Ryan White Title III HIV Capacity Development and Planning Grants - The proposed project “FY 2025 RWHAP Part C Capacity Development Program” will expand dental service capacity at the Institute of Advanced Medicine (IAM) of the Mount Sinai Health System (MSHS) in NYC (d/b/a St. Luke’s-Roosevelt Hospital Center (SLRHC). The IAM is the dedicated umbrella across the MSHS for all HIV services and has provided primary care and support services to people with HIV (PWH) since 1986 (and dental services since 2004). Two of the IAM’s four HIV primary care clinics house its Dental Services Program: 1) Jack Martin Fund Center (JMFC) in Central Harlem; and 2) Samuels Clinic at Mount Sinai West Hospital in Clinton. In 2024, the JMFC served 3,221 PWH and 1,694 HIV- patients. Of those, 41% are Black and 32% are Hispanic/Latino. Males comprise 69%; females 28%; 3% are transgender or other sexual identities. Nearly 70% are on Medicaid or Medicare. In 2024, the Samuels Clinic served 1,477 PWH and 459 HIV- patients. Of those, 35% are Black and 39% are Hispanic/Latino. Males comprise 73%; females 22%; 5% are transgender or other sexual identities. Nearly 68% are on Medicaid or Medicare. The IAM’s Dental Services Program is open to all IAM patients. In 2024, the program served 1,193 unique patients, including 547 HIV+ and 129 HIV- dental patients at the JMFC and 491 HIV+ and 29 HIV- dental patients at the Samuels Clinic. In 2024, the program had 8,268 patient visits, for services including diagnostic, preventive, nutritional counseling, restorative, periodontic, prosthodontic, and emergency services. The proposed activity, which falls under the Infrastructure Development category, is the purchase of new dental equipment for both clinics, including digital scanners and hand pieces (drills), and new dental patient chairs (for Samuels Clinic). Insufficient dental equipment negatively affects the optimal provision of quality dental care services. Without the proper equipment, dental processes can take longer and patients need to be rescheduled until the equipment is available. Sterilization of dental equipment is not allowed in IAM dental clinics; all items must be sent to a centralized facility in a hospital miles away from each clinic. Turnover time for the sterilization of instruments and equipment is 2 days and, as a result, daily dental procedures are often limited due to lack of equipment. We expect that the enhanced capacity building of dental services infrastructure at IAM will improve access to and outcomes among our low-income, underserved priority populations by 15%. Our patients are disproportionately affected by HIV and have poor health outcomes. They include Black (including African, African-American and Afro-Caribbean) and Hispanic/Latino populations; LGBTQ+; women, infants, children, and youth; sexually active young adults; people leaving jail or prison; older adults; and individuals with a history of mental health and/or substance use issues. The Harlem and Clinton areas of Manhattan are Medically Underserved Areas (MUA) for primary care. Central and East Harlem are also Health Professional Shortage Areas (HPSA) for primary care, dental health care, and mental health care. Census tracts designated as Dental Health HPSAs are located throughout the communities the IAM serves, with concentrations in the Upper West Side, Central Harlem-Morningside Heights, and Washington Heights-Inwood neighborhoods of Manhattan. Both Harlem and Clinton have some of NYC’s highest HIV seroprevalence rates and unmet oral health care needs. The funding amount requested for the one-year period of performance is $150,000.
