Restricted Scope for Carryforward: Ryan White Part C: Outpatient Early Intervention Services to HIV Positive Persons

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: $654,268 Funding Preference: Increased Burden, Rural Areas, Underserved Project Abstract BCC Service Area: The Bluegrass Care Clinic (BCC) is a university-affiliated clinic at the University of Kentucky Healthcare (UKHC), which has served as the safety net for HIV primary care for 63 counties in central and eastern KY since 1990. The Ryan White Program at UKHC serves 1660 persons living with HIV (PWLH) with comprehensive medical care and supportive services. Board-certified infectious diseases (ID) physicians provide HIV care services and serve as consultants for hospitalized PLWH. A multidisciplinary team approach to care includes on-site services of: 9 ID physicians, 3 internists, a nurse practitioner, a pediatrician, 2 clinical pharmacists, 3 mental health counselors, a dietician, two nurses, two Health Educators, 14 Medical Case Manager (MCMs), and one non-MCM. In this application the BCC proposes to continue providing comprehensive HIV services to the entire 20,054 square mile, 63 county Kentucky service area. HIV Epidemiology of the Service Area: Of the 63 targeted counties served, 51 of the counties are designated as Appalachian, 38 are federally recognized as economically distressed and 43 counties have been identified as medically underserved. African Americans and Hispanics are disproportionately represented in the patient population of the BCC; of the PLWHA served in 2020 YTD, 74% were White, 23% were Black, and 8% were Hispanic. In 2020, 54% percent of the PLWH served at the BCC were below the federal poverty level (FPL); an additional 23% had incomes between 100 and 200% of the FPL. Unprotected sex is the most common risk factor for PLWH within the BCC’s service area; 60% identified MSM as their primary risk factor, an additional 23% identified heterosexual sex as their primary risk factor. Key Ryan White Part C Services: The BCC requests $654,268 per year for two years continue to address the emerging needs of our PLWH target population by providing the following proposed services: 1) Access to high quality, comprehensive HIV primary care services; 2) Referral to medical specialty care (mental health and substance abuse services); 3) Medical Case Management; 4) Nutritional assessment/counseling services; 5) Access to oral health care via UK’s RWHAP Dental Program; 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 (CQM) program; 10) Consumer involvement in program development, implementation, and evaluation activities; 11) Prevention case management and HIV testing and counseling for high-risk partners, friends, and family members of patients; and 12) Patient Support Groups (Men’s, Women’s, & Hispanics). Target population to be served: The proposed project targets persons at-risk for HIV disease in the service area, including persons of color, young MSM, migrant farm workers, and medically underserved, and rural residents. The project is designed to address unmet needs and to overcome barriers to care. The BCC requests funding preference for increased burden, rural areas, and the medically underserved. University of Kentucky Research Foundation on behalf of the Bluegrass Care Clinic - H76HA00719