The AIDS Resource Center of Wisconsin's approach to caring for HIV patients has made it a national model.
If you are HIV positive and homeless, are you more likely to seek shelter or to go a doctor’s appointment? If you are hungry, are you more likely to seek food or take your meds? Homelessness and hunger are just two of many barriers to health care faced by Wisconsinites living with HIV.
But since the mid-1980s, the AIDS Resource Center of Wisconsin (ARCW) has been here to help them. Now, the organization is gaining national recognition.
“ARCW wraps its arms around a group of human beings who, in general, are poor and often stigmatized,” says Dr. Lee Biblo, chief medical officer at Froedtert Hospital and ARCW board member. “It guides them through a complicated maze of medical bureaucracy and has been an effective safety net.”
The ARCW model, delivered in nine locations around the state, is called the “medical home” model. This integrates medical, dental and mental health clinics, along with a pharmacy and social services, including food pantries, a legal-aid program, housing support and social work case management. Thanks to ARCW, each year, 3,000 HIV patients in Wisconsin receive the health care and social services they need for long-term survival.
“Services are provided in one location, by one team of individuals, and using a single electronic health record,” says Michael Gifford, president and CEO of ARCW. “This is so important for ensuring that patients take their antiretroviral medications.”
ARCW has a longstanding home-delivery program from its pharmacy and its network of eight food pantries. It also offers transitional and long-term housing, and rent and utility assistance. Its Legal Services Program helps with employment discrimination cases and the wrongful denial of Social Security benefits.
In addition, every patient who comes into an ARCW clinic gets screened for substance abuse and depression, as more than half of all HIV patients have mental health issues. “This is a challenging population,” says Biblo, “and ARCW serves them in a way that makes us proud as human beings.”
As a result, ARCW’s clinical outcomes are recognized as among the best in the country. Today, 85 percent of ARCW patients have an undetectable viral load (the level of HIV in the blood), indicating that their HIV is managed as well as medically possible. This exceeds the national average of HIV specialty clinics of 77 percent and the overall national average of only 28 percent.
In late 2013, ARCW was asked by the federal government to be one of three founding members of the National Center for Innovation in HIV Care. This collaboration will provide free training and technical assistance to AIDS service organizations (ASOs) to help them navigate the changing health care landscape.
ARCW, a “go-to” resource for other ASOs across the country, provides technical assistance and support to ASOs in 19 states. “Nationally, ARCW is well-respected as a highly efficient organization,” says Bill Hardy, president and CEO of the AIDS Resource Center Ohio, which has sought help from ARCW. “There is great advantage and efficiency in learning from other ‘best practice’ models. There is no need to reinvent the wheel.”
ARCW is also a leader in optimizing the Affordable Care Act. Its aggressive outreach strategy resulted in more than 700 patients signing up for insurance, reducing its percentage of uninsured patients down to 16. And its designation as a state “health home” (only 16 states have the status) allows for additional federal reimbursement for integrated care.
Despite ARCW’s successes, there is still much to do. “Society may have moved beyond the AIDS epidemic, but there are several hundred new infections in Wisconsin each year, and in 2011, 130 people died,” Gifford says. “HIV is still a very serious public health threat here, especially to young people.”