PROJECT, FHCSD AND VCC WILL DEPLOY HEALTH NAVIGATORS (HNS) WHO WILL CONDUCT OUTREACH THROUGHOUT THE COUNTY AND IN-REACH THROUGH OUR COMBINED 34 (FHCSD-24 AND VCC-10) PRIMARY CLINICS (COMPLETING 700 IN YEAR 1 AND 800 IN YEARS 2-5 ENCOUNTERS) TO RECRUIT THE POF, INCLUDING MEN WHO HAVE SEX WITH MEN (MSM), PEOPLE WHO INJECT DRUGS (PWID), MSM+PWID, CIS- AND TRANSGENDER WOMEN, AND THEIR SEXUAL AND DRUG-USING PARTNERS. HNS WILL PROVIDE HIV/HCV (PRELIMINARY AND CONFIRMATORY) TESTING AND COUNSELING, COMPLETING (600 IN YEAR 1 AND 700 IN YEARS 2-5 HIV AND 150 IN YEAR 1 AND 200 IN YEARS 2-5 HCV) TESTS, AND AS MANY SUD/COD SCREENINGS. HNS WILL LINK 80% HIV+ AND 95% OF HCV REACTIVE OR HIGH-RISK (FOR HIV) NEGATIVES (HRNS) TO CARE, INCLUDING IN-HOUSE HIV/VIRAL HEPATITIS PRIMARY CARE, RYAN WHITE MEDICAL AND NON-MEDICAL CASE MANAGEMENT, AND PREP, WITHIN HOURS AND NO MORE THAN 30 DAYS, REPORTING ALL HIV/HCV POSITIVES TO LOCAL AND STATE OFFICIALS AS REQUIRED. HNS WILL ALSO PROVIDE SUD/COD SCREENINGS AND REFERRALS/LINKAGES TO IN-HOUSE PROVIDERS, ENROLLING (80 IN YEAR 1 AND 100 IN YEARS 2-5) FROM ALL GROUPS WILLING TO PARTICIPATE AND SCREEN POSITIVE FOR AN SUD/COD INTO CHOOSING LIFE, EMPOWERMENT, ACTION, RESULTS (CLEAR), AN EVIDENCE-BASED, GOAL SETTING, RISK REDUCTION, AND MULTI-SESSION INTERVENTION. 75% OF CLEAR ENROLLEES REFERRED FOR SUD/COD CARE WILL RECEIVE COMPREHENSIVE SUD/COD SCREENING AND ASSESSMENTS, DEVELOP INDIVIDUAL SERVICE PLANS (ISPS), AND PARTICIPATE IN EVIDENCE-BASED SUD/COD TREATMENT AND RECOVERY SUPPORT SERVICES. 70% OF CLEAR COMPLETERS WILL REALIZE AT LEAST ONE BENEFICIAL LIFE CHANGE. MOST OF THE LOTUS PROJECT’S KEY PERSONNEL, THE PROGRAM DIRECTOR, PROGRAM MANAGER, PROGRAM COORDINATOR, HEALTH NAVIGATORS, ARE BI-CULTURAL AND BI-LINGUAL. ALL STAFF HAVE EXPERIENCE WORKING WITH THE POF AND ARE TRAINED IN TRAUMA INFORMED CARE AND MOTIVATIONAL INTERVIEWING. THE EXTERNAL EVALUATOR, WHO IS FROM THE INSTITUTE OF PUBLIC HEALTH AT SAN DIEGO STATE UNIVERSITY, HAS COLLABORATED WITH FHCSD FOR OVER 25 YEARS. VCC WILL FOCUS ON REACHING AND LINKING TO CARE THE POF IN SAN DIEGO’S NORTH COUNTY.

NURSE EDUCATION, PRACTICE, QUALITY, AND RETENTION - INTERPROFESSIONAL COLLBORATIVE PRACTICE

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

ARRA - HEALTH INFORMATION TECHNOLOGY IMPLEMENTATION

COMPREHENSIVE HIGH-IMPACT HIV PREVENTION PROJECT FOR YOUNG MEN OF COLOR WHO HAVE SEX WITH MEN SERVING SAN DIEGO COUNTY'S CENTRAL AND NORTH REGIONS

FY 2023 EXPANDING COVID-19 VACCINATION

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

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

NURSE EDUCATION, PRACTICE, QUALITY, AND RETENTION - INTERPROFESSIONAL COLLBORATIVE PRACTICE

CONNECTING KIDS TO COVERAGE OUTREACH AND ENROLLMENT COOPERATIVE AGREEMENTS - THE GOALS OF INSURE YOUR KIDS SD! ARE TO REDUCE THE NUMBER OF CHILDREN WHO ARE ELIGIBLE FOR, BUT NOT ENROLLED IN MEDI-CAL (CALIFORNIA’S MEDICAID PROGRAM), TO IMPROVE RETENTION OF CHILDREN ENROLLED IN MEDI-CAL, AND TO ASSIST PARENTS AND FAMILIES TO NAVIGATE THE APPLICATION AND RENEWAL PROCESS. OUR PROJECT WILL CONTINUE TO DEPLOY ENROLLMENT STRATEGIES THAT HAVE BEEN PROVEN EFFECTIVE OVER SEVERAL YEARS, COMBINING IN-REACH AND OUTREACH EFFORTS WITH ONLINE STRATEGIES AND THE AVAILABILITY OF VIRTUAL APPOINTMENTS TO MAXIMIZE REACH AND IMPACT. INSURE YOUR KIDS SD! STAFF WILL CONTINUE TO CONDUCT IN-REACH ACTIVITIES AT OUR HEALTH CENTERS, INCLUDING PEDIATRIC AND PRENATAL PATIENTS AND OUTREACH ACTIVITIES IN THE COMMUNITY AND AT CONVENIENT PARTNER SITES. OUR DEDICATED INSURANCE ENROLLMENT HOTLINE COMBINED WITH TARGETED MESSAGING FROM SOCIAL MARKETING AND GEOFENCING TECHNOLOGY WILL CONNECT ELIGIBLE CHILDREN, PARENTS, AND PREGNANT INDIVIDUALS TO ENROLLMENT ASSISTANCE SERVICES. FHCSD IS REQUESTING A TOTAL BUDGET OF $1,500,000 OVER 36 MONTHS TO ACHIEVE THE FOLLOWING GOALS: (1) ASSIST 9,411 CHILDREN, 4,844 PARENTS, AND 613 PREGNANT INDIVIDUALS TO SUBMIT A MEDI-CAL OR COVERED CALIFORNIA (CCA) (STATE HEALTHCARE EXCHANGE) ENROLLMENT APPLICATION; (2) ENROLL 6,404 CHILDREN, 3,201 PARENTS, AND 249 PREGNANT INDIVIDUALS IN MEDI-CAL OR CCA; AND (3) RENEW MEDI-CAL OR CCA COVERAGE FOR 3,658 CHILDREN, 1,650 PARENTS, AND 214 PREGNANT INDIVIDUALS. FUNDS WILL SUPPORT PERSONNEL AND TRAVEL (MILEAGE REIMBURSEMENT) TO CONDUCT IN-REACH, OUTREACH, AND ENROLLMENT ASSISTANCE TO ELIGIBLE CHILDREN, PARENTS, AND PREGNANT INDIVIDUALS. ADDITIONALLY, FUNDS WILL BE USED FOR ONLINE PATIENT ENGAGEMENT EFFORTS (ADS) TO DEPLOY TARGETED MESSAGING TO HARD-TO-REACH POCKETS OF UNINSURED CHILDREN, PARENTS, AND PREGNANT INDIVIDUALS. ESTIMATED NUMBER OF PEOPLE TO BE SERVED AS A RESULT OF THE AWARD OF THIS GRANT: 14,868

CONNECTING KIDS TO COVERAGE OUTREACH AND ENROLLMENT COOPERATIVE AGREEMENTS

NEXUS COMPREHENSIVE PATIENT NAVIGATION PROGRAM (NEXUS - CPNP)

RECOVERY ACT HEALTH CENTER CLUSTER PROGRAM

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

QUALITY IMPROVEMENT FUND - JUSTICE INVOLVED - FAMILY HEALTH CENTERS OF SAN DIEGO, INC. (FHCSD) (H80CS00224) WILL INCREASE THE NUMBER OF JUSTICE-INVOLVED INDIVIDUALS REENTERING THE COMMUNITY (JI-R) WHO ARE ACCESSING IN-SCOPE HEALTH CENTER SERVICES THAT ADDRESS CRITICAL HEALTH AND HEALTH-RELATED SOCIAL NEEDS BY IMPLEMENTING A MULTIFACETED, INNOVATIVE PROGRAM. FHCSD’S REENTRY SUPPORT SERVICES WILL ENGAGE A MINIMUM OF 1,000 JI-R IN PARTNERSHIP WITH THE SAN DIEGO COUNTY SHERIFF’S DEPARTMENT DURING THE 2-YEAR PROJECT PERIOD OF PERFORMANCE. NEEDS: JUSTICE-INVOLVED INDIVIDUALS (JII) HAVE A HIGHER RISK FOR INJURY AND DEATH THAN THE GENERAL PUBLIC, PROMPTING CALIFORNIA TO BECOME THE FIRST STATE IN THE NATION TO OFFER MEDICAID SERVICES SPECIFICALLY TARGETING ELIGIBLE YOUTH AND ADULTS IN STATE PRISONS, COUNTY JAILS, AND YOUTH CORRECTIONAL FACILITIES FOR UP TO 90 DAYS PRIOR TO THEIR RELEASE. AFTER RELEASE, JII FACE A HIGHER BURDEN OF MULTIPLE PHYSICAL AND MENTAL HEALTH CONDITIONS, INCLUDING SUBSTANCE USE DISORDER (SUD), AS WELL AS HIGHER RATES OF UNINSURANCE, POVERTY, AND USE OF EMERGENCY DEPARTMENT SERVICES THAN THE GENERAL POPULATION (HAWKS ET AL, 2020). NAVIGATING THE HEALTHCARE SYSTEM IS ALREADY CHALLENGING FOR MOST PEOPLE, BUT JII OFTEN HAVE A HARDER TIME DUE TO INCOMPLETE/MISSING DOCUMENTS, LOW HEALTH LITERACY, AND OTHER COMPETING LIFE PRIORITIES (E.G., FINANCIAL INSTABILITY, HOUSING INSTABILITY AND FOOD INSECURITY). OVER 100,000 OF THE APPROXIMATELY 1 MILLION UNINSURED CALIFORNIANS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE RESIDE IN SAN DIEGO COUNTY. EVEN AFTER SUCCESSFUL OUTREACH AND ENROLLMENT EFFORTS, JII FIND THEMSELVES UNABLE TO ACCESS THE SERVICES THEY NEED. A PILOT PROJECT INVOLVING JII WHO WERE FHCSD PATIENTS FROM 2017-2021 FOUND THAT AT ENROLLMENT ONLY ABOUT HALF HAD HEALTH INSURANCE COVERAGE, ONE THIRD WERE SEEKING CARE AT A CLINIC, ONE THIRD HAD AN UNMET HEALTH NEED, ONE THIRD WERE EMPLOYED, AND 85% REMAINED UNSTABLY HOUSED. PROPOSED SERVICES: FHCSD’S REENTRY SUPPORT SERVICES WILL BUILD UPON EXISTING EVIDENCE-BASED PRACTICES FROM THE TRANSITIONS CLINIC NETWORK (TCN) AND OFFER WRAPAROUND SERVICES TO CONNECT OR RECONNECT JI-R TO IN-SCOPE HEALTH CENTER SERVICES THAT ADDRESS THEIR UNIQUE CRITICAL HEALTH AND HEALTH-RELATED SOCIAL NEEDS. THE MULTIDISCIPLINARY CARE TEAM WILL INCLUDE COMMUNITY HEALTH WORKERS (CHW) WITH LIVED EXPERIENCES WITH INCARCERATION AND A CLINICAL CASE MANAGER WITH EXPERTISE IN VALUE-BASED CARE QUALITY OUTCOMES WHO TOGETHER WITH FHCSD’S LARGER SYSTEM OF CARE, WILL ASSESS, INFORM, REFER, AND ASSIST JII IN ACCESSING COMPREHENSIVE SERVICES IN A CULTURALLY RESPONSIVE MANNER. THE CHWS AND CLINICAL CASE MANAGER WILL SUPPORT JI-R WITH PRE-RELEASE TRANSITIONAL CARE MANAGEMENT TO ADDRESS BOTH SOCIALLY AND CLINICALLY COMPLEX NEEDS THAT REQUIRE FULL WRAPAROUND COORDINATION OF CARE. THE MULTIDISCIPLINARY CARE TEAM WILL WORK WITH THE JI-R CLIENTS ON INDIVIDUALIZED CARE PLANS AND HELP THEM NAVIGATE SERVICES IMMEDIATELY UPON RELEASE, INCLUDING BUT NOT LIMITED TO: CONNECTING THEM TO HEALTH INSURANCE COVERAGE, ESTABLISHING A MEDICAL HOME, AND ARRANGING TRANSPORTATION TO THEIR FIRST MEDICAL APPOINTMENT. FHCSD WILL IDENTIFY AT LEAST ONE PROVIDER CHAMPION WHO WILL SEE PATIENTS AND ALSO SUPPORT ORGANIZATION-WIDE EFFORTS TO ENHANCE CARE FOR JII CLIENTS. FHCSD WILL ALSO PARTNER WITH SAN DIEGO SECOND CHANCE TO OFFER CLIENTS WITH ACCESS TO SUPPORTIVE RESOURCES (E.G., JOB AND HOUSING READINESS) THAT AIM TO REDUCE RECIDIVISM AND BREAK THE CYCLE OF INCARCERATION IN THE COMMUNITY. POPULATIONS TO BE SERVED: FHCSD’S REENTRY SUPPORT SERVICES WILL ENGAGE A MINIMUM OF 1,000 JI-R ADULTS WITH CHRONIC CONDITIONS AND/OR AN UNMET BEHAVIORAL HEALTH NEED WITHIN THE SAN DIEGO COUNTY SHERIFF’S DEPARTMENT’S SYSTEM. THE POPULATION OF FOCUS WILL CONSIST OF RACIALLY AND ETHNICALLY DIVERSE, LOW-INCOME INDIVIDUALS WHO ARE PRIMARILY RESIDENTS OF OR ORIGINALLY HAVE TIES TO SAN DIEGO COUNTY.

PRODIGY PROJECT (PRODIGY)

HEALTH INFRASTRUCTURE INVESTMENT PROGRAM

FEMALE GENITAL CUTTING (FGC) COMMUNITY-CENTERED HEALTH CARE AND PREVENTION PROJECT

CONNECTING KIDS TO COVERAGE OUTREACH AND ENROLLMENT GRANT

PS06-618 HIV PREVENTION PROJECTS FOR YOUNG MEN OF COLOR AND YOUNG TRANSGENDER

ENHANCING STI AND SEXUAL HEALTH CLINIC INFRASTRUCTURE (ESSHCI) PROGRAM

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE - DEMONSTRATION/IMPLEMENTATION SITES

A MALE FAMILY PLANNING INITIATIVE IN CENTRAL SAN DIEGO

HUMAN IMMUNODEFICIENCY VIRUS(HIV)PREVENTION PROJECTS FOR CBO

THE SUPPORT FOR TRAUMA-AFFECTED REFUGEES (STAR) PROGRAM

HOME TO HEALTH (H2H) SAN DIEGO

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

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

FY 2024 BEHAVIORAL HEALTH SERVICE EXPANSION - FAMILY HEALTH CENTERS OF SAN DIEGO, INC. (FHCSD) (H80CS00224) WILL INCREASE THE NUMBER OF PATIENTS RECEIVING MENTAL HEALTH (MH) AND SUBSTANCE USE DISORDER (SUD) SERVICES, INCLUDING MEDICATION FOR OPIOID USE DISORDER (MOUD), BY 2025 (11.3% IN MH, 5.7% IN SUD, AND 34.8% IN MOUD) BY ENHANCING ITS STAFF CAPABILITIES THROUGH RECRUITMENT AND ADDITIONAL TRAINING. NEEDS: MH AND SUBSTANCE USE CRISES, ALONG WITH SUBSTANTIAL INEQUITY IN ACCESS TO CARE, ARE OF SIGNIFICANT CONCERN IN SAN DIEGO COUNTY. IN 2022, ABOUT 30% OF THE POPULATION REQUIRED HELP FOR EMOTIONAL/MENTAL HEALTH PROBLEMS OR ALCOHOL/DRUG USE, WITH AN OVERALL INCREASING TREND OVER THE YEARS. ACROSS FHCSD, OF THE 159,114 PATIENTS SERVED IN 2023, 14% RECEIVED MH AND 1.12% RECEIVED SUD SERVICES, MARKING RESPECTIVE INCREASES OF 28% AND 32% SINCE 2018. FURTHERMORE, SAN DIEGO COUNTY FACES A SEVERE SHORTAGE OF BEHAVIORAL HEALTH (BH) WORKERS, COMPROMISING ITS ABILITY TO PROVIDE MH AND SUD SERVICES EFFECTIVELY. A 2022 REPORT INDICATES THAT THE REGION EMPLOYS AROUND 17,000 BH PROFESSIONALS, 8,000 FEWER THAN THE REQUIRED 25,000, LEADING TO AN UNMET NEED FOR CARE OF OVER 6% FOR MH AND SUD SERVICES. PROJECTIONS SUGGEST A NEED TO HIRE 1,641 BY 2027, AN INCREASE OF 656 POSITIONS. FHCSD, ONE OF THE NATION’S LARGEST FEDERALLY QUALIFIED HEALTH CENTERS, ALSO EXPERIENCES ONGOING CHALLENGES IN RECRUITING BH PROFESSIONALS. OUR PATIENT POPULATION IS HIGHLY DIVERSE AND VULNERABLE, WITH 75% LIVING AT OR BELOW 100% OF THE FEDERAL POVERTY GUIDELINES AND 89% BELOW 200%, 27% UNINSURED, 77% RACIAL AND/OR ETHNIC MINORITIES, 39% BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH, AND 16.5% WITHOUT HOMES. IN 2023 ALONE, WE SERVED 21,770 MH, 1,777 SUD, AND 627 MOUD PATIENTS. PROPOSED SERVICES: TO STRENGTHEN OUR SYSTEM CAPACITY TO MEET THE GROWING NEEDS OF OUR COMMUNITY, OUR MAIN PRIORITY IS EXPANDING OUR BH WORKFORCE, SPECIFICALLY AT OUR NEW STAND-ALONE BH CLINIC SITES, TO ENSURE AN ADEQUATE PROVIDER SUPPLY FOR INTEGRATIVE AND COMPREHENSIVE BH CARE. THIS INCLUDES RECRUITING ADDITIONAL LICENSED CLINICAL SOCIAL WORKERS, MARRIAGE & FAMILY THERAPISTS, AND SUD COUNSELORS. SPECIALIZED, COMPREHENSIVE, AND INTEGRATED TRAINING WILL BE OFFERED TO ENHANCE BH PROFESSIONALS' SKILLS IN PROVIDING MH AND SUD SERVICES, INCLUDING PAIN MANAGEMENT WHILE SERVING AS AN INCENTIVE TO PROMOTE THESE POSITIONS AND ADDRESS RECRUITMENT CHALLENGES. USING THE COLLABORATIVE CARE MODEL TO ENHANCE INTEGRATIVE CARE, FHCSD PLANS TO EXPAND SERVICES BY INTEGRATING ITS EXISTING MH AND SUD/MOUD PROGRAMS WITH CURRENT AND SOON-TO-EXPAND PHYSICAL THERAPY (PT) CAPABILITIES TO ADDRESS CHRONIC PAIN ALONGSIDE BH NEEDS. THIS INTEGRATION WILL ENSURE A MORE COMPREHENSIVE AND COORDINATED APPROACH TO PATIENT CARE. OUR INTEGRATED CASE CONSULTATION GROUP WILL INCLUDE MH, SUD, AND PT STAFF AND PROFESSIONALS TO ADDRESS COLLABORATIVE TREATMENT PLANS FOR PATIENTS WHILE MONITORING AND EVALUATING THEIR GOALS AND PROGRESS. AS A RESULT OF THESE INITIATIVES, WE EXPECT TO SERVE AN ADDITIONAL 2,470 PATIENTS FOR MH, 102 FOR SUD, AND 218 FOR MOUD BY 2025. THESE EFFORTS ALIGN SEAMLESSLY WITH OUR PRIORITIES OF EXPANDING ACCESS TO CARE, IMPROVING QUALITY OF CARE, AND ADDRESSING HEALTH DISPARITIES HOLISTICALLY AMONG OUR MH AND SUD/MOUD PATIENTS. POPULATIONS TO BE SERVED: THIS INITIATIVE IS PART OF A BROADER STRATEGY TO IMPROVE SPECIFIC CLINICAL OUTCOMES AND ADVANCE HEALTH EQUITY AMONG OUR PREDOMINANTLY LOW-INCOME AND UNDERSERVED PATIENT POPULATION. FHCSD SERVES AN AVERAGE OF 20,000 MH, 1,500 SUD, AND 480 MOUD PATIENTS ANNUALLY THROUGH 21 BH FACILITIES ACROSS SAN DIEGO COUNTY, INCLUDING 3 OUTPATIENT SUD TREATMENT CENTERS, 16 FREE-STANDING MH CENTERS WITH 3 CENTERS DEDICATED TO CHILDREN AND YOUTH, 2 MOBILE COUNSELING CENTERS, AND A MOBILE MOUD PROGRAM. OUR FOCUS POPULATION CONSISTS OF RACIALLY AND ETHNICALLY DIVERSE, LOW-INCOME INDIVIDUALS AND FAMILIES WITH MH AND SUD/MOUD NEEDS ACROSS OUR CARE SYSTEM IN SAN DIEGO COUNTY, CALIFORNIA, WITH PARTICULAR FOCUS ON OUR NEW BH CLINIC SITES.

FY 2023 BRIDGE ACCESS PROGRAM

PS09-947 MPOWERMENT OUTCOME MONITORING PROJECT

HEALTH CARE AND OTHER FACILITIES

TEACHING HEALTH CENTER PLANNING AND DEVELOPMENT PROGRAM

ACCELERATING CANCER SCREENING - PROJECT TITLE: ACCELERATING EQUITABLE ACCESS TO CRC SCREENING AND REFERRAL TO FOLLOW-UP CARE HCP GRANT NUMBER: H80CS00224 ORGANIZATION NAME: FAMILY HEALTH CENTERS OF SAN DIEGO, INC. (FHCSD) ADDRESS: 823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102 PROJECT DIRECTOR: JOB G GODINO, PHD, DIRECTOR OF QUALITY IMPROVEMENT AND INNOVATION CONTACT PHONE NUMBERS: 619-515-2344 (VOICE); 619 237-1856 (FAX) EMAIL ADDRESS: JOBG@FHCSD.ORG WEBSITE ADDRESS: WWW. FHCSD.ORG FUNDS REQUESTED: $500,000 NEEDS TO BE ADDRESSED: THE POPULATION OF FOCUS LACKS ACCESS TO CRC SCREENING AND REFERRAL TO FOLLOW-UP CARE DUE TO ACCESS AND AFFORDABILITY BARRIERS, BARRIERS IN THE PATIENT EXPERIENCE, AND THE NEED FOR IMPROVED CANCER TRAINING (WORKFORCE DEVELOPMENT) AND SCREENING PROCESSES AND PROTOCOLS WITHIN THE HEALTH CENTER. PROPOSED SERVICES: FHCSD WILL RECRUIT, HIRE, AND TRAIN 2 QUALITY OF CARE (Q OF C) PATIENT NAVIGATORS (PNS), WHO WILL DRAW ON ORGANIZATIONAL QI EFFORTS TO IMPROVE CANCER SCREENING, SUCH AS IT ENHANCEMENTS TO IDENTIFY ELIGIBLE PATIENTS; NEW WORKFLOWS TO INCORPORATE CRC EDUCATION, SCREENING, AND NAVIGATION IN THE CLINIC SETTING; AND FORMALIZED REFERRAL NETWORK TO SUPPORT DIAGNOSTIC COMPLETION. THE Q OF C PNS WILL ALSO WORK ONE-ON-ONE WITH PATIENTS, USING LEARNED BEST PRACTICES TO PROVIDE CULTURALLY SENSITIVE EDUCATION, INSTRUCTIONS FOR COMPLETING FIT KITS, AND NAVIGATION TO OVERCOME BARRIERS INCLUDING FEAR, STIGMA, TRANSPORTATION, SCHEDULING, INSURANCE/FINANCIAL, ETC. FHCSD’S PATIENT ENGAGEMENT/OUTREACH SPECIALISTS (PE/OS) AT THREE TARGET CLINICS WILL ALSO ENGAGE COMMUNITY MEMBERS IN CRC EDUCATION, PROVIDING A WARM HAND-OFF TO FHCSD Q OF C PNS FOR SCREENING AND REFERRALS TO FOLLOW-UP CARE IF NECESSARY. POPULATION GROUPS TO BE SERVED: THE PROPOSED PROJECT WILL SERVE NEW AND EXISTING COMMUNITY HEALTH CENTER PATIENTS INCLUDING SPECIAL POPULATIONS (PHPC, HCH), WITH A TARGETED FOCUS ON INCREASING EQUITABLE ACCESS TO CRC SCREENING AND FOLLOW UP FOR LATINX, BLACK, AND HOMEL ESS POPULATIONS WHICH EXPERIENCE DISPARITIES IN CRC INCIDENCE/PREVALENCE, MORTALITY, AND SCREENING RATES. IN SAN DIEGO COUNTY, BLACKS HAVE THE HIGHEST CRC INCIDENCE RATES AT 36.2% COMPARED TO 32.0% FOR WHITES AND 28.8% FOR LATINX. BLACKS ALSO HAVE THE HIGHEST MORTALITY RATES AMONG THOSE AGES 65 AND OLDER (69.47%) COMPARED TO 69.08% FOR WHITES AND 40.87% FOR LATINX. BOTH CALIFORNIA AND SAN DIEGO TRAIL BEHIND US SCREENING RATES, WHICH, BASED ON THESE DISPARITIES, DISPROPORTIONATELY IMPACT RACIAL AND ETHNIC MINORITIES AND PERSONS EXPERIENCING HOMELESSNESS. INCREASE ACCESS AND ADDRESS BARRIERS TO CANCER SCREENING AND REFERRAL TO CARE AND TREATMENT: BY DECEMBER 31, 2023, FHCSD WILL INCREASE THE NUMBER OF PATIENTS SCREENED FOR CRC BY 3,513, REPRESENTING A 5% INCREASE IN OUR CRC SCREENING RATE FROM 40.83% TO 45.83%. IN ADDITION, WE WILL INCREASE THE NUMBER OF PATIENTS ASSISTED WITH ACCESSING APPROPRIATE FOLLOW-UP CARE WITHIN 30 DAYS OF RECEIVING AN ABNORMAL CRC TEST BY 476 PATIENTS, UP FROM A BASELINE OF ZERO. PROPOSED PARTNERSHIPS: FHCSD WILL PARTNER WITH NCI-DESIGNATED CANCER CENTER MOORES CANCER CENTER (MCC) AT UNIVERSITY OF CALIFORNIA SAN DIEGO (UCSD) HEALTH AND ITS ACCELERATING COLORECTAL CANCER SCREENING AND FOLLOW-UP THROUGH IMPLEMENTATION SCIENCE (ACCSIS). IN ADDITION, THE PROJECT WILL BE SUPPORTED BY SHARP GROSSMONT HOSPITAL AND PATH.

AFFORDABLE CARE ACT (ACA) GRANTS FOR SCHOOL-BASED HEALTH CENTERS CAPITAL PROGRAM

AFFORDABLE CARE ACT (ACA) GRANTS FOR SCHOOL-BASED HEALTH CENTERS CAPITAL PROGRAM

CAPITAL DEVELOPMENT

ELECTRONIC HEALTH RECORD IMPLEMENTATION INITIATIVE

** AWARDS ISSUED PRIOR TO JANUARY 20, 2025, WERE FUNDED UNDER PREVIOUS ADMINISTRATIONS AND MAY NOT REFLECT THE PRIORITIES AND POLICIES OF THE CURRENT ADMINISTRATION.** NON-TECHNICAL SUMMARYCURRENT ISSUE AND IMPORTANCE:SUB-OPTIMAL DIETS SIGNIFICANTLY CONTRIBUTE TO CHRONIC HEALTH CONDITIONS SUCH AS HYPERTENSION (HTN) AND TYPE-2 DIABETES (T2D), PARTICULARLY AMONG LOW-INCOME POPULATIONS WHO FACE BARRIERS TO ACCESSING AND AFFORDING NUTRITIOUS FOODS. NUTRITION ASSISTANCE PROGRAMS LIKE SNAP AND WIC AIM TO MITIGATE FOOD INSECURITY, BUT CHALLENGES REMAIN IN PURCHASING NUTRIENT-DENSE PRODUCE OVER INEXPENSIVE, PROCESSED FOODS. THIS ISSUE IS CRITICAL AS IT LEADS TO HEALTH DISPARITIES, INCREASED MEDICAL COMPLICATIONS, AND HIGHER HEALTHCARE COSTS, AFFECTING BOTH INDIVIDUALS AND THE BROADER COMMUNITY.IN SAN DIEGO, NEARLY ONE IN FOUR RESIDENTS EXPERIENCES NUTRITION INSECURITY. AT FAMILY HEALTH CENTERS OF SAN DIEGO (FHCSD), OVER 25,000 OF THE 159,000 PATIENTS SERVED ARE FOOD INSECURE, WITH SIGNIFICANT REPRESENTATION FROM LOW-INCOME, LATINO/A, AND BIPOC COMMUNITIES. FHCSD ALSO SERVES OVER 14,200 PATIENTS WITH T2D AND 31,700 PATIENTS WITH HTN, REFLECTING THE SOCIAL DETERMINANTS OF HEALTH AFFECTING OUR LOW-INCOME POPULATION AND THE COMPLEX HEALTHCARE NEEDS OF THOSE LIVING WITH CO-OCCURRING CHRONIC CONDITIONS. ADDRESSING THE UNDERLYING CAUSE OF THIS ISSUE IS ESSENTIAL FOR IMPROVING PUBLIC HEALTH, REDUCING ECONOMIC BURDENS, AND ENHANCING COMMUNITY WELL-BEING.METHODS AND APPROACHES:TO TACKLE THIS ISSUE, THE PRODUCE DELIVERY PROGRAM AND FOOD AS MEDICINE (PDP-FAM) INITIATIVE WILL DELIVER 20-POUND FRESH PRODUCE BOX SUBSCRIPTIONS DIRECTLY FROM A LOCAL FAMILY FARM TO THE HOMES OF OVER 400 LOW-INCOME, FOOD-INSECURE PATIENTS WITH HTN OR T2D. THESE DELIVERIES WILL BE PAIRED WITH CULTURALLY TAILORED NUTRITION-HEALTH EDUCATION, PROVIDING PRACTICAL SKILLS FOR INCORPORATING FRESH PRODUCE INTO THEIR DIETS AND MANAGING THEIR HEALTH CONDITIONS. FURTHERMORE, THE PROGRAM AIMS TO ENHANCE SUSTAINABILITY THROUGH PARTNERSHIPS IN THE FOOD AND HEALTHCARE SECTORS, INCLUDING MANAGED CARE PLANS. BY ENTERING INTO CONTRACTS WITH PROVIDERS THROUGH MEDI-CAL (CALAIM), WE WILL EXTEND ACCESS TO HEALTHY FOODS FOR ELIGIBLE PATIENTS FOR A MINIMUM OF 6 MONTHS, BEYOND THE 12-MONTHS OF FARM-FRESH PRODUCE BOX DELIVERIES. IN DOING SO, WE WILL DEVELOP A MODEL FOR EFFECTIVELY USING UNDERUTILIZED MEDICAL BENEFITS, SUCH AS CALAIM, TO SERVE LOW-INCOME POPULATIONS IN SAN DIEGO COUNTY. WE WILL COLLECT DATA THROUGH SURVEYS AND HEALTH METRICS BEFORE, DURING, AND AFTER THE INTERVENTION TO TRACK CHANGES IN DIET QUALITY, FOOD SECURITY, HEALTH OUTCOMES, AND HEALTHCARE USE.GOALS AND EXPECTED IMPACT:THE ULTIMATE GOAL OF THE PDP-FAM INITIATIVE IS TO IMPROVE DIETARY HABITS AND HEALTH OUTCOMES FOR PARTICIPANTS, REDUCE FOOD INSECURITY, AND LOWER HEALTHCARE COSTS. BY ACHIEVING THESE GOALS, THE PROJECT AIMS TO CREATE A RIPPLE EFFECT OF BENEFITS, INCLUDING HEALTHIER COMMUNITIES, REDUCED STRAIN ON HEALTHCARE SYSTEMS, AND STRONGER SUPPORT FOR LOCAL AGRICULTURE. THIS HOLISTIC APPROACH NOT ONLY ADDRESSES IMMEDIATE HEALTH NEEDS BUT ALSO PROMOTES LONG-TERM, SUSTAINABLE IMPROVEMENTS IN PUBLIC HEALTH AN,D COMMUNITY RESILIENCE.

HEALTHY BEHAVIORS IN WOMEN

HOME TO HEALTH (H2H) SAN DIEGO

FY 2023 EARLY CHILDHOOD DEVELOPMENT

HEALTH CENTER PROGRAM SERVICE EXPANSION - SCHOOL BASED SERVICE SITES (SBSS)

PRIMARY CARE TRAINING AND ENHANCEMENT -- RESIDENCY TRAINING IN STREET MEDICINE - PROJECT AND NEEDS TO BE ADDRESSED: FAMILY HEALTH CENTERS OF SAN DIEGO (FHCSD) IS APPLYING FOR HRSA-25-078, PRIMARY CARE TRAINING AND ENHANCEMENT-RESIDENCY TRAINING IN STREET MEDICINE (PCTE-RTSM). FHCSD PLANS TO ENHANCE STREET MEDICINE (SM) TRAINING FOR FHCSD’S ACGME-ACCREDITED FAMILY MEDICINE RESIDENCY PROGRAM (FMRP) RESIDENTS. WE WILL IMPLEMENT PRECISION EDUCATION STANDARDS TO ENHANCE OUR TRAINING APPROACH AND OUR DIDACTIC AND CLINICAL CURRICULA CONTENT SPECIFIC TO STREET-BASED CARE - SO THAT RESIDENTS ARE ABLE TO BRING SENSITIVE, QUALITY HEALTHCARE AND PSYCHOSOCIAL SUPPORT DIRECTLY TO THEIR PATIENTS EXPERIENCING HOMELESSNESS, REACHING THEM WHERE THEY ARE AT, WHERE THEY ARE MOST COMFORTABLE, AND REGARDLESS OF THEIR ABILITY TO PAY. WE PLAN TO CREATE A NEW PARADIGM FOR TRAINING ACTIVITIES AT FHCSD THAT WILL ENHANCE ALL ASPECTS OF LEANING, TEACHING, AND PATIENT CARE IN THE SM SETTING. A CROSS-ORGANIZATIONAL, MULTI-DISCIPLINARY CURRICULUM DEVELOPMENT TEAM WILL REDESIGN THE CURRENT 2-WEEK SM ELECTIVE INTO A 2+-MONTH COMPETENCY-BASED CURRICULUM, ROTATION, PROFESSIONAL DEVELOPMENT, AND ROBUST EVALUATION METHODOLOGY. THE RE-DESIGNED AND EXPANDED ROTATION WILL PROVIDE PERSONALIZED AND CONTINUOUS LEARNING, ASSESSMENT, AND FEEDBACK FOR TRAINEES, THEIR FACULTY, THEIR TRAINING COACHES, AND A BROAD SWATH OF PRECEPTORS FROM ACROSS MULTIPLE SM ROLES. PEH IN SAN DIEGO FACE SIGNIFICANT BARRIERS TO THE MOST BASIC OF SERVICES, AND THEIR SITUATIONS TYPICALLY COMPLICATE THE CARE THEY ARE ABLE TO RECEIVE. THIS PROGRAM WILL TRIPLE THE NUMBER OF FMRP RESIDENTS EACH YEAR WHO OBTAIN COMPETENCY AND EMPATHY AS THEY LEARN TO UNDERSTAND AND TREAT THE COMPLEX HEALTH CHALLENGES FACED BY PEH, AND WILL DRIVE EXPANSION OF THE SM PROGRAM INTO NEW VENUES AND ADDITIONAL SERVICE HOURS. PROPOSED SERVICES: ACCESS TO RESIDENT EXPERIENTIAL TRAINING AND TRAINING VENUES FOR THIS PROGRAM WILL BE PROVIDED IN CONJUNCTION WITH THE SM TEAM AND AT A NUMBER OF SM VENUES ACROSS SAN DIEGO, INCLUDING THROUGH STREET ROUNDS; IN ENCAMPMENTS, HOMELESS SHELTERS, AND SAFE SLEEPING PROGRAM LOTS; ALONGSIDE OUR SYRINGE SERVICES PROGRAM AND MOBILE MEDICATION ASSISTED TREATMENT UNITS; AND ANYWHERE PEH IN NEED ARE FOUND OUTSIDE OF TRADITIONAL CLINIC SITES. THE MULTI-DISCIPLINARY CURRICULUM TEAM WILL DEVELOP THE EXPANDED PROGRAM UTILIZING PRECISION EDUCATION MODELS, LEARNING CONTRACTS, RUBRIC-BASED ASSESSMENTS AND EVALUATIONS, PROFESSIONAL DEVELOPMENT IN POSITIVE COACHING AND PRECEPTING, AND AN EMPHASIS ON COMPETENCY-BASED, EXPERIENTIAL, FIELD-BASED LEARNING. TRAINING CONTENT WILL ADDRESS MEDICAL CARE FOR ACUTE AND CHRONIC CONDITIONS, CO-MORBIDITIES, SUBSTANCE USE DISORDERS AND CUTTING-EDGE TREATMENT, MENTAL HEALTH CONCERNS INCLUDING PSYCHIATRY, BEHAVIORAL HEALTH NEEDS, INTERPROFESSIONAL TEAMWORK, MEDICO/LEGAL ISSUES, AND AN IN-DEPTH UNDERSTANDING OF THE MANY SOCIAL DETERMINANTS OF HEALTH (SUCH AS SOCIAL ISOLATION) THAT IMPACT CARE FOR THIS PATIENT POPULATION. POPULATION GROUPS TO SERVE: IN THE PAST YEAR, FHCSD SERVED OVER 166,000 PATIENTS ANNUALLY, INCLUDING OVER 28,000 PEOPLE EXPERIENCING HOMELESSNESS (PEH), BOTH SHELTERED AND UNSHELTERED. THE TARGET POPULATION IS PRIMARILY UNSHELTERED, THOSE WHO PREFER TO BE SEEN OUTSIDE OF THE STANDARD CLINIC SETTING. WHETHER UNSHELTERED OR UNSTABLY HOUSED, THEY WILL BE SEEN ACROSS SAN DIEGO BUT PRIMARILY IN FIELD-BASED VENUES IN THE CENTRAL, EAST, AND SOUTH SAN DIEGO REGIONS. THEY WILL RECEIVE CARE REGARDLESS OF THEIR ABILITY TO PAY. VENUES WILL BE CLUSTERED IN COMMUNITIES HISTORICALLY AND CURRENTLY NEGATIVELY IMPACTED BY AND AT HIGHEST RISK FOR HOMELESSNESS. LOCAL NEEDS ASSESSMENTS SHOW THEY ARE A HIGHLY VULNERABLE GROUP, LACKING SAFETY, SECURITY, PRIVACY, AND SUPPORT NETWORKS AND WITH SIGNIFICANT HEALTH AND PSYCHOSOCIAL CONCERNS.

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

HEALTHY BEHAVIORS IN WOMEN

AFFORDABLE CARE ACT PATIENT CENTERED MEDICAL HOME FACILITY IMPROVEMENTS GRANT PROGRAM

CAPITAL ASSISTANCE FOR DISASTER RESPONSE AND RECOVERY EFFORTS

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

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

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 - SUMMARY OF REQUEST: FHCSD IS ONE OF THE NATION’S TEN LARGEST FEDERALLY QUALIFIED HEALTH CENTERS (FQHC), THE LARGEST PROVIDER OF HEALTHCARE TO UNINSURED INDIVIDUALS IN CALIFORNIA, AND ONE OF THE LARGEST PROVIDERS OF COMPREHENSIVE HIV SERVICES IN SAN DIEGO COUNTY. THE SECOND FQHC IN THE NATION TO RECEIVE THE JOINT COMMISSION ACCREDITATION AS A PRIMARY CARE MEDICAL HOME (PCMH) AND RECOGNIZED BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE AS A LEVEL 3 PCMH, FHCSD HAS BEEN PROVIDING HIGH-QUALITY, CULTURALLY COMPETENT PRIMARY HEALTHCARE SERVICES TO LOW-INCOME, MEDICALLY-UNDERSERVED SAN DIEGANS FOR OVER 50 YEARS. FHCSD IS REQUESTING FUNDING UNDER THE INFRASTRUCTURE DEVELOPMENT CATEGORY USING THE DENTAL EQUIPMENT FOR EXPANDING DENTAL SERVICE CAPACITY ACTIVITY. THE PROPOSED PROJECT WILL EXPAND DENTAL CAPACITY THROUGH THE PURCHASE OF DENTAL EQUIPMENT WHICH WILL SERVE PEOPLE WITH HIV (PWH) AND LOW-INCOME SAN DIEGANS. FHCSD IS REQUESTING FUNDING PREFERENCE BASED ON QUALIFICATION 2: UNDERSERVED POPULATIONS. TARGET POPULATION AND NEED: FHCSD SERVES OVER 167,000 PATIENTS ANNUALLY, INCLUDING OVER 26,000 PEOPLE EXPERIENCING HOMELESSNESS, OVER 17,000 DENTAL PATIENTS, AND NEARLY 1,400 PWH. 87% OF FHCSD PATIENTS ARE LOW-INCOME AND 70% ARE CONSIDERED IMPOVERISHED. FHCSD HAS FEDERAL HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) DESIGNATIONS IN PRIMARY CARE, DENTAL CARE, AND MENTAL HEALTH. FHCSD’S DENTAL HPSA SCORE OF 25 OUT OF 26 MEANS IT IS THE HIGHEST SCORE AMONG ALL DESIGNATED DENTAL HPSAS IN SAN DIEGO COUNTY. ON AVERAGE, ONLY ONE OUT OF EVERY FOUR PWH IN FHCSD’S SYSTEM OF CARE WITH A DOCUMENTED NEED FOR DENTAL CARE RECEIVED THE CARE THEY NEEDED ANNUALLY. IN 2022, FHCSD WITNESSED EVEN FEWER PWH RECEIVING DENTAL CARE DUE TO THE COVID-19 PANDEMIC, WITH ONLY 17% OF HIV+ PATIENTS ACCESSING ORAL HEALTH SERVICES THEY NEEDED. LOW-INCOME, UNINSURED/UNDER-INSURED, AND MEDICALLY UNDERSERVED PWH ARE PARTICULARLY VULNERABLE AND FACE TREMENDOUS CHALLENGES ACCESSING ORAL HEALTH CARE DUE TO UNINSURANCE/UNDER-INSURANCE, LACK OF FINANCIAL RESOURCES, TRANSPORTATION ISSUES, LACK OF CHILDCARE, AND LONGSTANDING STIGMA ASSOCIATED WITH AN HIV DIAGNOSIS. ROUTINE ORAL HEALTH CARE IS A KEY COMPONENT TO ACHIEVING VIROLOGICAL SUPPRESSION FOR PWH. THE PROPOSED PROJECT WILL BE A PART OF A COMPREHENSIVE, HOLISTIC APPROACH TO ENSURE PWH GET AND STAY HEALTHY, INCLUDING PRIMARY CARE, MENTAL HEALTH, AND REFERRALS TO AN ARRAY OF SUPPORTIVE SERVICES. PROPOSED ACTIVITIES AND FUNDING REQUEST: FHCSD IS REQUESTING $150,000 TO IMPLEMENT THE PROPOSED PROJECT. FUNDS WILL ALLOW THE ORGANIZATION TO ENSURE PWH AND LOW-INCOME SAN DIEGANS HAVE ACCESS TO HIGH-QUALITY ORAL HEALTH SERVICES DELIVERED BY A MULTIDISCIPLINARY CARE TEAM THROUGH THE PURCHASE OF A CHAIRSIDE ECONOMICAL RESTORATION OF ESTHETIC CERAMICS (CEREC) SYSTEM, STAFF TRAINING, INCREASED NAVIGATION SERVICES, AND THE DEVELOPMENT OF POLICIES AND PROCEDURES FOR BEST PRACTICES IN PROVIDING DENTAL SERVICES TO PWH.

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

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

TEACHING HEALTH CENTER (THC) GRADUATE MEDICAL EDUCATION (GME) PAYMENT PROGRAM - PROJECT ABSTRACT - HRSA-25-091 THCGME FAMILY MEDICINE RESIDENCY PROGRAM PROJECT TITLE: FHCSD FAMILY MEDICINE RESIDENCY PROGRAM APPLICANT NAME: FAMILY HEALTH CENTERS OF SAN DIEGO, INC. ADDRESS: 823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541 PD NAME: ZACHARY THOMAS, MD CONTACT PH. NO.: (619) 515-2400 EMAIL ADDRESS: ZACHARYT@FHCSD.ORG WEBSITE ADDRESS: WWW.FHCSD.ORG/EDUCATION/GME/RESIDENCY-PROGRAMS/FAMILY-MEDICINE OVERVIEW: FAMILY HEALTH CENTERS OF SAN DIEGO (FHCSD), A NOT-FOR-PROFIT FEDERALLY QUALIFIED HEALTH CENTER (FQHC) AND COMMUNITY-BASED AMBULATORY PATIENT CENTER, IS REQUESTING SUPPORT FOR TWO ADDITIONAL FAMILY MEDICINE (FM) RESIDENT FTES. FHCSD SEEKS TO PERMANENTLY EXPAND ITS EXISTING HRSA THCGME FAMILY MEDICINE RESIDENCY PROGRAM (FMRP) BASED ON ITS ACCREDITATION FROM THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) FOR UP TO 24 RESIDENT FTES (8-8-8), EFFECTIVE JANUARY 24, 2024. THE THREE-YEAR PROGRAM, WHICH BEGAN TRAINING RESIDENTS WITH HRSA THCGME FUNDING IN 2014 AND OPERATES ALONE, AIMS TO RECRUIT AND TRAIN RESIDENT PHYSICIANS FROM DIVERSE BACKGROUNDS TO PROVIDE HIGH-QUALITY, CULTURALLY SENSITIVE PRIMARY CARE IN AMBULATORY PATIENT CARE SETTINGS FOR UNDERSERVED COMMUNITIES. SINCE FHCSD’S FMRP INAUGURATION, 48 NEW FAMILY MEDICINE PRIMARY CARE PHYSICIANS HAVE COMPLETED THEIR RESIDENCY AND ENTERED THE WORKFORCE, 26 (54%) OF WHOM CONTINUE TO PRACTICE IN MEDICALLY UNDERSERVED SETTINGS AND HEALTH PROFESSIONAL SHORTAGE AREAS. ADDITIONAL FUNDING IS REQUESTED TO INCREASE THE TOTAL COMPLEMENT OF FM RESIDENT FTES BY 2 RESIDENT FTES PER YEAR, FOR A FULL COMPLEMENT OF 24 RESIDENT FTES (8-8-8), BASED ON OUR AY 2023-24 BASELINE OF 18 (6-6-6). NEEDS TO BE ADDRESSED AND POPULATION GROUP(S): FHCSD SERVES MORE UNINSURED PATIENTS THAN ANY OTHER COMMUNITY CLINIC IN THE NATION (42,523 PEOPLE). IN 2023, IT DELIVERED CULTURALLY SENSITIVE SERVICES TO 159,114 UNIQUE PATIENTS FROM DIVERSE, LOW-INCOME BACKGROUNDS ACROSS SAN DIEGO COUNTY’S CENTRAL, EAST, SOUTH, AND NORTH REGIONS, 89% OF WHOM LIVED AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) AND 39% WHO WERE BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH. PATIENTS EXPERIENCE PERSISTENT DISPARITIES, WITH POORER HEALTH OUTCOMES THAN RESIDENTS IN OTHER COUNTY REGIONS. AS A CRITICAL SAFETY-NET HEALTHCARE PROVIDER, FHCSD SEEKS TO IMPROVE ITS CAPACITY TO CARE FOR PATIENTS EXPERIENCING PERSISTENT BARRIERS TO ACCESS (E.G., POVERTY, LACK OF TRANSPORTATION, HOUSING COSTS, LANGUAGE, STIGMA), WHILE ALSO REDUCING THE SHORTAGE OF FAMILY MEDICINE PRIMARY CARE PHYSICIANS BY TRAINING AND RETAINING QUALITY PROVIDERS PREPARED FOR A CAREER DEDICATED TO LOW-INCOME AND MEDICALLY UNDERSERVED COMMUNITIES. DESCRIPTION OF SERVICES AND TRAINING LOCATION: HOUSED WITHIN ONE OF THE 10 LARGEST FQHCS IN THE NATION, FHCSD’S FMR PROGRAM IS BASED AT THE CITY HEIGHTS FAMILY HEALTH CENTER (CHFHC)—THE FAMILY MEDICINE CENTER (FMC)—WHOSE PATIENT POPULATION IS IMPOVERISHED AND EXCEPTIONALLY DIVERSE. IN 2023, THE CHFHC SERVED 23,845 INDIVIDUALS WHO REPORTED LIVING BELOW 200% OF THE FPG (94% OF TOTAL CASELOAD). OF THOSE WHO REPORTED RACE AND ETHNICITY DATA, 44% WERE HISPANIC, 9% WERE AFRICAN AMERICAN, 4% WERE MULTIRACIAL, 4% WERE ASIAN/PACIFIC ISLANDER, AND 16% WERE NON-HISPANIC CAUCASIAN; NEARLY A THIRD (31%) WERE BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH, WITH 18+ LANGUAGES SPOKEN BY PATIENTS AND STAFF. THE 10 CORE FMR PROGRAM SITES CONSIST OF 4 PARTICIPATING HOSPITALS (INCLUDING ONE PEDIATRIC SPECIALTY HOSPITAL), A DERMATOLOGY PRACTICE, AND 5 FHCSD COMMUNITY CLINICS. FM RESIDENTS WILL RECEIVE DIVERSE LEARNING EXPERIENCES ACROSS DISCIPLINES, INCLUDING INTERNAL MEDICINE, EMERGENCY (ADULT AND PEDIATRIC), NEONATAL AND ADULT INTENSIVE CARE, OUTPATIENT SURGERY, HIV/HCV MEDICINE, ADDICTION MEDICINE, OBSTETRICS AND GYNECOLOGY, PEDIATRICS, INTEGRATED CLINICAL SERVICES FOR PEOPLE EXPERIENCING HOMELESSNESS, SPORTS MEDICINE, POPULATION HEALTH, AND MORE.

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

SCHOOL-BASED HEALTH CENTERS CAPITAL PROGRAM

HEALTH CARE AND OTHER FACILITIES

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

NEXUS COMPREHENSIVE PATIENT NAVIGATION PROGRAM (NEXUS - CPNP)

HEALTH INFRASTRUCTURE INVESTMENT PROGRAM

AFFORDABLE CARE ACT - CAPITAL DEVELOPMENT GRANTS

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS