Getting to Zero New Infections- Strengthening the Integration of HIV and Mental Health Treatment CDC National Prevention Conference Panel Presentation December 7, 2015 CDR Stacey R. Evans, PhD, MSW Health Resources and Services Administration HIV/AIDS Bureau
Objectives Participants will be able to identify two areas that the Health Resources and Services Administration s (HRSA) HIV/AIDS Bureau (HAB) supports in the delivery of mental health and substance abuse treatment Participants will be able to list two initiatives that HAB has engaged in to advance knowledge and skills in the delivery of health and supportive services to underserved populations with HIV infection Participants will be able to describe mental health and substance abuse collaborative initiatives between HRSA and other HHS Operating Divisions.
Health Resources and Services Administration (HRSA) The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, is the primary Federal agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable. Comprising five bureaus and ten offices, HRSA provides leadership and financial support to health care providers in every state and U.S. territory.
HRSA Mental Health Initiatives Since 2008, HRSA s efforts to increase access to mental health services have included the following: With the support of the Affordable Care Act and added more than 3,000 mental health providers to HRSA-funded primary health care centers - total now almost 6,400 Number of mental health providers in National Health Service Corps quadrupled from 800 in 2008 to 3,300 in 2015
HIV/AIDS Bureau Mission The Ryan White HIV/AIDS Program provides HIVrelated services in the United States for those who do not have sufficient health care coverage or financial resources to coping with HIV disease. The program fills gaps in care not met by other payers.
Overview-Ryan White HIV/AIDS Program Part A (Cities) Part B (States and Territories) ADAP AIDS Drug Assistance Program Part C (Community Based Organizations) Early Intervention Services Capacity Development Part D (Women, Infants, Children and Youth) Part F (Other programs) AIDS Education and Training Centers (AETCs) Special Projects of National Significance (SPNS) Dental Programs Minority AIDS Initiative (MAI)
Overview-Ryan White HIV/AIDS Program The largest Federal program focused exclusively on HIV care Supports the provision of primary medical care and essential support services for low-income people living with HIV (PLWH) who do not have health care coverage or are underinsured Works with cities, states, and local community-based organizations to provide a comprehensive system of care, reaching over 500,000 people living with HIV per year A smaller, equally critical portion of program funding is invested technical assistance, clinical training, and the development of innovative models of care Fiscal year 2015 funding: $2.32 billion
Who We Serve The Ryan White HIV/AIDS Program served half a million (524,675) people in 2013 Approximately 2 out 3 people living with HIV (PLWH) who are engaged in medical care are served by the RWHAP 47% Black/African American and 23% are Hispanic (2013) Close to 90% are living at or below 200% of the Federal Poverty Level (2013)
HRSA Regions (%) N RI 12,979 R2 37,187 R3 39,647 R4 73,654 R5 30,307 R6 32,219 R7 3,867 R8 4,617 R9 42,305 R10 4,104 RET 86 84 83 82 78 79 79 79 76 69 VLS 85 78 80 77 80 73 79 82 82 83 Table 1. Client retention and viral suppression, by HRSA region
HIV/AIDS Bureau Mental Health and Substance Abuse Initiatives AIDS Education and Training Centers (AETCs) New Provider Toolkit: Mental Health/Substance Use Care: Clinic/Health Center Readiness Assessment, which is available: http://aidsetc.org/resource/mentalhealthsubstance-use-care-clinichealth-center-readinessassessment-tool 30% of AETC ongoing training includes behavioral health topics on an annual basis
HIV/AIDS Bureau Mental Health and Substance Abuse Initiatives AIDS Education and Training Center Program (AETCs) Special Projects of National Significance (SPNS) www.aidsetc.org
HIV/AIDS Bureau Mental Health and Substance Abuse Initiatives Special Projects of National Significance (SPNS) An Evaluation and Innovation Methods for Integrating Buprenorphine Opioid Abuse Treatment in HIV Primary Care Settings http://hab.hrsa.gov/abouthab/special/buprenorphine.html Building a Medical Home for Multiply Diagnosed HIV-Positive Homeless Populations Initiative http://medheart.hdwg.org/resources The Minority AIDS Retention and Re-Engagement Project
2015 Department Collaborations HAB and the Assistant Secretary for Planning and Evaluation (ASPE) partnered to host the Women and Youth consultations HAB, the National Institute of Mental Health (NIMH), and the National Institute of Allergy and Infectious Diseases (NIAID) partnered to host the Trauma and HIV consultation
2015 Department Collaborations SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) http://www.integration.samhsa.gov/ Integration of HIV Prevention and Medical Care into Mental Health and Substance Abuse Treatment Programs for Racial/Ethnic Minority Populations at High Risk for Behavioral Health Disorders and HIV CIHS Issue Brief Project: Implementing Best Practices in Behavioral Health Screening in Integrated Care Settings
HAB Behavioral Health Workgroup LCDR Monique Worrell, DMHAP LCDR Monique Richards, DMHAP LT Cara Alexander, DCHAP Ruby Neville, DCHAP Barbara Kosogof, DCHAP LT Mekeshia Bates, OTCD Jesse Ungard, DPD LT Holly Berilla, DPD Connie Jorstad, DPD Glenn Clark, DSHAP Michael Goldrosen, DSHAP Stacey Evans, DSHAP
Question and Answer Session
Thank You