609 Grant Proposal Brailyn Bray Karina Corral Katelyn Murphy Robert Leumaga

HIV/AIDS PREVENTION AND EDUCATION COALITION
PROJECT
Prepared By:
Brailyn Bray BS, MPH (c)

Karina Corral BS, MPH(c)
Katelyn Murphy BS, MSHSA (c)
Robert Leumaga BS, MPH (c)
[Type here]
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HIV/AIDS Prevention and Education Coalition Project
ABSTRACT
There are limited resources available for residents in San Bernardino County, California.
Human immunodeficiency virus (HIV) and auto immunodeficiency syndrome (AIDS) are prevalent
among those living with HIV in the county. This includes 605 adults within the age group 18 years of
age or older who are: female and male, transgender, gay, bisexual, or other men who have sex with
men (MSM). The prevalence of HIV cases indicates the need for HIV prevention interventions and
health programs. The San Bernardino County – Public Health Communicable Disease Section
declared, that most HIV infections occur more often among people under age 30 than any other age
group. Individuals 20-29 years of age account for 44.1% of these new HIV case. Within the
communities of San Bernardino County, 51.6% of Hispanics make-up most of HIV related cases,
although Blacks accounted for the highest incidence rate of 22.3 cases per 100,000. In 2016, gay and
bisexual males, and MSM accounted for nearly 61.4% of all HIV cases in San Bernardino County. The
PrEp For Your Future Health Clinic is a community health-based organization focused on changing
individual health behaviors and sexual risk outcomes among ethnic minorities. This intervention will
address for incorporating program and services that better serve those living with HIV in San
Bernardino County. Some of these services include: Your Future Transportation Services Program and
Linkages to Care, Early Intervention Program Services. The PrEp For Your Future Health Clinic has
provided more than 15 years of treatment and prevention, outreach, services individually and education
services through a street-level and a multidisciplinary approach to those living with HIV of San
Bernardino County. The clinic is committed to reducing the spreading of HIV and addressing the
cultural needs of the county’s diverse population.
Keywords: HIV, AIDS, risk, interventions, health programs, health behaviors
Info@prephealthclinic.com
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TABLE OF CONTENTS
Specific Aims………………………………………………………………………………4
Working Hypothesis/Needs………………………….………….………….………5
Literature Review………………………………….……………………….………6
General Program Plan……………………………………………………………...7
Target Populations………………………………………….………………………….…9
Approaches and Methods……………………………………….….……………………..12
Project Goals and Objectives……………………………………………………….12
Activities and Timeline……………………………………………………………..13
Program Evaluation Plan…………………………………………………………………14
Agency Capacity and Project Management……………………………………………..16
Budget and Budget Justification………………………………………………………....17
Community Support………………………….……………………….…………………..20
References………………….………………………….………………….………………..21
Appendixes………………………………………………………………........….…….….22
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SPECIFIC AIMS
Today, there are currently 36.7 million people living with human immunodeficiency virus
(HIV), acquired immunodeficiency syndrome (AIDS), and roughly 5,000 diagnosed every day with
HIV. HIV is the virus that causes HIV infection, while AIDS is the most advanced stage of HIV
infection. According to the Center of Disease Control and Prevention (CDC), “HIV is spread through
contact with the blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids, or breast milk of a HIV
positive mother”. Although there is no known cure, people living with HIV and/or AIDS can live
longer, healthier lives if proper care and support is provided. Antiretroviral therapy (ART) is the
primary intervention used to treat those infected with HIV. ART cannot cure HIV, however is can help
with healing, treatment, and rehabilitation. If a HIV positive individual adheres to medication daily, it
may decrease the amount of virus in their bloodstream also known as their viral load. Decreasing your
viral load can help reduce the likelihood of transmission of HIV. Individuals not currently infected
with HIV may take medication daily for a specific time period to decrease the likelihood of becoming
HIV positive.
Currently, San Bernardino County is facing a need for HIV prevention care programs and
services due to the rise in numbers of HIV positive community members. As a community-based
health organization, we plan to improve our patient care access to medical services by implementing a
transportation service. San Bernardino has over 22,000 square miles, which means easy access to
HIV/STD services is a barrier for San Bernardino County residents which contributes to poor health
outcomes. By developing a transportation service to and from our clinic, we can increase our patient
continuum of care rate and reach all areas of the community. By providing these services, we can
expand on our patient referrals, and continue to grow as a clinic.
PrEp For Your Future has developed 3 aims to better assist our target population.
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 Aim 1 will increase access to care by providing alternative transportation to the clinic.
PrEp for Your Future will give our patients bus vouchers, gas vouchers, and house pick-
up/drop-off services. This will increase continuum of care rates and the overall health
outcomes for those living with HIV.
 Aim 2 will reduce the expansion of HIV infections. This will be done by administering
HIV testing to populations who are most at risk. We will have our certified HIV testing
counselors test people in the San Bernardino County through street outreach and various
testing sites in addition to the clinic
 Aim 3 will reduce HIV health disparities. Working with high-risk individuals, we can
provide them with resources to care and support in order to live healthier more stable
lives.
By expansion of services will establish a better foundation for all community-based health
organizations clients in San Bernardino County. By increasing staff, enhancing services, improving
access to transportation we can positively impact our target population.
Working Hypothesis
Providing transportation to clients to access medical care will provide individuals living with
HIV/AIDS full access to continuum of care services. Our goal is to provide an effective transportation
program for HIV positive individuals, to strengthen our Linkages to Care Program and reduce
behaviors that put people at high risk for unintended health disparities.
Literature Review
Early treatment of HIV infections reduces transmission of HIV from person to person and
improves overall health outcomes (Lankowski et. al, 2014). There are numerous barriers that can affect
the early treatment of HIV infections. Common examples of barriers include transportation issues, lack
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of knowledge/awareness of resources, inability to pay for treatment, too distant from clinics and for
women incorrect management of HIV infection in anticipation of and/or during pregnancy (Squires et.
al, 2011). Reasons for lack of access to healthcare services can be due to “availability, accessibility,
accommodation, affordability and acceptability of care (Sagrestano et. al, 2013). Modes of
transportation that patients rely on include private (own car), public (bus) and reserve (such as taxicab
or Medicaid van). Approximately half of patients rely on one mode of transportation, a quarter rely on
two modes of transportation and the remaining quarter rely on three or more modes to access HIV
related services (Sagrestano et. al, 2013). Lack of access to appropriate transportation services has been
found to interfere with continuing treatment for those living with HIV.
In descriptive studies conducted in Sub-Saharan Africa the following barriers were noted, lack
of transportation was commonly associated with lack of money to pay for transportation to and from
the clinic and from having to decide between paying for transportation versus basic necessities such as
feeding one’s family or purchasing medications for opportunistic infection prophylaxis, lack of social
supports to overcome transportation barriers, poor road conditions, difficulty accessing reliable
transportation and the inability to take time off from work to travel long distances to receive services
(Lankowski et. al., 2014). Patients facing these challenges will likely default on treatment, not adhere
to viral therapy, and suffer from opportunist infections associated with HIV (Lankowski et. al, 2014).
A qualitative study conducted among HIV-Positive Women in the Rural Southeastern United
States, reported implications for interventions of participants that were HIV Positive, which included
environmental and community factors, such as lack of patient and provider relationships as well as
access to transportation (Kempf et. al, 2010). It has also been documented that there are “numerous
opportunities for improved communication between healthcare providers and HIV infected women
regarding gender-based issues, particularly as they relate to management of HIV infection in
anticipation of and/or during pregnancy (Squires et. al, 2011).
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In another quality study HIV-infected adults (≥18 years) from three urban, Ryan White
Program funded clinics in Philadelphia – Hospital of the University of Pennsylvania MacGregor
Infectious Diseases Clinic, Temple University Comprehensive HIV Program, and the Jonathan Lax
Treatment Center at Philadelphia FIGHT (community based) participated in qualitative, semi-
structured interviews (Yehia et. al, 2015). Services these clinics offered included access to many Ryan
White-funded and community services including counseling, support groups, transportation assistance,
social work services, and case management to help individuals apply for housing and income
assistance. (Yehia et. al, 2015). Of these participants approximately, half did not retain clinic services
due to expensive and unreliable transportation, experiencing stigma, and insufficient insurance (Yehia
et. al, 2015). All participants cited “presence of social support, patient-friendly clinic services
(transportation, co-location of services, scheduling/reminders), and positive relationships with
providers and clinic staff as facilitators” as incentives to retention of care (Yehia et. al, 2015).
Retention of care is essential to optimally benefit from HIV care, “provide opportunities to monitor
response to HIV therapy, prevent HIV-associated complications, deliver ancillary services and been
shown to also improve survival and reduces the risk of HIV transmission to others” (Yehia et. al,
2015). Although retention of care is needed for HIV treatment to succeed, “only 50–75 % of HIV-
infected individuals in the United States (U.S.) linked to care meet national retention in care standards
(e.g. completion of two or more HIV primary care appointments per year)” (Yehia et. al, 2015).
General Program Plan
The PrEp For Your Future Clinic provides several programs and services for our target
population. Programs include the following: Linkages To Care and Retention, Early Intervention
Program Services, and Your Future Transportation Services Program. As a community based-health
organization, all of our services are focused on meeting the National HIV/AIDS strategy objectives
provided by The San Bernardino County Department of Public Health. There are three main objectives
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for HIV prevention services: 1) reducing new HIV infections, 2) increasing access to care to improve
health outcomes for people living with HIV, and 3) reducing HIV-related health disparities.
Your Future Transportation Services Program: Links individuals living with HIV or AIDS
to transportation services. There are various transportation systems throughout San Bernardino County
provided by both East Valley and West Valley San Bernardino Omnitrans, and other transportation
authorities within San Bernardino County. Clinical transportation services will be available for patients
with disabilities who cannot utilize our gas and/or bus vouchers. Organizational vehicles that are
Americans with Disabilities Act (ADA) compliant and medically equipped will be provided weekly
during business hours to transport patients to and from the clinic for scheduled services.
Linkages to Care and Continuum of Care: links individuals living with HIV to healthcare
and continuum of care, to ensure those living with HIV/AIDS have the resources and ability to receive
the services they need to improve their health and quality of life. As a San Bernardino County
community based-health organization, linkages to care and retention assistance provides new clients
with access to medical insurance, counseling, services to notify sex or needle sharing partners of
possible exposure, assistance with making appointments, health education, and referrals to other
programs. Within Linkages to Care we have Early Intervention Program (EIP) services that aim to
increase community awareness and assist the target population in developing new strategies to reduce
risks and improve treatment. Service will include: medical examinations, evaluation and treatment,
laboratory services, risk reduction and prevention education, treatment education, and adherence
support.
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TARGET POPULATIONS
The target populations are 605 adults within the age group of 18 years of age or older, living
with HIV/AIDS infections and newly diagnosed, which includes female and male, transgender, gay,
bisexual or other MSM. These target populations are patients who mostly have utilized and are in need
of HIV health care services at the clinic periodically. The majority of the 605 HIV/AIDS patients
reside in neighborhoods of San Bernardino County where there’s high rate of low-income,
homelessness, and high-poverty population. They have lower socioeconomic status (SES), reside in
rural areas of the county with less or no means of transportation to the clinic, and are members of
ethnic minorities. 20% of the target population are also undocumented immigrants.
Indeed, other key factors that attributed to the high prevalence of HIV/AIDS among the target
populations are; less than high school education or no education, illiteracy, language barrier, lack of
family or home support networks, engaging in injection hard drugs, and some with mental disabilities.
The lack of having HIV screening programs for these adults living with HIV increases their
chances of ailments and neglect. For counties comparison (Table 1), there are 62% of San Bernardino
County adults that have never been screened for HIV/AIDS in comparison to 60% of Riverside County
adults (CHNA, 2017). This means individuals be unknowingly infected with HIV/AIDS and exposing
others without willingly knowing.
Table 1: HIV Screenings in Riverside County and San Bernardino County (2011-2015)
Report Area Survey Population Total Adults Never Percent Adults Never
(Adults Age 18+) Screened for HIV / AIDS Screened for HIV / AIDS
Report Area 2,693,765 1,646,085 61.1%
Riverside County, CA 1,389,490 834,942 60.09%
San Bernardino County, CA 1,304,275 811,143 62.19%
California 23,991,050 14,593,763 60.83%
United States 214,984,421 134,999,025 62.79%
Source: https://assessment.communitycommons.org/CHNA/report?page=4&id=512&reporttype=libraryCHNA
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According to San Bernardino County-Public Health Communicable Disease Section’s 2016
Annual Morbidity Report, an estimate 4,031 people were living with HIV/AIDS in the county in 2016.
Within this population approximately 200 HIV and 100 AIDS cases are reported to the department
each year, and 84% were males and 16% were females. The County reported 16% of HIV positive
individuals were unaware of their infectious status and 23% of new HIV diagnoses developed
AIDS within 90 days. The county’s 2016 Annual Morbidity Report acknowledged that from 2015-
2016, there was an increase of 12.1% of new HIV cases (San Bernardino County, 2017).
Most HIV infections occurred among young people under age 30 than any other age group.
Individuals 20-29 years of age accounted for 44.1% of these new HIV cases (Figure 1). Among the
race/ethnicity, 51.6% of Hispanics made-up most of the cases, but Blacks accounted for the highest
incidence rate of 22.3 cases per 100,000. In 2016, gay and bisexual males (MSM) accounted for 61.4%
of all HIV cases in San Bernardino County (San Bernardino County, 2017).
Figure 1. HIV Cases by Age and Race/Ethnicity, San Bernardino County: 2016
Source: http://wp.sbcounty.gov/dph/wp-content/uploads/sites/7/2017/09/Annual-Report-2016-Final.pdf (p.26)
The San Bernardino HIV/AIDS program surveillance indicated a trend of high prevalence from
2014-2016. Risk factors associated with the increase were activities and mode of transmission by
MSM, IDU (injection drug use), MSM/IDU, heterosexual sex, perinatal, and other. The clinic is
determined to provide decent transportation services and well-organized health care HIV/AIDS
services to support HIV individuals within the target areas and populations of San Bernardino County.
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The availability of the funding for the clinic means positive and persisted health changes for the
target population, especially among young diagnosed HIV adults, to participate in project activities and
provide HIV services that are not easily available to them. The urgency of HIV/AIDS health services,
testing, prevention, and treatment is imperative and critical to the health of those living with HIV in the
county.
In addition, the county’s public health infectious disease epidemiology division indicated in
their 2016 STI/HIV Update report of the STD-HIV connection. The report notes STD infection
increases the chances of transmitting and getting infected with HIV by three to six times, especially
among the high-risk population in the county (San Bernardino County, 2017).
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APPROACHES AND METHODS
Project Goals
The PrEp For Your Future Health Clinic’s mission is to prevent, treat, and improve the health
and wellbeing of individuals living with HIV/AIDS in San Bernardino County. As a health-based
organization we are committed to meeting the needs of our target population, addressing social
determinants of health, and promoting health education through outreach. To meet sponsors goals,
execution of all program activities will be disseminated following a timeline for each program deadline
in order to ensure the needs of the target population is being met. The PrEp For Your Future Health
Clinic’s goal is to improve the lives of our clients through comprehensive program services for those
infected by or at risk of HIV and AIDS in San Bernardino County. To improve program services,
services will include a transportation services for clients to improve access to medical care
appointments, HIV/STD counseling, and testing.
To reach this goal, the objectives include the following:
Objective 1: By the end of each month, staff will have monitored the total number of appointments attended
by each patient through monthly Linkages to Care Program Logs.
Objective 2: Continuum of care rate of clients who receive transportation services will have increased by 5%
at the end of the calendar year. This will be measured through monthly client appointment logs and inventory
of monthly transportation vouchers disbursement.
Objective 3: By the end of each calendar year, a minimum of 600 people in San Bernardino County will have
been tested for HIV. This will be measured through HIV test site logs.
Objective 4: At the end of each month, at least half of the number of clients who tested positive for HIV will
have utilized linkages to care services. This will be measured by surveys and follow-up appointment monthly
schedule.
Objective 5: 100% of our HIV test counselors will have attended at least one HIV/STD Health Education
training, measured by yearly practicums that are monitored and approved by the program director of completion
of training.
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Activities and Timeline
Staffing/Training
Year 1 (January - December 2019)
PrEp For Your Future Clinic will recruit and hire clinic transportation drivers during January to March 2018. Once hired
training will commence for a period of 9 months (March 2018-2019). Existing staff will receive monthly trainings on new
procedures, survey collection, testing, counseling, and outreach. 100% of our HIV test counselors will have attended at least
one HIV/STD Health Education training. Survey process will commence.
Year 2 (January 2020-December 2020)
All staff will continue with monthly trainings encompassing any changes, survey collection, processes and recertification.
Any additional purchased vehicles will lead to retraining of drivers.
Year 3 (January 2021-December 2021)
All staff will continue with monthly trainings encompassing any changes, survey collection, processes and recertification.
During October 2021 survey results will be evaluated and put in a report to be shared as part of our grant requirement. Report
will show any trends and if intervention was successful.
Clinic Transportation Program
Clinic Transportation program will be set up in January 2019. Two ADA compliant vehicles will be purchased and retrofitted
with clinic specifications during January- March 2019. Routes will be created and tested during January 2019- March 2019.
Coolers will be purchased year 1 and year 2 of the program. During the months of January- March 2019 clinic drivers will be
recruited and hired. Training will commence in March 2019 and continue on a monthly basis. From March 2019 free
transportation to HIV/AIDS high-risk target population including (female, male, transgender, gay, bisexual, or MSM) within
the age group 18 years of age or older) in San Bernardino County, to and from the PrEp For Your Future clinic will
commence and continue for the entire timeframe of the grant and thereafter. Maintenance will start in March 2019 and will be
done every 3 months. Maintenance program will continue until the end of the grant.
Community Outreach
Clinic Services- existing services will continue at the clinic. New procedures of sample collection, testing and storage will
commence in March 2019. Free HIV testing to the target population through programs and services at the clinic 6 days
(Monday-Saturday) operational hours (8am-5pm). Goal of 50% tested recipients will return for results and support during the
first year. Survey collection of use of care and transportation services will commence in January and continue all year.
Promotion- community outreach will continue with existing patients and promotion will be done at community events and
high-risk areas.
Workshops- will begin in February 2019 and will be offered on a monthly basis. Topics covered will be with HIV/AIDS and
STD education and awareness of the available help when comes to being insured or uninsured, undocumented, and other
available resources to reduce health risks from HIV.
Clinic Services- existing services will continue at the clinic. Free HIV testing to the target population through programs and
services at the clinic 6 days (Monday-Saturday) operational hours (8am-5pm). Survey collection of use of care and
transportation services will continue. Goal of 50% tested recipients will return for results and support during the second year.
Survey collection of use of care and transportation services will continue all year.
high-risk areas.
Workshops- will continue to be offered on a monthly basis. Topics covered will be with HIV/AIDS and STD education and
awareness of the available resources for clients both insured or uninsured and undocumented, in addition to other available
resources to reduce health risks.
Year 3 (January-December 2021-December 2021)
Clinic Services- existing integrated services will continue at the clinic. Sample collection, testing and storage will continue
free HIV testing to the target population through programs and services at the clinic 6 days (Monday-Saturday) operational
hours (8am-5pm). Goal of 50% of test recipients will return for results and support during the third year.
high-risk areas.
Workshops- will begin in February 2019 and will be offered on a monthly basis. Topics covered will be with HIV/AIDS and
STD education and awareness of the available help when comes to being insured or uninsured, undocumented, and other
available resources to reduce health risks from HIV.
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PROGRAM EVALUATION PLAN
The PrEp For Your Future Health Clinic has a variety of integrated health programs. Evaluation
activities focus on the key areas of:
 Managing and measuring program performance
 Improving the quality of HIV programs
 Prevention of HIV infected persons and Prevention activities
o Counseling: HIV positives, partners, and mother to child HIV transmission
 Evaluation of reporting compliance
The planning process and outcome objectives will be tracked and determine to improve health
status. Internal technical assistance in evaluation will be provided by Dr. Gary Stephenson of
California State University, San Bernardino. External evaluation will be performed by medical staff
from San Bernardino Community Hospital to provide accountability to funders and other stakeholders.
Outcome objectives and evaluation measured through clinical services. A basic logic model of
(inputs, outputs, and outcomes) was put in place to achieve expected results during the planning
process.
● Free HIV testing at the clinic is 6 days a week (Monday-Saturday) at operational hours (8am-
5pm). Those that are scheduled a time to return for results will also be measured. Currently
(75%) of test recipients return for results and seek support during the first year.
● Patients who test positive for HIV, to referred to our Linkages to Care Program. Clients who
are referred and continue care will be measured and monitored through monthly logs.
● Patients who test positive for HIV, are also counseled and automatically qualify for our
transportation program. Free transportation vouchers on public transportation (Omnitrans) and
clinic ADA transportation services will be monitored based on an appointment basis.
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● Informed consent from patients is required. All personal information is confidential following
HIPPA and used for medical evaluation only.
[Please see Program Evaluation Plan - Logic Model in the Appendixes]
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AGENCY CAPACITY AND PROJECT MANAGEMENT
Agency Capacity
PrEp For Your Future Clinic provides programs and services for our target population in San
Bernardino which include: Linkages To Care and Retention and Early Intervention Program Services.
Services we provide are free HIV testing and counseling services. Counseling services are offered for
HIV positives, partners and mother to Child HIV transmission. We also have a referral system for
prevention and treatment with other nonprofits and clinics in our area. We are a multimillion dollar
clinic that is funded by a variety of sources such as private donors, foundations and government grants.
We work with local colleges and hospitals to access the needs of the community. Our patients pay little
to no copays and are offered a wide range of services that are offered long term. Our staff has been
extensively trained and educated within our community, so they are able to have not only the medical
perspective of treatment but also a community involvement. The clinic also works with world renown
researchers and consultants Françoise Barré-Sinoussi, Luc Montagnier,Robert Gallo and Deborah L.
Birx.
Project Management: 3 Components of the Project
Component #1 Component #2 Component# 3

Clinic ran by: Transportation Program ran by: Community Outreach ran by:
Health Education Assistant (2) Health Education Assistant (2) Health Education Assistant (2)
Communicable Disease Specialist (2) HIV Test Counselor (6) Communicable Disease Specialist (2)
HIV Test Counselor (6) Receptionist (1) HIV Test Counselor (6)
Counselor (2) Accountant/Controller (1) Counselor (2)
Receptionist (1) HIV/STD Program Coordinator (1) HIV/STD Program Coordinator (1)
Accountant/Controller (1)
HIV/STD Program Coordinator (1)
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BUDGET AND BUDGET JUSTIFICATION
Part I: Organizational Budget: Fiscal Year: 2019

1. Support-Income Source Amount
Government grants $12,000,000
Foundations ($610,000), Corporations ($45,000) $655,000
United Way or other federated campaigns $220,000
Individual contributions-other shareholders $60,000
Fundraising events and products $230,000
Investment income $12,616,000
2. Revenue-Income Source
Government contracts ($564,000), Earned Income ($417,000) $981,000
Revenue Income $981,000
Total Income $13,597,000
3. Item-Expenses Amount
Salaries, wages and benefits $2,080,299
Insurance and/or other taxes $595,074
Consultants and professional fees $40,000
Travel ($113,000), Equipment ($300,000) $413,000
Supplies ($38,980), Printing & Copying ($15,000) $53,980
Telephone and fax ($16,000), Postage and delivery ($6,000) $22,000
Rent and utilities costs (facility costs) $40,000
Other (specify)-External/Internal Administrative Costs $140,000
Total Expense $3,384,353
Difference (Income less Expense) $10,212,647
Part II: Project (Program) Expenses

Item Amount FT/PT
Salaries & wages: breakdown by individual position, indicate full/part-time $2,080,299
Health Education Assistant (2) $72,000 x 2 = $144,000 $144,000 2.0 FTE
Communicable Disease Specialist (2) $86,000 x 2 = $172,000 $172,000 2.0 FTE
HIV Test Counselor (6) 6 x $38,480 = $230,880 $230,880 6.0 FTE
Counselor (2) $60,737 x 2 = $121,474 $121,474 2.0 FTE
Receptionist (1) $47,840; Accountant/Controller (1) $82,000 $129,840 2.0 FTE
Accountant/Controller (1) $82,000 $82,000 1.0 FTE
HIV/STD Program Coordinator (1) $65,300 1.0 FTE
SUBTOTAL $2,943,793
Insurance, benefits and other related taxes $596,876
Consultants and professional fees $40,000
Travel (Private Vehicle $45,000; Airfare $25,000; Per Diem/Subsistence $43K)) $113,000
Equipment (Archival Materials-phlebotomy equipment, testing-chairs/-tables) $65,000
Supplies (office supplies, staff laptops/desktops) $38,980
Printing & copying (archival documents, education & printer materials, etc.) $15,000
Telephone/fax ($16,000) Postage & delivery (meter-stamps, envelope ($6000) $22,000
Rent/utilities costs ($40,000), In-kind expenses ($15,000); Depreciation ($35,000) $90,000
Total Expense $3,924,649
Difference (Income less Expense) $9,654,351
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Part III: Budget Justification
Category PHA Request Leverage

1. Salaries
Health Education Assistant (2) $72,000x2= 144,000A $36,000
This position will act to Assess the needs, develops goals and objectives, plans implementation strategies and
evaluates community health and patient education programs designed to motivate lifestyle change, prevent disease,
promote health and decrease known risk factors associated with poor health. Prepares health education reports,
assists in writing grant proposals, writes and designs articles, visual aids, pamphlets and news media materials such
as newspaper, radio and television releases; interprets the role and services of their respective health care department
to the general public, public and private organizations and other agencies. Develops and maintains collaborative
partnerships with community agencies and citizen’s groups aimed at the solution of health problems faced by the
community. Coordinates meetings, workshops, conferences, institutes and seminars; assists in the preparation of
manuals, outlines and guides to describe health services to specific groups. Trains departmental staff in health
education techniques; may work with department division heads and program managers to develop and maintain the
health education portion of their programs.
Communicable Disease Specialist (2) $86,000x2=172,000 $30,960
This position will act as the HIV/STI specialist and will communicate research findings on various types of diseases
to health practitioners, policy makers, and the public. Educate healthcare workers, patients, and the public about
infectious and communicable diseases, including disease transmission and prevention. Supervise professional,
technical and clerical personnel. Oversee public health programs, including statistical analysis, health care planning,
surveillance systems, and public health improvement. Provide expertise in the design, management and evaluation
of study protocols and health status questionnaires, sample selection and analysis.
HIV Test Counselor (6)-Hourly Rate: $18.50 $38,480 X6 = $230,880 $57,720
This position will administer fingerstick test to collect blood samples from patients. HIV Test Counselors will
provide HIV/STD education to individuals who test positive. Provide support to patients living with HIV/AIDS and
other communicable disease. Test counselors adhere to HIPPA (Health Insurance Portability and Accountability
Act) standards for patient confidentiality.
Counselor (2) $60,737x2=$121,474A $30,368.50
Provide support to patients infected with HIV/AIDS; conduct testing for the disease; communicate information about
HIV/AIDS and help patients deal with emotional reactions; assist patients through various stages of their disease.
Receptionist (1) $47,840A $11,960
Under general direction, performs a wide variety of administrative/secretarial support duties for an
agency/department head requiring independent judgment and action; supervises and directs subordinate secretarial
and other office support staff; and performs other related duties as required.
Accountant/ Controller (1) $82,000A $20,500
Establishes, reviews, revises, and maintains controls on fiscal record keeping functions in an assigned unit. Examines
and analyze fiscal recordkeeping systems and procedures. Prepares trial balances, reconciliations, worksheets, and
schedule. Analyze the classification and distribution of income and expenditures to proper accounts. Develop
complex rate or cost models.
HIV/STD Program Coordinator (1) $65,300
Integrates new strategies into prevention services (HIV counseling and testing, education, outreach programs).
Facilitates team meetings that include prevention, medical, case management, for successful program delivery.
Develops collaborative relationships with community organizations to provide client-centered education, screening
and linkage to care services. Develops new policies and programs to ensure the best practices are being delivered
to maintain relationships with external partners. Works closely as a liaison on administrative teams.
2. Fringe Benefits (Medical) $187,508.5 + $70,000 = $257,508.5 $64,377.12
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We make a payment to a worker in addition to salary or wages. It may take the form of cash, goods, or services, and
may include such items as health insurance, pension plans, and personal time off. We also allow up to $5,000
annually to any employee needs for education.
3. Consultant Fees $40,000 $10,000
The providing of expert knowledge to a third party for a fee. Consulting is most often used when a company needs
an outside, expert opinion regarding a business decision. We use this primarily for population data, and any need for
lawful expertise.
4. (a) Travel – Local Private Vehicle $45,000 $11,250
Two ADA complied company vehicles are used to provide transportation services for patients who need assistance
to and from their current residence for scheduled appointments at the clinic.
(b) Travel – Transportation, Airfare $25,000 $6,250
Our target population may be local; however, we do annually go to conferences to gain more insight on better
teaching mechanisms for preventative measures.
(c) Travel – Per Diem/Subsistence $43,000 $1,075
In any case of our employees traveling a far distance or needing to stay at a location overnight we allow a per diem
per day, per employee. The food per Diem is 25$ a day, along with a hotel budget that can be varied on location. We
average about 7 long stay locations a year to partner with other states on their current education practices.
5. Consumable Supplies and Materials PHA Request Match
General Office Supplies $38,980 $9,745
General office supplies, including paper, pens, writing tablets, envelopes and other mailing and office materials.
We do provide laptops for all staff including desktops at the facility.
Archival Materials $65,000 $0
This is for medical equipment, HIV testing chair, testing table stand, computers
6. Services $93,000 $0
Communications (telephone/fax/cell costs) $16,000 $0
Printing Services $15,000 $0
All paper and printing. This will be for all medical records. We keep hard copies for all patients for reference as
well as an online document. This cost includes printer paper as well as ink for all paper.
Postage $6,000 $0
For all marketing purposes to reach out to future patients as well as to send follow up- in mail postage to reach
out to current patients.
Facilities Cost $40,000 $0
To lease our clinic, it cost approximately $3,333.33 a month, which is an estimated $40,000 a year.
Staff Training $16,000 $0
Training will be conducted and delivered by in-house certified employees: Health Education Specialists,
Communicable Disease Specialists and Counselors. This training is critical to ensure all the PrEp For Your
Future clinic’s 13 employees have the basic HIV/STD counseling and testing skills to ensure adequate delivery
of program services. Trainings include: motivational interviewing, how to deliver test results, how to administer
HIV test, and what to expect when working with low-income and homeless populations.
7. Other Costs Request Match
Computers & Accessories $4,000
Printer/Scanner ($500), Projector ($450) $950
Health education workshops/trainings and counseling are held at the clinic, in addition the distribution of
materials for health information and marketing of program services and additional resources are essential for
recruitment external partners and our target population
8. Indirect
External/Internal Administrative Costs $140,000 $0
Outside contractors/evaluators. Information systems, legal, housekeeping.
Total: $1,524,432.5
20
COMMUNITY SUPPORT
HIV is stigmatized by many individuals and in some specific communities more than others.
Most of these stigmas are developed from misconceptions and lack of health education. Being
diagnosed with HIV can be life threatening as well as a stressful life event. Thus, having community
support is essential to living a more stable life. According to Dr. Friedland (1996), social support
reflects on several levels of care. Our clinic provides a variety of support resources and links clients to
additional resources to further meet the needs of our target population.
We currently have the support from:
 California State University of San Bernardino Health Clinic
 San Bernardino-Mayor
 Foothill Aids Project- Founder
 Health Care Professionals - R. Johnson, M.D
 Inland Empire HIV planning Council – President
 Current Patients
 Ryan White Fund
The PrEp for Your Future Clinic will continue to serve the community of San Bernardino County with
the help from our faithful partners and stakeholders.
[Please see Letters of Recommendations in the Appendixes]
21
REFERENCES
Kempf, M., McLeod, J., Boehme, A., Walcott, M., Wright, L., Seal, P., & ... Moneyham, L. (2010). A
Qualitative Study of the Barriers and Facilitators to Retention-in-Care Among HIV-Positive Women in
the Rural Southeastern United States: Implications for Targeted Interventions. AIDS Patient Care &
Stds, 24(8), 515-520. doi:10.1089/apc.2010.0065
Lankowski, A. J., Siedner, M. J., Bangsberg, D. R., & Tsai, A. C. (2014). Impact of Geographic and
Transportation-Related Barriers on HIV Outcomes in Sub-Saharan Africa: A Systematic Review.
AIDS and Behavior, 18(7), 1199–1223. https://doi.org/10.1007/s10461-014-0729-8
Sagrestano, L. M., Clay, J., Finerman, R., Gooch, J., & Rapino, M. (2013). Transportation
vulnerability as a barrier to service utilization for HIV-positive individuals. AIDS Care, 26(3), 314–
319. https://doi.org/10.1080/09540121.2013.819403
Squires, Kathleen E., Sally L. Hodder, Judith Feinberg, Dawn Averitt Bridge, Staats Abrams, Stephen
P. Storfer, and Judith A. Aberg. (2011). “Health Needs of HIV-Infected Women in the United States:
Insights from The Women Living Positive Survey.” AIDS Patient Care & STDs 25, no. 5 (May 2011):
279–85. https://doi.org/10.1089/apc.2010.0228.
Community Health Needs Assessment. (2017). CHNA. Retrieved from

https://assessment.communitycommons.org/CHNA/report?page=4&id=512&reporttype=libraryCHNA
San Bernardino County. (2017). Department of Public Health Communicable Disease Section. 2016
Annual Morbidity Report. 26-27. Retrieved from http://wp.sbcounty.gov/dph/wp-
content/uploads/sites/7/2017/11/Annual-Report-2016-Final.pdf
Yehia, B. R., Stewart, L., Momplaisir, F., Mody, A., Holtzman, C. W., Jacobs, L. M., & Shea, J. A.
(2015). Barriers and facilitators to patient retention in HIV care. BMC Infectious Diseases, 15, 246.
http://doi.org/10.1186/s12879-015-0990-0
22
APPENDIXES
Letters of Recommendations
Appendix A: Thomas D Morales
March 2, 2018
Tomas D Morales
California State University San Bernardino
5500 University Parkway
San Bernardino, CA, 92404
To Whom it may concern,
It is with much enthusiasm that I am writing to recommend the services of PrEp For Your Clinic.
CSUSB Student Health Center has been using this clinic for our students for the past five years and
have always been completely satisfied with their performance. They do an excellent job, are always
punctual, and show great care for our campus community.
We have also hired them on occasion for extra jobs, such as outreach programs, support groups, and
other educational seminars. They have been very punctual and always do exactly what we ask of
them. This has tremendously helped out community of students.
I'm happy to recommend the services of PrEp For Your Future Clinic. If you have any questions,
please feel free to contact me.
Sincerely,
Tomas D. Morales
president_morales@csusb.edu
23
Appendix B: R. Carey Davis
February 26, 2018
Government official,
PrEp For Your Future is a fantastic initiative that will offer great benefits to our community.
The spread of HIV and AIDS in our area has been a contentious and complex issue for
many years. PrEp For Your Future will have a great impact on reducing the spread of the
disease and will also provide specialized care to individuals who have been infected. With
an increased resource base, PrEp For Your Future will have the ability to reach even more
members of our community. They will be able to offer more counseling, educational, and
medical services to our San Bernardino residents by supporting them with a safe and
reliable transportation system to and from the clinics. I fully support the efforts of the
PrEp For Your Future Clinic and look forward to seeing their positive impacts grow here in
San Bernardino.
Thank You,
R. Carey Davis
R. Carey Davis
Mayor, San Bernardino
24
Appendix C: R. J. Davis
3/01/2018
To whom it may concern,
It is with great pleasure to formally endorse PrEp For Your Future Clinic. We have had the honor of
working with them for years and we truly see the great impact they have given our San Bernardino
Community.
Our community will greatly benefit from their expansion and we hope them the best in finding the
funds to make this possible. We know their clinic to be highly dependable and all of our team truly
enjoys working with them.
Please do not hesitate to call if you would like any of us at the foothill aids project to go into more
detail of our recommendation.
Best,
Foothill Aids Project (FAP)

R. J. Davis, Founder
25
Appendix D: R. Johnson, M.D
PrEp For Your Future Clinic

5500 University Parkway,
San Bernardino, CA 92407
(909) 537-5000
March 5th, 2018
To Whom it may concern:
It is with great enthusiasm that I submit this letter of recommendation on behalf of PrEp For Your
Future Clinic. As a senior faculty person at the University, I have had opportunity to see many
successful clinics throughout my years. Rarely do I have an opportunity to work with a group as
talented as this clinic.
I first encountered the PrEp For Your Future Clinic when I served as a facilitator of small groups that
we call clinical tutorials. In these small-group interactive sessions, patients learn to do a history and
physical examination, develop a problem list, and learn basic differential diagnoses. Patients develop
their own learning issues and report back to the group. It was obvious from the beginning that Prep for
your Future Clinic would benefit the community in many ways. This clinic is well organized and
delivers at an appropriate level.
In summary, PrEp For Your Future is not only very accomplished, but has tremendously helped
evolve our community. They are reliable and dependable. This clinic is well liked by patients, and their
families. In my 20 years of practicing medicine Prep for Four Future is one of top three clinics I have
worked with, therefore it is my pleasure to enthusiastically endorse PrEp For Your Future Clinic.
Sincerely,
R. Johnson, M.D
R. Johnson, M.D
26
Appendix E: Program Evaluation Plan – Logic Model
TITLE:
Continuum Of Care Services For Individuals Living With HIV/AIDS
NEED:
To increase continuum of care for individuals living with HIV/AIDS
GOAL:
To provide integrated program services that will increase continuum of care among HIV positive individuals.
Target Pre and Post
Inputs Activities Outputs Short-term Outcomes
Population Measures
Any person Transportation Transportation # of clients Risk behaviors decreased Pre-test assessment
living in San Resources services which received on health behaviors
Bernardino include: $75 transportation Post-test survey on
County. monthly gas card vouchers and treatment services,
-male or female voucher, bus pass, visited clinic. and counseling
- gay and ADA
-bisexual compliant vehicles Logs of number
-lesbian Training seminars, # of certified test Medium-term Outcomes HIV test
-Men sex with Counseling and protocols, and counselors administered, logs
documents for # of individuals who Clients HIV positive and
Men (MSM) Testing Personnel negative develop and adhere to of monthly medical
HIV Test Kits counselors and received HIV test care appointments
testers. # of clients who personalized high risk
High risk (needle reduction and treatment
received pre-test and
sharing) Pre- Test and Post- post-test counseling strategy Inventory log of #
- alcohol abuse Test HIV Counseling survey HIV incidence decreased clients enrolled in
- prostitution to all clients tested transportation
- homeless program and # of
Community Mobile clients who
Age: Van Outreach received
Testing will transportation
18 years of age administer HIV vouchers (gas/bus
Tests.
or older pass). Mileage log
Refer HIV + Clients # of clients tested Longer-term Outcomes
Referral System to treatment services. positive for HIV that
of mobile vehicle
for Prevention and “Linkages to Care” were referred to Quality of Counselors for client
Treatment Services treatment, care, and increase.Increase in prevention transportation
support services and treatment services for HIV services.
positive individuals
HIV morbidity and mortality Referral system
decreased
database
HIV transmission rates
decreased.

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HIV/AIDS PREVENTION AND EDUCATION COALITION

Brailyn Bray BS, MPH (c)

Keywords: HIV, AIDS, risk, interventions, health programs, health behaviors

expand on our patient referrals, and continue to grow as a clinic.

outcomes for those living with HIV.

testing sites in addition to the clinic

access to transportation we can positively impact our target population.

regarding gender-based issues, particularly as they relate to management of HIV infection in

anticipation of and/or during pregnancy (Squires et. al, 2011).

Program funded clinics in Philadelphia – Hospital of the University of Pennsylvania MacGregor

Treatment Center at Philadelphia FIGHT (community based) participated in qualitative, semi-

(transportation, co-location of services, scheduling/reminders), and positive relationships with

General Program Plan

others without willingly knowing.

According to San Bernardino County-Public Health Communicable Disease Section’s 2016

Source: http://wp.sbcounty.gov/dph/wp-content/uploads/sites/7/2017/09/Annual-Report-2016-Final.pdf (p.26)

APPROACHES AND METHODS

appointments, HIV/STD counseling, and testing.

To reach this goal, the objectives include the following:

Activities and Timeline

PROGRAM EVALUATION PLAN

activities focus on the key areas of:

 Managing and measuring program performance

 Improving the quality of HIV programs

 Prevention of HIV infected persons and Prevention activities

o Counseling: HIV positives, partners, and mother to child HIV transmission

 Evaluation of reporting compliance

transportation program. Free transportation vouchers on public transportation (Omnitrans) and

clinic ADA transportation services will be monitored based on an appointment basis.

HIPPA and used for medical evaluation only.

[Please see Program Evaluation Plan - Logic Model in the Appendixes]

AGENCY CAPACITY AND PROJECT MANAGEMENT

Project Management: 3 Components of the Project

Component #1 Component #2 Component# 3

BUDGET AND BUDGET JUSTIFICATION

Part I: Organizational Budget: Fiscal Year: 2019

Part II: Project (Program) Expenses

Part III: Budget Justification

Category PHA Request Leverage

additional resources to further meet the needs of our target population.

We currently have the support from:

 California State University of San Bernardino Health Clinic

 Foothill Aids Project- Founder

 Health Care Professionals - R. Johnson, M.D

 Inland Empire HIV planning Council – President

 Ryan White Fund

the help from our faithful partners and stakeholders.

[Please see Letters of Recommendations in the Appendixes]

Community Health Needs Assessment. (2017). CHNA. Retrieved from

Appendix A: Thomas D Morales

To Whom it may concern,

Appendix B: R. Carey Davis

February 26, 2018

To whom it may concern,

Foothill Aids Project (FAP)

Appendix D: R. Johnson, M.D

PrEp For Your Future Clinic

March 5th, 2018

To Whom it may concern:

Appendix E: Program Evaluation Plan – Logic Model

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