Ryan White Title III HIV Capacity Development and Planning Grants - FY 2025 RWHAP Part C Capacity Development Program Category: HIV Care Innovation – Streamlining RWHAP Eligibility Funding Amount Requested: $150,000 Project Summary: Community Special Services (CSS), a program of Community Medical Centers (CMC), requests $150,000 in funding through the FY 2025 RWHAP Part C Capacity Development Program to implement an HIV Care Innovation initiative focused on streamlining RWHAP eligibility for uninsured and underinsured people with HIV (PWH). This initiative will embed a dedicated Eligibility Advocate within the CSS Special Services Clinic to facilitate rapid enrollment in Medi-Cal, Covered California, and Ryan White services, removing critical barriers to timely HIV care. Needs to be Addressed: Fresno County continues to face significant challenges in HIV care engagement, particularly for low-income, uninsured, and undocumented populations. Current barriers in insurance eligibility verification and recertification contribute to delays in linkage to care, low ART adherence rates (58.2%), and retention challenges (49.3%). The CSS clinic serves 62.5% of the people living with HIV in the service area, yet nearly 12.3% remain uninsured or underinsured, increasing their risk for delayed treatment, disease progression, and ongoing transmission. Proposed Services: The proposed Eligibility Advocate initiative will: Expedite the insurance assessment and enrollment process by embedding a trained advocate within the CSS Special Services Clinic. Support uninsured and underinsured PWH by navigating Medi-Cal eligibility, Covered California enrollment, and Ryan White program services. Minimize patient burden by reducing the need for multiple visits, offsite paperwork submission, and prolonged waiting times for eligibility verification. Enhance retention and ART adherence by ensuring insurance coverage continuity and reducing financial barriers to care. Provide transportation assistance to increase clinic accessibility for rural and undocumented populations. Population Groups to Be Served: This initiative will primarily serve low-income, uninsured, and underinsured PWH in Fresno County, with a focus on racial and ethnic minority populations (Black/African American and Latinx communities), undocumented individuals, and those experiencing housing instability. These groups face the highest barriers to timely care and treatment adherence. Intended Impact: The Eligibility Advocate initiative will strengthen CSS’s organizational capacity to deliver high-quality HIV primary care by reducing administrative delays, improving access to health coverage, and supporting rapid linkage to HIV treatment. This project will contribute to achieving national HIV goals, including: Increasing retention in care from 49.3% to at least 65% within 12 months. Improving ART initiation and adherence, increasing coverage from 58.2% to 75%. Reducing time from diagnosis to first HIV medical visit, ensuring at least 80% of newly diagnosed patients enter care within 30 days. Enhancing long-term financial sustainability by leveraging Medi-Cal and Ryan White funding streams to support care delivery beyond the grant period. By embedding insurance navigation services directly into the clinic workflow, this initiative will remove critical access barriers, improve health outcomes, and support Fresno County’s progress in ending the HIV epidemic among its most vulnerable populations.
