1. Sustaining Primary Care-Public Health Partnerships for Engagement in Care – The Partnerships for Care Demonstration Project
Sue Lin, PhD, MS
Director, Quality Division, Office of Quality Improvement Bureau of Primary Health Care (BPHC) Health Resources and Services Administration (HRSA)

2. HRSA’s Bureau of Primary Health Care Strategic Goals
Increase Access to Care
Advance Quality and Impact
Optimize Operations
Health Center Program Mission: Improve the health of the nation’s underserved communities and vulnerable populations

3. Health Center Program National Impact
Source: Uniform Data System, 2017

4. Partnerships for Care (P4C) Demonstration Project
In 2014, HRSA collaborated with OHAIDP/SMAIF and CDC to lead
HRSA awarded $30 million to support expanded HIV service delivery over 3 years at 22 Health Centers in Florida, Maryland, Massachusetts and New York
Workforce Development
Infrastructure Development
Quality Improvement/Evaluation
5 P4C
Focus Areas
Service Delivery across
the HIV Care Continuum
Sustainable Partnerships with
CDC-funded State Health Departments

5. P4C and the Health Center Program
Between 2013 and 2014:
Nearly 13% of health centers were also Ryan White HIV/AIDS Program (RWHAP) Part C grantees
1 in 3 health center patients with HIV are served at
non-RWHAP health centers
P4C was designed to enhance HIV service delivery for non-RWHAP health centers and improve health outcomes for PLWH
P4C
Source: UDS

6. Leveraging Partnerships Across Federal Agencies
National HIV/AIDS Strategy 2020, Goal 4:
Achieving a More Coordinated National Response to the HIV Epidemic
Coordination at the Federal level should cascade outward to the health care system
Active coordination exchanges ideas and strategies between leaders with common goals
Health Centers – Primary Care Safety Net Program
CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention
State Health Departments
HRSA’s Bureau of Primary Health Care
Array of
services across communities
and populations that collectively
help people
be healthy
Medical
services to individual patients with immediate health needs
Promote health and well-being of all people
Primary Care-Public Health Partnership
Primary Care
Public Health
Source: Institute of Medicine, March 2012.

7. HIV Care Integration P4C Demonstration Project 2014-2017
↑ HIV testing by 27% to 1.8 million patients
84.5% of HIV patients were
Served 165,745 HIV patients
linked to care
over 616,392 visits
P4C Demonstration Project
The 22 P4C health centers built and sustained their expanded HIV service delivery through:
Optimized HIV testing, linkage to care, and pre-visit planning policies and procedures
Continued partnerships with state health departments through joint case conferencing
Past: Partnerships for Care (P4C) Demonstration Project
Present: P4C Toolkit & Southeast Practice Transformation Expansion Project (SEPTEP)
Future: Public Health Surveillance & Practice Transformation
2017 UDS data shows: 1,808,062 million patients were tested for HIV (increase from 2016 of 27%) (Table 6A, Line 21, Column b); 165,745 HIV Patients were served (increase from 2016 of 5%) at over 616,392 Visits (Table 6A, Line 1-2); 84.5% of HIV patients were linked to care (increase from 83.2% in 2016) (Estimated % of patients seen within 90 days of first diagnosis of HIV) (Table 6B, Line 20)
For the HIV care continuum, P4C health centers (79.1%) reported higher than the CDC national average (57.9%) for viral suppression of their HIV-positive patients.
Partnerships for Care (P4C) was a 3-year demonstration project ( ) supported by the Secretary’s Minority AIDS Initiative Fund and HRSA’s Health Center Program Funding to expand the provision of HIV prevention and care services within communities disproportionately impacted by HIV. 22 HRSA-funded health centers partnered with four CDC-funded state health departments in Florida, Maryland, Massachusetts, and New York to improve health outcomes across the HIV care continuum for PLWH, especially among racial and ethnic minorities.
HIV Testing: US Preventive Services Task Force recommends screening adolescents and adults aged for HIV at least once in their lifetime, regardless of risk. P4C health centers provided routine HIV testing to 77,347 patients aged years in the first 2 years ( ) who had never before been tested for HIV.
HIV Care Continuum:
Linkage to Care within 90 days of HIV diagnosis
Retention in Care is defined as HIV medical patients from the previous (vs. current) year who had at least 2 HIV medical visits in the current year
Prescribed Antiretroviral Treatment and Achieved Viral Suppression
The Southeast Practice Transformation Expansion Project (SEPTEP) is a 9-month HRSA project (September 2017-June 2018) funded by HRSA/BPHC’s Health Center Program in collaboration with the HIV/AIDS Bureau (HAB) AIDS Education and Training Centers (AETC) Program. The goal of SEPTEP is to advance HIV testing, linkage to care, and prevention at HRSA-funded health centers in the Southeast United States (Region 4), which has the nation’s highest rates of HIV diagnoses.
SEPTEP leverages lessons learned from BPHC’s P4C demonstration project and HAB’s AETC Program practice transformation projects. Health centers will receive HIV T/TA and practice transformation support from the Southeast AETC at Vanderbilt University to build the capacity of primary healthcare providers and teams caring for patients living with HIV and/or at highest risk for HIV infection in underserved communities.
SEPTEP health centers have achieved PCMH recognition and are not dually funded through Part C of the Ryan White HIV/AIDS Program
Coaching for practice transformation leadership includes a 2-day in-person workshop to (1) build core leadership skills in communication and strategic planning to overcome implementation barriers and (2) learn best practices for HIV testing, prevention, and motivational interviewing. The workshop is followed by communities of practice to present cases, discuss lessons learned, and share strategies for overcoming barriers to HIV practice transformation.
Additional resources can be found on HRSA/BPHC’s HIV Primary Care Integration webpage
HIV and Primary Care Training and Technical Assistance Resources
URL-

8. Thank You!
Sue Lin, PhD, MS Division Director, Quality Division, Office of Quality Improvement Bureau of Primary Health Care (BPHC) Health Resources and Services Administration (HRSA)
@HRSAgov
facebook.com/HHS.HRSA