Download New York - HIV Medicine Association

New York
132,523
people in New York are living with HIV infection, including those ever classified as AIDS
11.7% Private Insurance
45.8% Medicaid
3.8% Medicare
9.3% Other Public
15.1% No Insurance
13.2% Multiple Sources
Distribution of Ryan White Funding by Part
Poverty
Part A
$117,371,363
Part B
$162,007,850
Part C
Part D
$23,266,638 $12,496,769
Part F
$10,242,033
MAI
$12,753,387
Percentage living below 200%
of Federal Poverty Level
83.7%
Percentage living in poverty
(below 100% of Federal Poverty Level)
66.2%
77,763 clients received services in New York’s Ryan White Program
72.6%
of HIV positive clients who had at least one medical visit and had at least
one viral load reported are virally suppressed
Sources: HRSA Data Warehouse (datawarehouse.hrsa.gov).
AIDSVu (aidsvu.org). Emory University Rollins School of Public Health.
St. Luke’s Roosevelt Hospital Center: Center for Comprehensive Care
New York City
Victoria Sharp, MD, [email protected], (212) 523-6050
Georgina Osorio, MD, MPH, [email protected], 212-523-2613, www.centerforcare.org.
In 1986, AIDS Services were established at St. Luke’s Roosevelt Hospital, and a major re-organization occurred in
1997, at which point AIDS Services were expanded and renamed the Center for Comprehensive Care (CCC). Since
1997, the CCC has been providing a comprehensive model of care to the most low-income and marginalized HIV
infected individuals in New York City. Ryan White Part C funding has been critical to supporting the delivery of high
quality, comprehensive HIV primary care to patients with no other source for lifesaving HIV care and treatment.
New York City has the highest AIDS case rate in the country, with more AIDS cases than Los Angeles, San
Francisco, Miami, and Washington D.C. combined. The CCC is positioned to meet the needs of people living with
HIV/AIDS in New York City with two hospital-based clinics and a free standing clinic on West 17th Street strategically
located in the neighborhoods with the 1st and 2nd highest HIV/AIDS prevalence rates. The CCC’s catchment area
extends to all five boroughs (44% of patients are from Manhattan, 23% Bronx, 18% Brooklyn, 10% Queens and 1%
Staten Island).
What We Provide: The CCC provides the continuum of care through the Samuels Clinic at Roosevelt Hospital,
Morningside Clinic at St. Luke’s Hospital and West 17th Street Clinic in Chelsea. There are dedicated inpatient
services at both hospitals. The CCC provides full-service co-located care (“one-stop shopping”) delivered by experts
in HIV medicine at both clinic sites. Services include: HIV counseling and testing, HIV primary care, specialty care,
mental health services, case management and social work, on-site pharmacy, treatment adherence support, dental
care, screening and referral for substance abuse, nutrition counseling, domestic violence screening and intervention,
complementary therapies, special programs and events, and linkage to community based services.
Our Patients: The CCC currently serves more than 5,000 HIV-positive, predominantly poor patients. A majority of our patients
are people of color: 43% are Black (including African American, Caribbean, and African) and 35% are Hispanic/Latino.
One fifth of CCC patients are Black and Latina women. While the CCC offers pediatric services to approximately 200
youth, most of our patients are adults aged 40-59 years.
Clinic Insurance Status
Current Challenges: There are more than
100,000 persons living with HIV/AIDS in New
York City alone, and an estimated 25% of
people unknowingly living with HIV. Poverty,
mental illness, substance use, violence, and a
multitude of other co-morbidities pose
challenges to HIV-positive individuals in New
York City accessing and staying connected to the
continuum of service needed for effective
management of HIV disease.
Medicaid
21.4%
0.8%
15.1%
Medicaid Managed Care
Medicare
13.4%
0.3%
12.8%
Medicare Managed Care
36.1%
Private Insurance
None
Other Public
Each year HIV outpatient services providers
face increasing fiscal constraints. The
widespread use of HIV medications and treatment support services has decreased acute episodes of illness requiring
inpatient care for many of our patients with HIV/AIDS. However, without funding that keeps pace with clinic patient
caseloads and increased medical costs, more people living with HIV/AIDS in our community will go without regular
outpatient care and will require more intensive and costly interventions, such as hospitalizations. One study from
the Part C Clinic at the University of Alabama at Birmingham found that patients treated at the later stages of HIV
disease required 2.6 times more health care dollars annually than those receiving earlier treatment.