Capacity Building for Innovative Program Replication

Las Vegas 

Service gap addressed: Immediate access to care post-HIV diagnosis

Intervention: Rapid ART

Description:
The Southern Nevada Rapid stART (SNRS) was established to improve access to prompt HIV treatment initiation in the region. Led by the Office of HIV under Clark County Social Service, the initiative received support from the Pacific AIDS Education Training Center (AETC) to implement a comprehensive Rapid stART approach. Multiple stakeholders were involved in the Learning Collaborative, including the University Medical Center (UMC), the largest public hospital in Southern Nevada, the Southern Nevada Health District (SNHD) Community Health Center, Huntridge Family Clinic, and eight agencies funded by the Ryan White HIV/AIDS Program (RWHAP). Additionally, a non-RWHAP-funded agency also participated in the SPNS Learning Collaborative.

The Learning Collaborative achieved significant outcomes, such as expanding the number of Rapid stART testing facilities from three to 21. Moreover, a Rapid stART Rideshare program was established to address transportation barriers. Recognizing the importance of sustainability, the SNRS Learning Collaborative developed a comprehensive Rapid stART Manual. Further, they established the Rapid stART Response Team, which was responsible for facilitating coordinated action to ensure immediate access to care post-HIV diagnosis.

To maintain consistency and quality in the delivery of Rapid stART testing within the Rapid stART Care Continuum, the Learning Collaborative developed a dedicated Rapid stART Module. This module worked in conjunction with Rapid stART Performance Measures tools to monitor and assess the effectiveness of the program. The collaborative efforts of all stakeholders involved in the SNRS Learning Collaborative aimed to improve access to rapid HIV treatment initiation and enhance the overall care continuum for individuals diagnosed with HIV in Southern Nevada.

New Orleans

Service gap addressed: Engagement, re-engagement, and retention in care for people lost-to-follow-up and/or who have fallen out of care

Intervention: Community Health Worker

Description:
The City of New Orleans Mission: Undetectable CBA Learning Collaborative applied Quality Improvement (QI) methods and peer engagement to improve HIV care continuum outcomes. Mission Undetectable implemented community health worker intervention to improve engagement and retention in care of people with HIV in their EMA. Their Planning Team included staff from the city health department, state health department, SE AETC and nine RWHAP-funded clinics and community-based organizations. Mission: Undetectable also focused on emergency preparedness planning and relinking clients lost to care in the wake of Hurricane Ida.

Atlanta

Service gaps addressed: Retention in care and viral load suppression among African American/Black MSM and people of transgender experience.

Interventions: Project Connect and Retention through Enhanced Contacts; Collaborative Care Model; Peer Re-engagement program, TransLife Care, and In It Together.

Description:
The Atlanta CBA Learning Collaborative used the Patient Centered Medical Neighborhood concept to frame its intervention selection.  This concept acknowledges that when a single medical home cannot serve all patient needs, a broader support system becomes necessary.  Ideally the Patient Centered Medical Neighborhood includes all the caregivers and services interacting with each patient.  Atlanta’s participating sites then exercised agency-level autonomy in EII selection as long as the selected EII focused on the jurisdiction’s service gaps and populations of focus. Therefore, Atlanta implemented multiple EIIs compared to the other three jurisdictions which implemented an EII of singular focus. 

Mississippi

Service gap addressed: Access and engagement in care for people with HIV living in mostly rural locations.

Intervention: Community Health Worker

Description:
The statewide Mississippi CBA Learning Collaborative included staff from the state health department, the AETC (the University of Mississippi Medical Center), and eight RWHAP-funded clinics across the state. Leadership was provided by the Community Health Center Association of Mississippi (CHCAMS), the state's HRSA-funded primary care association. Their intervention was the Community Health Worker (CHW) model. Learning Collaborative activities included five learning sessions and a Harvest Meeting; CHW training conducted by the Aaron E. Henry Community Health Services Center; and the formation of the Mississippi Community Health Worker Association (MSCHWA), which has the registry for CHWs in the state. MSCHWA advocates for CHWs in the state and will sustain the CHW intervention model after the learning collaborative ends.

A complete series on CQM, its methods and tools, and how to incorporate CQM into the routine operations of an HIV clinic, by Jamie Shank for the Atlanta CBA Learning Collaborative. These webinars are:

•  Introduction to CQM for RWHAP Subrecipients
•  QI Principles - What QI is and What it Isn’t
•  QI Methodologies
•  Creating a Culture of Quality

Michael Hager presents the Patient-Centered Medical Neighborhood concept, used by the Atlanta CBA Learning Collaborative to help frame its discussion in selecting evidence-informed interventions.

An Innovative Care Engagement Intervention for Transgender Women of Color. By Josie Lynne Paul, Director of the TLC Program for Chicago House, Chicago IL, for the Atlanta CBA Learning Collaborative. Josie describes the implementation of this comprehensive Evidence-Informed Intervention for transwomen to improve the engagement in HIV care of transgender women of color, which she helped develop during the SPNS Transgender Women of Color initiative (2012-2017). 

By Tom Pietrogallo, CEO of the Poverello Center in Wilton Manor, FL for the Atlanta CBA Learning Collaborative. Tom presents on the critical, multifaceted work of peers in linking, re-engaging and support clients with HIV. 
 

UCSF CBA ETAP staff provided capacity building assistance to the four jurisdictions during this SPNS initiative. These two presentations were made to the Mississippi CBA Learning Collaborative during their Fourth Learning Session, November 2021. 

• Monitoring and Evaluating the Work of Community Health Workers. Dr. Starley Shade of UCSF discusses the importance of documenting the work of CHWs in the field. 
• Client Lists Refresher Training. UCSF’s Mary Guze reviews a client list EXCEL data collection tool developed by UCSF for use in Mississippi by CHWs to document their work with their clients.