Sunday, April 27, 2025
4/27/2025
Ryan White Part C Outpatient EIS Program - This proposal seeks support to enhance comprehensive medical and support services to persons living with and vulnerable to HIV/AIDS in the nine-county Chicago EMA. Despite an overall decrease in persons living with HIV (PLWH), new diagnoses in Chicago have risen by 0.5% compared to 2021. The Chicago EMA has been most affected by the HIV epidemic, with 83% of 40,225 living cases of HIV and AIDS reported to the Illinois Department of Public Health (IDPH) through 2022; and 78% of 1,282 newly diagnosed HIV and AIDS cases in 2022. In Chicago alone, 21% of the 627 new HIV/AIDS cases were served by Cook County HIV Programs. Cook County, fully encompassing Chicago, is the epicenter for HIV in Illinois, accounting for 53% of the state’s PLWH and 64% of all cases in Chicago EMA. Our programs provide services to 40% of patients known to be in care, and in 2023, 75% retained in care, 99% received ART, and 86/90% were virally suppressed. While the overall number of PLWH has decreased, the proportion of PLWH aged 50+ increased from 42% in 2016 to 47% in 2020. The CORE Center and the South Suburban HIV/AIDS Regional Clinics (SSHARC) viral suppression rate for PLWH ages 50+ was 92.5% (2023), 90.2% (2022) and 80.7% (2021). Cook County Health, the largest safety net healthcare provider in the Midwest, uses a multidisciplinary patient centered medical home model providing comprehensive medical and support services. We are seeking Part C funds to support primary medical care services, HIV testing and linkage to care services, behavioral health/peer support, and medical nutrition services for PLWH. We are the largest HIV service provider in the state providing services to 5,608 patients in 2021; 5,494 patients in 2022; and 5,440 patients in 2023. Our EIS program targets primarily poor, medically indigent, minority PLWH who are often marginalized, with limited interactions with the health care system. Both Chicago and Cook County have higher rates of unemployment, persons living below the federal poverty level, and people of color living in these regions. Even more striking, although African American/Black individuals represent only 23% of the Chicago population, they are 64% of the CORE Center/SSHARC patient population.?Seventy-two percent of our patients are unemployed and 72% have incomes below the federal poverty level; five and three times the rates for Chicago, respectively. Our program served over 11,800 primary care visits in 2023. The primary goal for this funding period is to increase the number of persons receiving targeted Counseling, Testing, and Referral services to 5,000 annually, broaden capacity of HIV testing and Linkage to Care among transgender and cis-gender women, African American MSM, Latinx MSM, and substance users. A priority will be continuity of behavioral health and social services to improve retention and virologic suppression and viral suppression rates among adolescent/young adults from 72% to 80%. Our services are designed to keep patients in care. Transportation is provided based on patient needs. Medical and supportive case management services (27,000+ encounters yearly) and substance abuse and mental health counseling (4,000+ units) are provided on site. Patient navigation services and support groups are available to newly enrolled patients, as are yearly nutritional assessments and counseling. Treatment adherence counseling services and legal assistance are provided. Benefits counselors meet with each patient to determine eligibility for public benefits programs, and assist with completing applications to Medicaid, Medicare, and public assistance programs. We will monitor 23 CQM performance metrics throughout the project period, aiming for improvements in at least two. With continuous evaluation and enhancements, supported by Part C funding, we will strive to maintain and strengthen our leadership in proving comprehensive, high-quality care to our patients, particularly the most vulnerable populations.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).