Health Centers and HIV/AIDS Testing and Care Achieving the HIV Testing Goals of the National HIV/AIDS Strategy US Conference on AIDS November 10, 2011 Seiji Hayashi, MD, MPH, FAAFP Chief Medical Officer U.S. Department of Health and Human Services Health Resources and Services Administration Bureau of Primary Health Care
Primary Health Care Mission Improve the health of the Nation s underserved communities and vulnerable populations by assuring access to comprehensive, culturally competent, quality primary health care services 2
Health Center Program Overview Calendar Year 2010 19.5 Million Patients 93% Below 200% poverty 38% Uninsured 62% Racial/Ethnic Minorities 1,052,000 Homeless Individuals 863,000 Farmworkers 173,000 Residents of Public Housing 77 Million Patient Visits 1,124 Grantees 8,100+ Service Sites Over 131,000 Staff 9,592 Physicians 6,362 NPs, PA, & CNMs Source: Uniform Data System, 2010, Service Sites: HRSA Electronic Handbooks Scope Repository 12/31/2010 3
Health Center Program National Presence October 2011 4
Health Center Program Growth: National Impact 2008-2010 20,000,000 19,500,000 19,000,000 18,500,000 18,000,000 17,500,000 17,000,000 16,500,000 16,000,000 15,500,000 Patients Jobs 135,000 8,400 130,000 8,200 125,000 8,000 120,000 7,800 115,000 7,600 110,000 7,400 105,000 7,200 100,000 7,000 2008 2009 2010 2008 2009 2010 Sites 2008 2009 2010 Year Year Year 2008 2009 2010 Growth from 2008-2010 (% Increase) Patients 17,122,535 18,753,858 19,469,467 2,346,932 (13.7%) Sites 7,518 7,892 8,156 638 (8.5%) Jobs 113,059 123,012 131,660 18,601 (16.5%)
Health Centers and HIV Patients Receiving HIV Testing All FQHCs (n=1124) Total 12 Cities FQHCs (n=223) Total Percent of All FQHCs RW Part C FQHCs (n=158) Total Percent of All FQHCs 781,750 325,338 41.6% 342,318 43.8% HIV Tests Conducted 860,249 361,766 42.1% 381,912 44.4% Patients with HIV Diagnosis Patient Visits for HIV Diagnosis 90,559 46,042 50.8% 58,279 64.4% 405,947 208,206 51.3% 270,179 66.6% Source: Uniform Data System, 2010, 6
BPHC s Quality Strategy Develop and enhance access to care Transform health center service delivery Data, HIT & Meaningful Use Patient Centered Medical Homes Patient Safety and Risk Management Local Health Systems Integration Recruit, develop, retain skilled workforce Coordinate and align policies and programs 7
Integrating HIV into BPHC s Quality Strategy QI Goals Develop and Enhance Access to Care Transform health center service delivery Examples of HIV Integration Enhance the accessibility and availability of services needed by people living with HIV Coordinate and integrate the health and support service needs of patients living with HIV (e.g., behavioral health, social services, medication management) Recruit, develop, retain skilled workforce Coordinate & align polices & programs Enhance ability of primary care providers to manage HIV and recruit HIV specialty providers, as appropriate Consider adoption of consensus-driven and established HIV performance measures 8
Leverage Partnerships & Collaborations Federal Initiatives National HIV/AIDS Strategy ECHPP &12 Cities Minority AIDS Initiative Federal Partners HRSA/HAB CDC, NIH, SAMHSA, CMS 9
Leverage Partnerships & Collaborations National, State, and Local Partners National Association of Community Health Centers Primary Care Associations National Cooperative Agreements HIV-Specific Stakeholders Community-based partners (ASO, CBHO, etc.) 10
Program Assistance Letters HIV Testing in Health Care Settings (PAL 2010-13) http://bphc.hrsa.gov/policiesregulations/policies/pdfs/pal201013. pdf Reviews CDC guidelines Highlights available resources HIV Care and Treatment in Health Centers (PAL 2011-06) http://bphc.hrsa.gov/policiesregulations/policies/pal201106.html Encourages integration of HIV into primary care Reviews guidelines and protocols Highlights available resources 11
Technical Assistance Examples All Grantee TA Call January 2011 National HIV/AIDS Strategy Improving HIV/AIDS Care in the Health Center Community Featuring four health centers http://bphc.hrsa.gov/technicalassistance/taresources/n hascallnotes040111.pdf.pdf Grantee Enrichment Call October 2011 Public Health Concerns of the LGBT Population Featuring The Fenway Institute HIV/AIDS resources on BPHC Technical Assistance Webpage 12
Questions Seiji Hayashi, MD, MPH, FAAFP Chief Medical Officer U.S. Department of Health and Human Services Health Resources and Services Administration Bureau of Primary Health Care 5600 Fishers Lane Rm. 17-105 Rockville, MD 20857 Telephone: 301.594.4110 Email: shayashi@hrsa.gov 13