Community Health Centers Will Need Sustained Support to Help Meet Administration’s New HIV Initiative, New Analysis Finds


February 22, 2019

WASHINGTON, D.C. and NEW YORK, NY (Feb. 26, 2019) – Community health centers today serve more than one in five people in the U.S. living with HIV/AIDS and receiving care for their condition. As a critical part of the HIV/AIDS prevention and treatment system, health centers will need sustained funding and additional resources to support the Trump Administration’s recent initiative to stop new HIV infections in the United States by 2030. In Medicaid non-expansion states, health centers will face an especially great challenge, given Medicaid’s role in funding health care for people with or at risk for HIV. These are the key findings from an analysis published today by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University Milken Institute School of Public Health (GW Milken Institute SPH).

The Trump Administration’s newly announced initiative calls for a significant expansion of health care, including outreach to at-risk populations, services aimed at preventing new infections, and ongoing care and treatment for people living with an HIV diagnosis. In order to strengthen HIV-related care, community health centers nationwide will need to increase prevention, treatment and management services and remain sustainable, the researchers write.

“The feasibility of the administration’s HIV initiative entirely depends on the availability, accessibility, and quality of health care,” said Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy at Milken Institute SPH, one of the authors of the analysis. “Community health centers will play a major role, given the size of the patient population they serve, the scope of care they offer and their accessibility in at-risk communities.”

The administration’s initiative calls for targeting high-burden states, counties, rural areas and cities, including seven states with substantial rural HIV burden, 48 counties in 19 states, Washington, D.C. and San Juan, Puerto Rico. While all community health centers will face some challenges in ramping up services, sustainable expansion will be especially difficult in the 10 high-burden states that have not adopted the Affordable Care Act Medicaid expansion, the authors of the analysis conclude.

In these states – Alabama, Florida, Georgia, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas – thousands of low-income, at-risk people may not be covered by Medicaid, which increases the risk of inadequate care and places additional burdens on health centers to identify sources of sustainable financing to support expanded care. The analysis recommends a 10-year reauthorization of the Health Center Fund, with additional funding targeted to HIV/AIDS prevention and treatment efforts, as well as expanded Medicaid coverage in the 10 high-burden, non-expansion states. 

“Extending the Health Center Fund will be a critical step, as will active efforts to encourage Medicaid expansion,” said Feygele Jacobs, DrPH, President and CEO of the RCHN Community Health Foundation, whose ongoing gift supports the Geiger Gibson Program.

The analysis, “Community Health Centers and the President’s HIV Initiative: Issues and Challenges Facing Health Centers in High-Burden States and Communities” can be accessed here.

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The Geiger Gibson Program in Community Health Policy, established in 2003 and named after human rights and health center pioneers Drs. H. Jack Geiger and Count Gibson, is part of the Milken Institute School of Public Health at The George Washington University.

The RCHN Community Health Foundation is the only foundation in the U.S. dedicated solely to community health centers. The Foundation’s gift to the Geiger Gibson program supports health center research and scholarship.

The Milken Institute School of Public Health at the George Washington University is the only school of public health in the nation’s capital.