FoundCare Inc., a Federally Qualified Heath Center (FQHC) located in Palm Beach County, FL, is comprised of FoundCare Health Center and Comprehensive AIDS Program of Palm Beach County. Its Practice Transformative Model is a compilation of four evidence-based practice models, including Practice Transformation, Patient-Centered Medical Home, HIV Care Model, and Model for Improvement. Their PTM seeks to implement and integrate an interdisciplinary care team comprised of medical professionals, case manager, and peer para-professionals, in an effort to better engage patients in care and improve outcomes. This care team will be supported by practice improvements, including task shifting, designed to ensure greater workforce efficiency and increased capacity in each discipline.

The focus of the PTM will be to assess and improve organizational capabilities along the HIV care continuum and close gaps between the stages of the care continuum for patients. Technical, practice facilitation, and capacity-building assistance will be provided by HealthHIV, a subject matter expert. The goals of this PTMF are to enhance FoundCare’s capacity and readiness to implement a practice transformative model; to develop and integrate a team approach to increase testing; to create seamless linkage to care; increase retention in care; promote viral suppression; and to fully integrate HIV care into primary care.