Interventions to build capacity of the HIV healthcare workforce: Lessons learned from practice transformation projects in California

The HIV care workforce is facing a shortage of providers. This guide provides an overview of two safety-net clinics in California that aimed to improve HIV care workforce capacity and patient access to care as part of a national demonstration project. The guide features a description of the key components of each clinic’s model and the lessons learned from implementation.

Food Insecurity and HIV Health: Nutrition Program Utilization among People Living with HIV in Alameda County

Food resource utilization among PLWH in Alameda County is not well understood. Project Open Hand (POH), a long-established food resource for PLWH in the Bay Area, serves medically tailored meals to PLWH in Alameda County. This brief report discusses the barriers and facilitators to POH utilization at their Oakland-based grocery center, and provides recommendations to improve access to healthy food resources among PLWH in the region.

The Impact of Mental Health Conditions on Public Insurance Costs of Treating HIV/AIDS

The prevalence of mental health conditions among people living with HIV (PLWH) is high (23% among Medicare and 28% among Medicaid enrollees).  Based on data from Medicare and Medicaid insurance claims from 2010, PLWH with mental health conditions had significantly higher treatment costs for both mental health and non-mental health conditions.  These data support further examination of how managed care capitations are set and whether they account for these greater expenditures.  Without adequate funding support, access for both mental health and physical health services for PLWH living with mental health conditions may be impacted.

Evaluating the Impact of Prior Authorization Requirements for PrEP and PEP in California

Prior authorization requirements have been considered a successful cost containment strategy for health insurance companies. However, previous research indicates that such requirements have negative impacts on medication access and patient adherence. California Senate Bill 159 is a current proposal to prohibit health plans and insurers from requiring prior authorization and step therapy requirements for Pre-exposure Prophylaxis (PrEP) and Post-exposure Prophylaxis (PEP.) This policy brief reveals the perspectives of clinical providers of PrEP/PEP and PrEP/PEP navigators in California on prior authorization requirements to prescribe PrEP and PEP.

Medical-Legal Partnerships to Support Continuity of Care for Immigrants Impacted by HIV: Lessons Learned from California

The United States(US) has experienced a surge of anti-immigrant policies and rhetoric,raising concerns about the influence on health outcomes for immigrants livingin the US. We conducted a qualitative study to understand how agencies inCalifornia were maintaining access to HIV care and prevention services forimmigrant clients. In this brief report, we describe the value of medical-legalpartnerships (MLPs) in addressing needs related to immigration andsupporting continuity of health care. We also outline facilitators for buildingthese partnerships between medical and legal services. Report available at: 

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