FY 2021 ending the HIV epidemic - primary care HIV prevention - raphael health center (RHC) is a federally qualified health center in indianapolis and was established in 1994

RHC's service area is about 7% of the marion county, indiana population and served 5,568 unique patients in 2020. We are unique in that we offer a full range of integrated care services, including primary care, behavioral health, dental and optometry. The majority of our patients reside in three ZIP codes: 46205, 46218, 46208. This particular geographic area has limited resources including lack of higher paying jobs, access to healthy foods and affordable and safe housing. In marion county, 15.2% of residents and 19.4% of children live below the federal poverty line. The lack of needed resources has led to poor health indicators for many of our patients. Although there are local HIV resources within the indianapolis metro area, the surge of STD and HEP c cases in marion county indicates there is more need than what is currently available. According to the marion county public health director, DR. Caine, the rate of reported acute hepatitis c infection in marion county rose from 0.6 to 7.6 per 100,000 population between 2013 and 2017. At least 86 percent of the new cases in 2017, patients reported injecting drugs within the last six months, and at least 58 percent reported sharing drugs and paraphernalia. The CDC estimates a prevalence between 9,200 and 11,400 cases of chronic hepatitis c for a population of marion county's size. HIV cases have also spiked. This background substantiates a strong need to implement HIV prevention and treatment services onsite at raphael health center. Raphael currently tests and connects HIV positive patients to services. However, we are proposing to implement a brand-new HIV program for raphael health center to target at risk and diagnosed HIV patients and community members. The RHC program will focus on providing testing to at risk patients that will be identified though a screening process. Our ELE ctronic medical records software called azara identified 2,09 eligible patients to be screened for HIV. From 1/2019 to 12/2019, RHC tested 1,065 patients. We believe that there are also more individuals in our community that are at risk and would come to RHC for HIV services if they are made aware of this new opportunity. For the prosed program, we anticipate hiring a full-time program coordinator that will oversee outreach, education and evaluation of the program and its patients. The program coordinator will work in tandem with our medical providers to prescribe prep and link patients to integrated care services; including overseeing counseling and education of patients. A treatment plan will be created for each patient based on screening and diagnoses. In effort to further support the management of the patient's health and well-being, we will also hire a community health worker (CHW). This program will include an .5 FTE medical provider to support the clinical needs of the program, including assessing patient risk factors and identifying their need for, and prescribing prep. With RHC's goal to markedly increase its HIV screening, assessment and initiating prep for the first time, we understand the need for education and training of staff and providers supporting the program. Therefore, we will include staff training dollars in the budget. Many of our patients already experience barriers such as transportation that hinders their ability to make IT to scheduled medical appointments. To alleviate that barrier for program participants, an important aim is to provide funds to cover rides to and from appointments via lyft, uber and public transportation. RHC 's goal is to provide prep testing to 10% (approximately 565 of our patients) of our patient population that is at risk for contracting, or diagnosed with HIV. Our goal would be to support at least 600 individuals that would need HIV prevention or treatment service and offe