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HRSA's December Quality Improvement Grantee Spotlight

The Whiteside County Health Department Increases Access to Care for Patients Living With HIV

Ryan White HIV/AIDS Program Grantee

In observation of “World AIDS Day” (December 1, 2012), this month the Health Resources and Services Administration’s (HRSA) is pleased to highlight the work of the Whiteside County Health Department (WCHD) and its program funded  by HRSA’s Ryan White HIV/AIDS Program. Since many residents of Whiteside County, a rural community in Illinois, have difficulty accessing the necessary care to manage their illness, WCHD Health Department works to increase access for rural HIV/AIDS patients by referring clients to seek services at its Federally Qualified Health Center (FQHC) and through personalize home visits. These services connect HIV-positive individuals with health care to help them achieve optimal health and self-sufficiency.

HIV in Illinois
With the sixth highest number of AIDS cases in the nation¹, Illinois views transportation as an essential service to ensure access for residents living with HIV, especially in communities with limited public transportation. Public transportation is virtually non-existent in many rural communities, and rural clients may not have cars or family members available to drive them to necessary health services. Without transportation, individuals are not able to access the medical, case management, mental health, oral health, and substance abuse services that are critical to managing their disease.

Rural residents face significant barriers in accessing medical care, both primary and specialty, as a result of limited transportation resources as well as limited number of providers. For example, “an individual living with HIV will have to drive, at minimum, one hour each way to see an infectious disease specialist or a dentist” states Todd Kisner, an HIV program supervisor for Northwest Illinois. Transportation issues are also a significant barrier for individuals who are aware of their HIV-positive status². Primary medical care is an important first step in fighting HIV. Once established with a primary care physician, an individual is referred to an infectious disease specialist to determine the appropriate care.

About The Whiteside County Health Department

The Whiteside County Health Department (WCHD) HIV/AIDS program is funded under Illinois' HIV Care Connect program by the Illinois Department of Public Health, with Ryan White Part B grants from HRSA’s HIV/AIDS Bureau. HRSA HIV/AIDS Bureau Ryan White Part B grants. WCHD’s lead agency (the Winnebago County Health Department) is responsible for administering the HIV Care Connect program for Northwest Illinois and coordinates services and  local programs in the region.  The goal of WCHD’s medical case management program, the cornerstone of the Part B service program, is to instill within each person living with HIV, the skills necessary to understand and manage their own healthcare. A list of support services offered by WCHD is listed in Table 1.
 

Medical Case Management Services	Medical Transportation
Outpatient Ambulatory Medical Care Services	Nutrition
Oral Health Care	Legal Services
Mental Health Services	Linguistics Services
Outpatient Substance Abuse Services	Housing Services
Treatment Adherence Counseling	Emergency Financial Assistance (Utility Assistance)

Table 1: List of Services Offered through the Whiteside County Ryan White Program

Whiteside County Community Health Clinic, Inc. (WCCHC), a FQHC operated by WCHD since 2006, supports the Ryan White program by helping to provide a comprehensive continuum of medical care and supportive services for persons with HIV/AIDS. WCHD and its associated FQHC are also recipients of two Affordable Care Act-funded grants^{3, 4}.

How Whiteside Addresses Barriers to Access

The Illinois HIV Care Connect program allows staff to directly refer clients to medical and support services to facilitate expedient access to both primary care and infectious disease clinicians. The co-location of Whiteside County’s Health Department and Community Health Center allows individuals attending medical case management sessions access to care and lab testing- many that same day.

Through Whiteside County Health Department and Whiteside County Community Health Clinic, Inc, clients have the opportunity to access valuable public health services for women, infants and children, case management services, and sexually transmitted disease and intimate partner testing services. Patients also have access to much needed primary care services such as medical, dental, behavioral health and laboratory testing.

In spite of the availability of services, residents of Whiteside County still experience significant barriers in properly managing their health.  This situation is further complicated by the relative lack of medical specialists in rural areas like Whiteside County and the great distance that a typical patient may routinely have to travel to obtain necessary care. As a result, WCHD’s Ryan White program also provides home-based outreach services to the community. Patients who are unable to travel are visited by the program’s medical case manager, Deb Leroy, R.N. Mrs. Leroy currently makes home visits to 39 enrollees across multiple counties. During each visit, she reviews and updates the enrollee’s care plan and provides disease management education. She also delivers food and provides recommended immunizations. Each patient is seen at least every month, and sometimes more often.

 

Figure 1: How Whiteside Increases Access to Service for Rural HIV/AIDS Patients

Conclusion

With the help of HRSA’s Ryan White HIV/AIDS Program, WCHD has successfully worked with the Winnebago County Health Department and Illinois HIV Care Connect to reduce barriers to access experienced by individuals living with HIV and AIDS. WCHD has successfully instituted a home visiting program and leveraged the available resources of a FQHC to provide access to case management, health care and support services for people living with HIV in a rural community.

For more information, please email Beth Fiorini, MS, Administrator of Whiteside County Public Health, at bfiorini@whitesidehealth.org.

_{1. http://www.idph.state.il.us/health/statshome.htm}

_{2. Illinois Department of Health, State of Illinois. Illinois Ryan White Part B HIV/AIDS Program – Statewide Coordination Statement of Need and Comprehensive Plan for HIV/AIDS Services. June 2012.}

_{3. http://www.hrsa.gov/about/news/2011tables/110929medicalhome.html}

_{4. http://www.hrsa.gov/about/news/2012tables/120927healthcentersquality.html}