December 11, 2012
Patients with HIV/AIDS in Vermont have received state-of-the-art care through the Comprehensive Care Clinics (CCC) for 25 years under the leadership of Christopher Grace, MD., professor of medicine and director of infectious diseases at the University of Vermont/Fletcher Allen Health Care, and Deborah Kutzko, nurse practitioner and leader of the clinic program. The clinic also employs a team of providers, nurses, social workers, and a dietitian and psychiatrist. The HIV/AIDS comprehensive care clinics were established in 1987. According to Melissa Farr, Vermont Cares Services program director, at that time, the establishment of a long-term clinical program to treat HIV was a heroic act, but because of the strong network of HIV care and treatment that distinguishes CCC, persons with HIV/AIDS in Vermont are living longer, healthier lives.
The program now includes four clinics across the state. They are supported by Ryan White CARE Act funding and other federal grants. At present, there are approximately 500 persons with HIV in Vermont, and according to Dr. Grace, the number of clinic patients increases each year by about 35 to 50. In 2011, the clinics provided health care for approximately 440 patients. Each clinic has a physician, nurse, social worker, dietitian, and psychiatric clinician. The model on which the clinics are based specifies an onsite nurse, onsite social worker, phone access to an infectious disease specialist, and visits once a month by a dietitian, and psychiatric nurse practitioner. Also once every month, a professor of medicine, an associate professor of medicine, and Dr. Grace visit different clinics. The group also has associates in northern counties of Vermont and upstate New York who assist with patient management.
One of the clinics, the Burlington clinic, cares for approximately 300 patients and is staffed by four physicians, in addition to Dr. Grace, and two other doctors who visit once per month. The Rutland clinic has 50 patients, the Brattleboro clinic, approximately 60 to 70, and St. Johnsbury, 20 patients. The collaborative relationship between Vermont CARES and the CCC facilitates patients' entry to medical case management and medical care. Patients are able to work with a team that is focused on supporting their overall wellbeing, including stable housing, good nutrition, growing social networks, and mental health support.