Ryan White Title III HIV Capacity Development and Planning Grants - FY 25 Ryan White Part C Capacity Development Program funds for low-income people with HIV (PWH) are requested to support Callen-Lorde’s efforts to systematically collect information about social determinants of health through electronic medical record (EMR) integration. Callen-Lorde’s EMR system, Epic, will be configured to seamlessly identify PWH who need SDOH screening, alerting staff members to perform the screening, and subsequently providing internal and external resources and referrals to address the SDOH needs. Funds will also be used to purchase Microsoft Surface tablets that will be utilized at each of our three clinics, allowing patients to complete screenings during the registration process and/or during a medical or behavioral health encounter. PWH have high rates of SDOH needs due to societal factors such as HIV stigma, poverty, housing insecurity, unemployment/under-employment, and discrimination. Addressing SDOH needs in a systematic manner will promote inclusive care through assessing for and addressing non-healthcare needs that can determine health outcomes. Furthermore, a vast body of research demonstrates that addressing SDOH needs such as housing, domestic violence, stigma, and education/employment leads to improved medication adherence, improved appointment adherence, and higher rates of durable viral load suppression among PWH. Funds will be used for staff time and effort to build the SDOH screening tool, foster integration of SDOH screening tool into the tablets, the Epic EMR, and other data reporting and analytics platforms like CPCI, staff training on how to conduct screening and provide resources/referrals for identified needs, and the strengthening of existing partnerships with community-based organizations and other healthcare facilities as well as the development of new partnerships that can address SDOH needs not supported in-house. This project falls under the HIV Care Innovation category and the activity of inclusive care for underrepresented communities with disproportionately high rates of HIV. This project has not been previously funded. The funding amount requested is $150,000 for the one-year period of performance.
