Special Projects of National Significance - Demonstration/Implementation Sites - Alameda County Health Care for the Homeless is a federally funded HRSA health center program providing health care services to some 10,000 persons experiencing homelessness each year throughout Alameda County. ACHCH is housed in the County of Alameda health department and is uniquely positioned to convene and direct a wide-ranging network of providers including the health department, multiple community health centers, and community-based organizations to detect and respond to health concerns of the over 25,000 county residents who experience homelessness annually. ACHCH provides comprehensive health and housing services to people experiencing homelessness, including behavioral health, primary care, specialty care, dental, interim and permanent housing, and recuperative care services, provided in clinical and portable street and shelter-based settings. ACHCH is leading a collaborative initiative to extend our capacity to reduce HIV mortality and reduce spread of HIV infections among unsheltered persons in Alameda County. ACHCH Street Health HIV Interventions Pilot (SHHIP) is HRSA-funded demonstration project based in an interdisciplinary team consisting of medical, mental health, substance use, housing and social services staff already experienced in direct provision of street medicine care to unsheltered persons. The SHHIP team will direct an ACHCH-managed network -- 14 street medicine teams, community HIV services providers, HIV primary care clinics, and County HIV public health investigators -- to provide services aimed at identifying and re-engaging unsheltered HIV patients into care, including providing antiretroviral therapy including direct on-site dispensing of ART medication, monitoring patient viral suppression as well as addressing patients’ other HIV primary care, housing and social needs as identified. The SHIPP Team will consist of: ACHCH medical director and staff; leadership of East Bay Getting to Zero, our leading community-based HIV services organization who convene the countywide HIV ACCESS network; the Alameda County Department of Public Health’s Office of HIV Care and Prevention and ACPHD Division of Communicable Disease Control & Prevention; team leads from the 14 ACHCH-directed Street Health Teams operated by four community health centers; the ACHCH/Alameda Health System Bridge Clinic, an innovative low-barrier hub for substance use disorder, HIV and hepatitis C treatment; and the AHS Pharmacy, ACHCH’s primary partner in the HRSA-funded Mobile Pharmacy initiative; and community HIV CBO CALPEP. These partners are all committed to equitable, inclusive and client-centered care that reduces stigmatizing attitudes, beliefs and behaviors. This collaboration will build on AHCHC’s already-existing HRSA PCHP HIV testing, PrEP, PEP and access to treatment services, as well as integrate ACHCH’s new HRSA-funded Behavioral Health Services Expansion mobile pharmacy program to directly bring access to pharmaceuticals including MAT, mental health and ART to patients wherever they are. Unsheltered persons in Alameda County bear a disproportionate burden of HIV disease, often untreated. High levels of substance use including injection drug use, combined with high levels of mental health conditions combined with individual displacement have until now made the tracking and follow up of unsheltered people living with HIV difficult. This has resulted in poor understanding of possible clusters of HIV infection in these populations. The AC SHHIP Team approach will effectively increase countywide capacity to map, track and reduce HIV infections through collaborative communication, data collection, direct health care services and coordination and evaluation. This collaborative will effectively participate as a key Demonstration Site in the nationwide Capacity Building Provider and Evaluation (HRSA-25-055-7) to further develop this model of coordinated HIV care.
