1. Prism Health North Texas Programs and Services
Free World Bound – MAI (FWB MAI)
Daron Kirven, FWB Director
January 31, 2019

2. Prism Health North Texas formerly known as AIDS Arms, Inc.
Mission Advancing the health of North Texas through education, research, prevention, and personalized integrated HIV care.

3. Prism Health North Texas Services
Serves 13 North Texas counties – depending on program
Services provided at several sites:
Two HIV medical care clinics (Oak Cliff Clinic and South Dallas Clinic) – primary HIV medical care and integrated behavioral health care with a co-located pharmacy at one site
Outreach, mobile/onsite testing services
Mobile/onsite case management, behavioral health care, psychosocial support services, HIV/HCV testing and risk reduction counseling
Clinical Trials
PrEP
HIV empowerment center for PLWH
Key goals:
Prevent HIV
Test those at high risk for HIV infection
Engage and retain HIV positive people in medical care and treatment
Help HIV positive people achieve viral suppression, optimal health

4. New Client Other Key Programs Case Management Outpatient Medical Care
New Client Intake
Welcome Appointment
Initial assessment
- barriers
- eligibility
- needs
- resources
Referrals/linkage to care
New
Client
Outreach, testing & risk reduction interventions in the community for
HIV+
High risk HIV-
Case Management
Increase Access/Understanding of HIV Care System
Assess - barriers to medical care, needs
Collect eligibility documentation/assess eligibility
Create care plan based on client needs/goals
Provide/coordinate referrals to care; ensure linkage
Monitor adherence to care and provide support
Make home visits/family education
Annual eligibility assessment for referrals
Risk reduction interventions
Ongoing follow-up & evaluation of referrals, needs
& emerging barriers to care
Identify clients who have dropped out of medical care
Outpatient Medical Care
Medical assessment & management
Treatment adherence interventions
Subspecialties: infectious disease, Internal medicine, dermatology, Psychiatry and disability assessments
Research/clinical trials
Nutritional counseling
Medical Case Management
Treatment education & support
ID/reduce barriers to subspecialty care
Coordinate medical referrals
Adherence to care interventions
Risk reduction education
Identify patients who are Lost to Care
Re-link to care
Medication Financial Assistance
Medicare Part D
ADAP – State Program
Pharmaceutical Financial Aid
Compassionate Care Programs
Other Key Programs
FWB Prison and Re-entry
Prevention Services
Family/individual psychotherapy
Substance abuse/mental health
treatment
Family educational support
Client Resource Library

5. PRISM HEALTH NORTH TEXAS
Re-Entry Programs – Free World Bound

6. DSHS MAI – FWB Re-Entry Program
Services:
Outreach
Health Education and Risk Reduction
Linkage to Medical Care
Enrollment in THMP
Linkage to Case Management Services
Copay assistance for prescriptions
Transportation
Linkage to Social Support Services

7. MAI PROGRAM STAFF Tymeka Phenix – Program Manager
Rosalind Lawrence – OES
Sheree Hoops – OES
(Outreach Education Specialist)

8. FWB HIGH IMPACT PREVENTION PROGRAM
Title: Free World Bound High Impact Prevention (FWB HIP) Program
Provided within the Prism Health North Texas system of care
Leverages totality of services to provide individuals with comprehensive and seamless care.

9. FWB HIP Program Overview
Outreach
Prevention with HIV positives (START Intervention)
Prevention with high risk HIV negatives (Personalized Cognitive Counseling (PCC) Intervention)
Linkage to Case Management Services
Counseling Testing and Referral (CTR)
Linkage to Care (Anti-Retroviral Treatment and Access to Services (ARTAS) Intervention)
PrEP
Navigation and Support Services
Condom Distribution

10. FWB MAI & FWB HIP Recruitment and Referral Process

11. FWB OUTREACH Transitional Facilities Parole and Probation Departments
Substance Abuse Facilities
Mental Health Facilities
Homeless Shelters
Housing for Re-Entry Persons
Other providers that work with the priority population

12. FWB – Flow of Services Incarcerated Population Re-entry Population
Project START Plus
2 sessions in correctional setting
Outreach CTR
HIV +
HIV+ and HIV-
Project START
4 sessions after release
HIV+ and HIV-
HIV+
HIV- at high risk for HIV
HIV+
ARTAS – Linkage to Care
STI eval & trtmt
PrEP eval and Rx
HIV Care
HIV medical care, medication assistance, psychosocial case management, and referrals to address barriers to care and/or meet client needs
HIV-
HIV+
HIV-
PCC
PrEP
Community Referral Network
Substance abuse and/or mental health treatment,
GED classes, job training, transportation assistance, food, clothing, housing, domestic violence assistance, family reunification services, etc.
Condom Distribution

13. THANK YOU!
QUESTIONS?