This announcement solicits applications for fiscal year (FY) 2016 to support a single organization that will serve as the Technical Assistance and Evaluation Center (TAEC) for a new initiative entitled Improving Access to Care:
Using Community Health Workers to Improve Linkage and Retention in HIV
Care. The goal of this three year cooperative agreement is to increase the utilization of community health workers (CHW) to improve access to and retention in health care; and to improve health outcomes for people living with HIV (PLWH) by strengthening the health care workforce, building healthier communities, and achieving health equity among racial and ethnic minority populations.
The project will focus on assisting HIV medical care provider sites, particularly those funded by the Ryan White HIV/AIDS Program (RWHAP), with the support needed to integrate CHWs into an HIV multidisciplinary team model through training, direct technical assistance, and collaborative learning sessions.
The TAEC will provide three levels of training and/or technical assistance (TA) comprising Direct TA, Webinars/Webcasts, and Learning Collaboratives.
Direct TA will be provided to up to ten (10) RWHAP medical provider sites serving racial/ethnic minority populations in geographic locations with low rates of retention and/or viral suppression as reported in the 2014 Ryan White Services Report (RSR).
The selected sites will also receive a subaward to support the development and implementation of their CHW program. The sites will be required to demonstrate need, interest, and capacity to sustain a CHW program during and after the project ends, and to fully cooperate with the TAEC in the multi-site evaluation. In consultation with the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB), the TAEC will be responsible for identifying the RWHAP medical provider sites to receive both the direct TA and a subaward, and for administering the subawards.
The RWHAP medical provider sites will be selected by the TAEC, in consultation with HAB, based on a pre-established set of criteria to include:
Identified Need - States/Jurisdictions with low retention rates or low viral suppression rates, among racial/ethnic minority populations, based on 2014 RSR data, with attention to African American and Latinos, including subpopulations, such as young MSM, youth, and substance users, as applicable.
Geographic Distribution - An attempt will be made to apply equitable geographic distribution across the United States to include both rural and urban settings.
Interest and Organizational Commitment/Capacity – Demonstrated interest and capacity to develop and implement a CHW program.
Sites will be required to demonstrate their ability and capacity to maintain a sustainable CHW model beyond the project period and the receipt of the initial TA provided by this cooperative agreement. Selected RWHAP sites may not allocate subawarded funds from this project to support a personnel salary in its entirety. Focus will be given to the selection of RWHAP medical provider sites that will support the incorporation of CHWs as part of an HIV multidisciplinary team model.
Sites must also demonstrate their capacity and willingness to participate fully in the multi-site evaluation required for this project.
RWHAP funded recipient or subrecipient organizations meeting these criteria are eligible to be considered for a subaward from the TAEC to implement a CHW program within an HIV medical care model intended to serve the priority populations outlined by the TAEC.
The TAEC will be responsible for the development and release of an application and awards to RWHAP recipient or subrecipient medical provider sites. The TAEC will develop and conduct webinars/webcasts for any HIV medical provider interested in gaining knowledge related to the development of a CHW program, with a focus on integrating CHWs into HIV multidisciplinary care and treatment teams.
Webinars/webcasts will also be utilized to increase the knowledge of any HIV medical provider with an interest in developing and/or strengthening a CWH component within their model of care The TAEC will also coordinate the formation and implementation of at least one learning collaborative with several learning sessions.
Learning collaboratives aim to capitalize on participants’ knowledge and skills with the principle that knowledge can be created within a group where members actively interact by sharing experiences and evaluating one another’s ideas.
The goal of the learning collaborative(s) will be the development of recipient/medical provider capacity around the use of CHWs to promote sustainability of CHW models.
The collaborative(s) will provide a venue for various stakeholders, medical providers and CHWs, to share and provide information and training on various components in the development and implementation of an effective CHW model, including:
the integration of CHWs into HIV multidisciplinary teams; building capacity of medical providers for an integrated CHW component; and discussing challenges and lessons learned from the implementation of CHW models.
At the conclusion of each collaborative learning session, participants will be provided action steps to be implemented prior to the next learning session, essentially giving each agency an outline for building capacity.
SMAIF funds may be used to pay stipends to organizations with successful CHW programs to lead the collaborative(s).
The TAEC will also be responsible for the development and implementation of an evaluation component to assess the effectiveness of project activities and the effectiveness of the CHW programs developed by the sites receiving direct TA.
Finally, the TAEC will be responsible for producing A CHW Implementation Guide, which will include:
(a) available CHW resources; (b) lessons learned from both learning collaboratives and direct TA sessions; (c) information on the various components required for the development and integration of an effective CHW program into an HIV primary care model; and (d) an evaluation tool to assess CHW programs in HIV care and treatment settings.