Ryan White Title III HIV Capacity Development and Planning Grants - St. John’s Community Health (SJCH) requests an award from the HIV/AIDS Bureau’s Ryan White HIV/AIDS Part C Capacity Development Program of $150,000 to support the agency’s efforts to diversify and expand its HIV/AIDS service structure and improve integration of comprehensive services for people living with HIV (PLWH). The goal of this project is to improve HIV and behavioral health outcomes for 700 PLWH in South Los Angeles and Compton through increased access to behavioral health and addiction medicine care. The proposed set of activities will be a coordination/integration of HIV primary care with behavioral health care project under the HIV Care Innovation category. Our aim is to build upon our HIV service structure leveraging our past and current experience implementing Part C Capacity Development Projects to more effectively coordinate with behavioral health services in order to improve the health, functioning, and stability of our patients with HIV. SJCH is a 27-site FQHC system located mostly within Los Angeles County’s Service Planning Area (SPA) 6—South LA—a low-income area whose population is disproportionately underserved and un-/underinsured, and experiences significantly poorer health outcomes overall than much of the rest of the County. South LA is home to 6,823 PLWH, not including the estimated 1,080 who do not know they are infected. In the most recent 5-year period for which there is available HIV surveillance data, a total of 273 new HIV case were diagnosed in SPA 6, representing 9% of new diagnoses in LA County, the second-highest rate among the 8 SPAs in 2023. HIV is far less visible and understood in South LA neighborhoods. Due to pervasive HIV-related stigma in South LA that results in lower levels of testing, as compared with other areas of the city where income levels are higher and HIV testing is a more culturally accepted practice, the prevalence rate is very likely underreported. With a linkage to care rate of 73%, 72% for engaged in care, 70% retained in care, and 62% achieving viral suppression, PLWH living in South LA have comparatively poor health outcomes. Particularly critical to improving performance on these measures is expansion of and increased access to existing culturally competent services that address SUD, MD, or co-occurring SUD/MD (COD). Based on current patient assessments, 510 in 701 of SJCH PLWH patients have a mental health and/or substance use disorder (many co-occurring). However, only 1 in 5 of those have been successfully linked to BH care. SJCH’s coordination and integration of HIV primary care with behavioral health (BH) services HIV Care Innovation project, will consist of: (1) conducting start-up activities needed to more effectively coordinate and integrate behavioral health services with HIV primary care; (2) launching a pilot of the model we develop and beginning data collection, evaluation and reporting on measures; (3) monitoring of progress and sharing of project results with other local entities invested in addressing the HIV epidemic in South LA communities and beyond; and (4) producing a sustainability plan for continuity of HIV/BH care integration to be expanded to SJCH’s service area in the San Bernardino and Riverside Counties. Systematic and comprehensive development of policies and procedures and training of staff will underpin activities. By the end of the 12-month project period, these efforts will also will have further developed the coordinated HIV programmatic infrastructure we have established in part with Ryan White Care Act funds and will have determined reliable baseline figures for Care Continuum indicators as they relate to integrated BH services—i.e., Viral Load Suppression (VLS) and Retention in Care (RIC)—and will have processes in place to begin to assess and improve progress on these and critical BH measures.
