This Special Projects of National Significance (SPNS) initiative,System-level Workforce Capacity Building for Integrating HIV Primary Care in Community Health Care Settings, is a multi-site demonstration and evaluation of system-level changes in staffing structures to improve health outcomes along the HIV Care Continuum. This initiative is funding fifteen (15) demonstration sites for four years to promote the design, implementation, and evaluation of innovative strategies to increase organizations’ workforce capacities and achieve efficient and sustainable service delivery practices that both optimize human resources and improve quality outcomes. The University of California at San Francisco is serving as the Evaluation and Technical Assistance Center (ETAC) for this initiative. The ETAC will coordinate the multi-site evaluation; provide programmatic technical assistance to the demonstration sites; and lead publication and dissemination efforts of best practices and lessons learned.
This initiative seeks to enhance the capacity and readiness of funded organizations in making structural changes to their workforce systems to improve the provision of quality care to people living with HIV (PLWH). The demonstration projects will implement and evaluate innovative Practice Transformative Models (PTMs) for the delivery of HIV treatment and comprehensive care services in order to better respond to the changing healthcare landscape, marked by shortages of HIV primary care physicians and increasing demand for access to quality HIV services. Evaluation of these innovative PTMs will identify best practices and methods to support other organizations to adapt and re-align their workforces, as well as factors that increase the potential for successful integration of HIV care into primary care and community healthcare settings serving vulnerable populations.
Structural workforce changes employed by the PTMs include physician extension or task shifting (i.e. transferring specific tasks from the physician-level to mid-level providers or other health workers); restructuring staff to meet the standards of Patient-Centered Medical Home; integration of community health workers and patient navigators into the medical team; and inter-professional team-based practice coordination or co-management (such as a generalist physician overseeing HIV care while in regular consultation with an HIV expert).
The overall goals of these proposed PTMs is to increase the number of HIV care providers in their organization; increase the potential for successful integration of HIV care into primary care; and enhance the capacity and readiness of the organization’s workforce to identify, link, and retain people living with HIV/AIDS towards a path of achieving viral load suppression.