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Part F: Continued

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National Centers Strengthen Training Efforts

AETCs became a part of the Ryan White HIV/AIDS Program following the 1996 reauthorization and were first funded through the program in FY 1997. The addition of four national training centers—the AETC National Resource Center, the AETC National Evaluation Center, the National HIV/AIDS Clinicians’ Consultation Center, and the National Minority AETC —all strengthened the ability of the AETCs to respond to the evolving needs of on-the-ground providers.

Specialized AETC Trainings

Over its history, the AETCs have been called on to provide a variety of specialized training and support, often with resources provided by other Public Health Service agencies. In 2003, for example, the AETCs were funded to provide targeted trainings to American Indians/Alaska Natives and providers of care and support services along the U.S.-Mexico border. The Substance Abuse and Mental Health Services Administration (SAMHSA) provided funding in 2004 for targeted training on HIV to mental health agencies and providers. In 2007, the Centers for Disease Control and Prevention provided funding to AETCs for training, consultation, and technical assistance on its new recommendations for HIV testing in primary care settings.

Reflecting on the role of the AETCs in the Ryan White HIV/AIDS Program, Frank notes, “I’ve always said that because we do training, we protect our investment. The dollars do no good if folks don’t know how to use the medicine.”1

Innovative Models of Care Through the SPNS Program

Originally housed in Part B, the SPNS program has been a proving ground for innovative models of care that focus on the most vulnerable populations of people living with AIDS. Congress moved the program into Part F in 1996. SPNS projects consist of sets of initiatives designed to address a specific community or service delivery challenge.

The program began with some of the first Federal grants to target adolescents and women living with HIV, and over the years, initiatives have been developed to reflect the evolution of the epidemic and the health care arena. For example, as more treatment options for HIV became available, the program examined models for supporting people living with HIV/AIDS in adhering to their prescribed treatments. As the Nation was moving to electronic medical records, the project launched its second health information technology initiative to promote and evaluate network systems serving people living with HIV/AIDS in underserved communities. Many of the initiatives also have focused on specific populations or health care settings, including youth, correctional facilities, and American Indians/Alaska Natives.

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    SPNS PROJECTS OVER the YEARS — A SAMPLE
  • Innovative Methods for Integrating Buprenorphine Opioid Abuse Treatment in HIV Primary Care
  • Enhancing Linkages to HIV Primary Care and Services in Jail Settings
  • Demonstration and Evaluation Models that Advance HIV Service Innovation Along the U.S.–Mexico Border
  • Assessing Existing Efforts to Increase Adherence to Medications

The Power of Replication

Underlying all the initiatives is a strong commitment to evaluation and dissemination of results. HRSA provided resources and expertise for grantees to evaluate their findings and to disseminate those findings to the HIV community, with the goal of replicating innovative initiatives at other sites. A 2005 study of 108 SPNS grants awarded from the beginning of the program in 1991 through 2002 found that large percentages of grantees had met the program’s mandate of developing innovative and integrated models of care targeting historically underserved groups and had effectively disseminated their results through a variety of tools.3

The legislation has always required that the potential for new SPNS models to be replicated be a factor in SPNS grant awards, and the first three versions of the legislation also included specific populations that might be served through the initiative. The 2006 reauthorization was far less prescriptive in terms of populations served, but it did include a new requirement that SPNS fund special programs to develop a standard electronic client information data system to improve the ability of Ryan White Program grantees to report client-level data. The goal is for Congress, HRSA, service providers, and planning bodies to have concrete data on how many people are being served along with important demographic information.

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