Program Income: Ryan White Part C: Outpatient Early Intervention Services to HIV Positive Persons 2025-2027

Program Abstract Project Title: HIV Early Intervention Services Program: Existing Geographic Service Areas Organization Name: University of Kentucky Research Foundation – Bluegrass Care Clinic Organization Address: 109 Kinkead Hall Lexington, KY 40506-0057 Project Director: Alice C Thornton, MD Contact Numbers: 859-323-4792 (W); 859-257-3477 (F) E-mail: [email protected] Web-Site: https://internalmedicine.med.uky.edu/bluegrass-care-clinic Funding Requested: $1,950,000 Funding Preference: Increased Burden, Rural Areas, Underserved Project Abstract: BCC Service Area: The Bluegrass Care Clinic (BCC), a university-affiliated clinic at the University of Kentucky Healthcare (UKHC), has served as a safety net for HIV primary care for 63 counties, 20,054 square miles, in central and eastern KY since the 1990s. With the award of Ryan White HIV/AIDS Program (RWHAP) Part C funds in 2001, Part B funds in 2006, Part D funds in 2009, Part B expansion funds in 2019, and addition of 340B RW Part C pharmacy income, the BCC has developed a comprehensive health care delivery system. The increased number and range of services is provided to a growing population of persons living with HIV (PWH), increasing 400% from 2001 (481 unduplicated patients) to 2023 (1956 unduplicated patients). In this application the BCC proposes to continue providing comprehensive HIV services to the entire 63 county KY service area. Infectious diseases (ID) physicians provide HIV care services and serve as consultants for hospitalized PWH. A multidisciplinary team approach to care includes on-site services of: thirteen ID physicians, two internists, one ID pediatrician, three advanced practice practitioners (APP), a psychiatrist, a psychiatric APP, two clinical pharmacists, three mental health (MH) counselors, a MH program coordinator, four nurse navigators (NN), four enrollment and eligibility coordinators, three health educators, 21 medical case managers (MCMs), two bilingual navigators, six support staff, and a full CQM team. HIV Epidemiology of the Service Area: Of the 63 targeted counties served, 51 are designated as Appalachian, 31 are federally recognized as being in part or whole low-income population, 56 are rural, and 52 have been identified as medically underserved. The BCC service area is predominately White (87%). African Americans and Hispanics (5% & 4% of BCC service area) are disproportionately represented in the patient population; of the PWH served in 2023, 63% were White, 24% Black, and 10% Hispanic. In 2023, 43% of the PWH served at the BCC were below the federal poverty level (FPL); an additional 26% had incomes between 100% and 200% of the FPL. Unprotected sex is the most common risk factor (90%); 65% identified MSM as their primary risk factor, and 25% identified heterosexual sex as their primary risk factor. Key Ryan White Part C Services: The BCC requests $650,000 per year for three years to continue to address the emerging needs of our PWH target population by providing the following proposed services: 1) Access to high quality, comprehensive HIV primary care; 2) Referral to medical specialty care; 3) Medical Case Management; 4) Nutritional assessment/counseling services; 5) Access to oral health care; 6) Multidisciplinary adherence education program; 7) Access to appropriate vaccines and emergency HIV and prophylactic medications; 8) Culturally and linguistically appropriate services; 9) Services consistently improved based on an active continuous quality management program; 10) Consumer involvement in program development, implementation, and evaluation activities; 11) HIV testing, counseling and linkage for high-risk groups and 12) Patient Support Groups. Target population: The proposed project targets persons at-risk for HIV disease in the service area, including persons of color, young MSM, people who inject drugs, medically underserved, University of Kentucky Research Foundation on behalf of the Bluegrass Care Clinic - H76HA00719 1 Program Abstract and rural residents. The project is designed to address unmet needs and to overcome barriers to care. University of Kentucky Research Foundation on behalf of the Bluegrass Care Clinic - H76HA00719 2