Project Grant H79SP083899

RESOURCES, ENGAGEMENT, AND COLLABORATIVE HEALTHCARE (REACH) - THE REACH (RESOURCES, ENGAGEMENT, AND COLLABORATIVE HEALTHCARE FOR HIV/AIDS/SUD/STI) PROGRAM, SPONSORED BY TARRANT COUNTY HOSPITAL DISTRICT (DBA: JPS HEALTH NETWORK), WILL EXPAND JPS'S ROBUST HIV/AIDS TREATMENT SERVICE LINE TO INCLUDE PREVENTION FOR HIV/AIDS AND DEVELOPING PREVENTION SERVICES FOR SUBSTANCE USE DISORDERS (SUDS), VIRAL HEPATITIS, AND OTHER SEXUALLY TRANSMITTED INFECTIONS (STIS) BY IMPLEMENTING THE SAMHSA ENDORSED HUB AND SPOKE MODEL IN A PUBLIC HEALTHCARE SYSTEM. REACH WILL SERVE 285 PATIENTS OVER THE FIVE-YEAR GRANT PERIOD (45 IN YEAR 1 AND 60 EACH IN YEARS TWO TO FIVE). WITH REQUESTED FUNDING, REACH WILL MEET SAMHSA'S GOALS TO PROVIDE PREVENTION SERVICES, EDUCATION, AND TARGETED OUTREACH TO PATIENTS AT HIGH RISK FOR HIV/AIDS, SUDS, VIRAL HEPATITIS, AND OTHER STIS, PARTICULARLY THOSE IN THE LGBTQIA+ COMMUNITY. MEASURABLE OBJECTIVES INCLUDE: 1) PROVIDING OUTREACH AT 3 OR MORE EVENTS PER QUARTER, 2) PROVIDING PREVENTION AND NAVIGATION SERVICES TO 100% OF CONSENTING PATIENTS, 3) INCREASING PEP AND PREP UPTAKE BY 20%, 4) PROVIDING 100% OF PATIENTS EDUCATION IF THEY RECEIVE A PRESCRIPTION FOR PEP OR PREP, 5) PROVIDING 100% OF PATIENTS' PARTNERS ACCESS TO PEP OR PREP IF CLINICALLY INDICATED AND 6) PROVIDING 100% OF ELIGIBLE AND CONSENTING PATIENTS WHO REQUIRE INTENSIVE SERVICES A REFERRAL TO SUD SPECIALTY TREATMENT. THE TARGET POPULATION OF REACH IS ADULTS WHO ARE AT HIGH RISK FOR HIV/AIDS, SUDS, VIRAL HEPATITIS, AND OTHER STIS. THE POPULATION OF NEED INCLUDES 2,385 AT-RISK HIV-NEGATIVE AND 3,484 AT-RISK SUDS ADULTS WHO WERE SERVED BY JPS PRIMARY CARE IN THE PAST 12 MONTHS. BLACK AND HISPANIC INDIVIDUALS MADE UP ALMOST 80% OF PATIENTS WHO REPORTED THE PRESENCE OF A BEHAVIORAL OR SEXUAL RISK FACTOR FOR HIV ACQUISITION OR A POSITIVE BACTERIAL SEXUALLY TRANSMITTED INFECTION AT A JPS CLINIC VISIT IN THE PAST 12 MONTHS. ANOTHER 3,484 INDIVIDUALS WERE AT RISK FOR DEVELOPING A SUD IN THE PAST 12 MONTHS AND APPROXIMATELY 15% OF INDIVIDUALS WERE AT RISK FOR BOTH HIV AND SUDS. THE GOAL OF REACH IS TO IDENTIFY AND SUPPORT RACIAL AND ETHNIC MINORITIES, PARTICULARLY THOSE WHO IDENTIFY AS PART OF THE LGBTQIA+ COMMUNITY, WHO ARE AT RISK FOR HIV/AIDS, SUDS, VIRAL HEPATITIS, AND OTHER STIS. SUPPORT AND PREVENTION SERVICES WILL BE PROVIDED VIA THE HUB AND SPOKE MODEL TO EXPAND CURRENT EFFORTS IN AN UP-STREAM WAY, THEREBY PREVENTING PATIENTS FROM POSITIVE STATUSES. REACH WILL EXPAND ACCESS TO LOW-THRESHOLD PREVENTION AND IMPROVE PATIENT RETENTION AND ENGAGEMENT BECAUSE THE PATIENT IS IDENTIFIED IN THE URGENT CARE CENTER OR EMERGENCY DEPARTMENT AND LINKED TO LONG-TERM SERVICES WITHIN THEIR PRIMARY CARE CLINIC. STRATEGIES AND INTERVENTIONS INCLUDE ALL REQUIRED ACTIVITIES AND 2 ALLOWABLE ACTIVITIES. REACH WILL BUILD ON JPS'S CURRENT RYAN WHITE FUNDED PROGRAMS, WHICH ACTIVELY PROVIDE TREATMENT FOR HIV/AIDS, TO CREATE LOW-THRESHOLD PROVISION OF PREVENTION OUTREACH AND EDUCATION FOR NOT ONLY HIV/AIDS BUT SUDS, VIRAL HEPATITIS, AND OTHER STIS. REACH WILL LEVERAGE RELATIONSHIPS WITH JPS'S SAMHSA ED-ALT AND SAMHSA SBIRT GRANTS TO CREATE ACCESS FOR THE TARGET POPULATION TO ONGOING SUD SERVICES IN PRIMARY CARE. WITH REQUESTED FUNDING, THE REACH PROGRAM WILL USE THE SAMHSA-ENDORSED HUB AND SPOKE MODEL TO IDENTIFY PATIENTS IN THE TARGET POPULATION IN THE EMERGENCY DEPARTMENT AND URGENT CARE CENTER (THE HUB) AND TRANSITION THEM TO LONGER-TERM PREVENTION SERVICES IN PRIMARY CARE (THE SPOKES). REACH WILL HIRE ADDITIONAL STAFF, IMPLEMENT TWO-WAY TEXTING TECHNOLOGY, AND INCREASE TRAINING FOR CLINIC STAFF THEREBY FURTHERING THE REACH OF THIS FUNDING.