Integrating HIV and Geriatric Services for PLWH 50 & Older

Principal Investigator: Bill Blum
San Francisco Department of Public Health HIV Health Services

Patient-Centered Medical Home Demonstration Project
Awarded: 2010

Project description: Description of Clinical Sites: The proposed demonstration program operates through a Lead Institution / Consortium structure. The Lead Institution for the program is San Francisco HIV Health Services (HHS), an organizational unit of the San Francisco Department of Public Health (SFDPH). HHS has responsibility for coordinating and overseeing the demonstration project, including preparing project reports and disseminating project findings. The project's two consortium members also function as the project's two clinical demonstration sites: 1) the UCSF Positive Health Program Ward 86 Clinic at San Francisco General Hospital and 2) 360: The Positive Care Center at the University of California San Francisco (UCSF) Parnassus campus. The two clinics are among the largest HIV medical providers in San Francisco and together serve over 1,000 persons with HIV age 50 and older.

Description of Major Components of the PCMH Intervention: San Francisco HIV Health Services will work in close collaboration with Ward 86 and the 360 Program to design, implement, and test one or more models of integrated HIV and aging care services incorporating geriatric specialty elements in the context of the urban HIV health clinic. The program is designed to implement and test a series of new approaches to address the complex needs of the growing population of persons 50 years and older living with HIV/AIDS in the context of the HIV patient-centered medical home. The consortium will collaborate with project researchers to track appropriate indicators that measure the intervention's impact on factors such as patient health and wellness, medication adherence, retention in care, and/or satisfaction with services. The consortium will utilize project findings to produce and disseminate new best practices guidelines for HIV and aging care throughout California, resulting in the development of an effective patient-centered medical home model specifically for older adults living with HIV.

Research Aims: The overarching goal of the proposed research program is to enhance the quality and length of life of persons 50 and older living with HIV by enhancing services in the patient-centered medical home setting. The project's three primary aims are: 1) To demonstrate the feasibility and effectiveness impact of incorporating an integrated series of HIV and aging assessments for patients 50 and older into the standard assessment battery of the HIV patient-centered medical home, including protocols for referring patients to differential levels of care based on assessment findings; 2) To test the impact, cost-effectiveness, and acceptability of a series of linked clinical enhancements and interventions for persons with HIV 50 and older within the HIV patient-centered medical home setting, including enhancements that impact patient wellness, socialization, and self-care motivation and interventions that enhance geriatric knowledge of clinic staff; and 3) To broadly disseminate findings of the intervention to researchers, clinicians, health care planners and providers, and others to enhance the quality of care for persons 50 and older with HIV in California.

Contact Person: Bill Blum, Principal Investigator -