Project Grant H8H46148

FY 2021 ENDING THE HIV EPIDEMIC - PRIMARY CARE HIV PREVENTION - BRIEF SUMMARY OF NEEDS TO BE ADDRESSED IN PROJECT: SHORTGRASS COMMUNITY HEALTH CENTER, INC., (SCHC) A 501(C)3 ORGANIZATION, WAS FOUNDED IN 2009, RECEIVED ITS NOTICE OF GRANT AWARD AS A NEW START COMMUNITY HEALTH CENTER IN JUNE 2012, AND BEGAN PROVIDING HEALTH CARE SERVICES FROM ITS MAIN SITE IN HOLLIS, OK, IN HARMON COUNTY. SCHC OFFERS MEDICAL, DENTAL, MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES. SCHC WILL USE PCHP FUNDS TO FOCUS ON INCREASING THE NUMBER OF PATIENTS COUNSELED AND TESTED FOR HIV; INCREASING THE NUMBER OF PATIENTS PRESCRIBED PREP; INCREASING THE NUMBER OF PATIENTS LINKED TO HIV CARE AND TREATMENT WITHIN 30 DAYS OF DIAGNOSIS. SCHC WILL ACCOMPLISH THIS BY CONDUCTING OUTREACH IN THE TARGETED SERVICE REGION AND POPULATIONS; UTILIZING 'OPT OUT' TESTING PRACTICES TO INCREASE HIV TESTING IN PATIENTS 15 YEARS AND OLDER; EDUCATING AND INCREASING WORKFORCE IN PRIMARY CARE; AND MAXIMIZING UTILIZATION OF PREP SERVICES FROM STATE AND LOCAL PARTNERS AND MEDICATION ASSISTANCE PROGRAMS. MAXIMIZING UTILIZATION OF PREP TREATMENT WILL INCLUDE DEVELOPING A REFERRAL SYSTEM, MOBILIZING A MULTIDISCIPLINARY TEAM, ENSURING FOLLOW-UP CARE AND ENGAGING PATIENTS THROUGH HIGH-INTENSITY SUPPORT WHICH WILL ENSURE LINKAGE TO QUALITY CARE. SCHC HAS A MOBILE SITE IT WILL USE TO REACH OUT TO DISPARATE POPULATIONS LOCATED IN COMMUNITIES WITHIN THE TARGET SERVICE AREA. SCHC IS IN PROCESS OF EXPANDING THEIR NUMBER OF PERMANENT SITES WITHIN THE AREA AND BY THE END OF JULY 2022 WILL HAVE A SITE IN ALTUS (JACKSON COUNTY) AND SCHOOL BASED HEALTH CENTER SITES IN OLUSTEE (JACKSON COUNTY) AND GRANITE (GREER COUNTY). THESE SITES WILL REDUCE TRANSPORTATION BARRIERS AND INCREASE SITES THAT CONDUCT HIV TESTING. SCHC WILL WORK WITH STATE PARTNERS TO EDUCATE PRIMARY CARE PROVIDERS IN THE IMPORTANCE OF SCREENING AND TESTING FOR HIV AND THE UTILIZATION OF AVAILABLE MEDICATION ASSISTED TREATMENT PROGRAMS AND PREP PROGRAMS IN THE STATE. SCHC PLAN ALSO INCLUDES IMPLEMENTING AL ERTS IN OUR EMR SYSTEM TO ASSIST PROVIDERS. PROPOSED TARGETED GEOGRAPHICAL AREA: THE RURAL SERVICE AREA IS IN FAR SOUTHWESTERN OKLAHOMA, BORDERING TEXAS, AND INCLUDES HARMON, GREER AND JACKSON COUNTIES IN OKLAHOMA. SCHC EXPANDED ACCESS TO HEALTH SERVICES THROUGH UTILIZATION OF A MOBILE VAN THAT TRAVELS TO THE NEIGHBORING COMMUNITIES IN JACKSON AND GREER COUNTIES. INCLUDED IN THIS IS AN OPPORTUNITY ZONE CENSUS TRACT 40065968700, A LOW-INCOME, ECONOMICALLY-DISTRESSED NEIGHBORHOOD LOCATED IN ALTUS (JACKSON COUNTY), OKLAHOMA. THE MAIN MUNICIPALITIES IN EACH COUNTY ARE HOLLIS LOCATED IN HARMON; MANGUM LOCATED IN GREER; WELLINGTON LOCATED IN COLLINGSWORTH, TEXAS; AND ALTUS, THE LARGEST MUNICIPALITY, LOCATED IN JACKSON COUNTY. THE COMBINED SERVICE AREA COVERS 2,906 SQUARE MILES. THIS IS A LAND AREA THAT IS LARGER THAN THE STATE OF DELAWARE (2,489 SQUARE MILES). THE AREA IS CLASSIFIED AS FRONTIER/RURAL WITH MANY OF THE SQUARE MILES BEING FARM OR CATTLE LAND. SCHC PERMANENT FACILITY LOCATION IS LOCATED IN HOLLIS WITH A POPULATION OF 2,352. COMBINED POPULATION FOR THE SERVICE REGION ZCTA'S IS 41,359. THE TRAVEL DISTANCE FROM HOLLIS TO ALTUS IS 38 MILES ALONG HIGHWAY 62 AND HOLLIS TO MANGUM IS 37 MILES ALONG HIGHWAY 33 AND 9 WHICH ARE NARROW 2 LANE HIGHWAYS. POPULATION GROUP TO BE SERVED: SERVICES ARE TARGETED TO UNINSURED/UNDERINSURED AND MEDICAID PATIENTS WITHIN THE SERVICE AREA. THE TARGET SERVICE AREA IS IDENTIFIED AS A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA (MUA) AND MEDICALLY UNDERSERVED POPULATIONS (MUP) WITH AN OPPORTUNITY TRACT LOCATED IN ALTUS, JACKSON COUNTY. THIRTY-FIVE PERCENT OF THE POPULATION IS LIVING AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL AND 17% IS LOW-INCOME UNINSURED. IN ADDITION TO THE POPULATION LISTED ABOVE, SCHC PROPOSED PROJECT WILL INCLUDE MIGRANT AND LBGTQ POPULATIONS IN THE SERVICE REGION. SINCE 2018, OUR PATIENT PANEL HAS TRENDED UPWARD FROM 2,382 UNDUPLICATED PATIENTS TO 3,362 IN 2020,