142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Building Sustainable Service Delivery Across the HIV Care Continuum: Community Based Organizations Connecting to the Dynamic Healthcare Landscape

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 1:50 PM - 2:05 PM

Marissa Tonelli , HealthHIV, Washington, DC
Michael D. Shankle, MPH , HealthHIV, Washington, DC
Brian Hujdich, BS , HealthHIV, Washington, DC

Implementation of healthcare reform, advancement of National HIV/AIDS Strategy, development of new public health strategies, reallocation of HIV funds, biomedical advances, and medicalization of HIV prevention are some of the fundamental shifts transforming the public health system. Many CBOs have not addressed their sustainability or relevancy in this dynamic environment and face closing, shrinking, or merging. Increased emphasis on accountability and focus on high-impact, scalable prevention strategies require CBOs to remain engaged and responsive.


An interactive, technical assistance (TA) program was developed to respond to CBO needs to remain relevant across the HIV care continuum. CBOs engaged in objective self-assessments of their programs, fiscal sustainability, readiness to evolve missions and services, and openness to developing collaborative models and strategic partnerships. Attendees from almost 100 CBOs, 63% in leadership roles, participated in an in-person training and remote TA. 78% indicated limited understanding of how healthcare reform will impact CBOs, 63% acknowledge limited business planning, and 70% of non-clinical CBOs hadn’t considered formal partnerships with clinical organizations, and 75% relied solely on public funding.

Lessons Learned:

Many CBOs have limited ability to translate national strategies into practice and need TA in strategic planning, funding diversification, partnership development and service delivery model adaptation. CBOs describe a lack of clinical and non-clinical provider collaboration opportunities.


Advanced TA is necessary to ensure the organizational sustainability of safety net programs. The integration of clinical and non-clinical services is essential to advance HIV service delivery and ensure fiscal and programmatic sustainability of CBOs.

Learning Areas:

Administration, management, leadership
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Program planning

Learning Objectives:
Describe the rapidly changing health care and HIV service delivery environment and its impact on CBOs/ASOs and their clients Discuss how CBOs can maximize integration of new models for HIV service delivery, including clinical and non-clinical service coordination Assess and diversify CBO business models and determine best practices for fiscal management and sustainability Identify best practices for identifying new alliances, strategic partnerships, and collaborations Explain how CBOs can implement sustainable practice transformation and maximize infrastructure to support the care continuum

Keyword(s): Community-Based Partnership & Collaboration, Affordable Care Act

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Director of Capacity Building Services at HealthHIV. I have been working in Public health for the last 20 years providing capacity building/technical assistance services to community based organizations and health departments. I developed this program and delivered and adapted the curriculum to over 400 participants across the country. I have provided these services on behalf of HHS, CDC, and HRSA.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.