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COVID-19 | Test to Treat Equity Grant

Connecting COVID-19 patients with therapeutic treatments to decrease related morbidity and mortality.

The California Department of Public Health (CDPH) has established the COVID-19 Therapeutics Equity Grant Program to expeditiously connect patients who test positive for COVID-19 with therapeutic treatment to decrease related morbidity and mortality.

CDPH has allocated up to $59 million to this “Test to Treat” grant program, which over the next 10 months will support safety-net providers to operationalize access to clinically appropriate COVID-19 therapeutics in a timely manner with a focus on three key expedited elements of COVID-19 assessment and treatment (testing, prescribing and therapeutics).

Application cycle open August 31, 2022 – September 30, 2022.


Overview

Since the beginning of 2020, health care organizations across the nation have tirelessly responded to patients’ needs in response to the COVID-19 pandemic. Providers shifted in-person visits to virtual visits, stood up new innovative workflows to test for COVID-19, and worked endlessly to ensure patients had access to the COVID-19 vaccine once it was available. Today, 2.5 years into this journey, organizations remain focused on ensuring treatment options are readily available to all populations.

The CDC and National Institutes of Health emphasize that rapidly connecting people who test positive for COVID-19 with treatment is effective in decreasing morbidity and mortality from COVID-19. This priority has been emphasized by both President Biden and Governor Newsom. Several treatments are available, effective, and recommended for treatment of non-hospitalized adults and children 12 years of age and older at high risk of progressing to severe COVID-19. To be effective, these treatments must be initiated as soon as possible after diagnosis and within five to seven days of symptom onset.[1] Pre-exposure prophylaxis is also available for those who qualify under the EUA.[2] Unfortunately, many vulnerable populations have had lower access to COVID-19 therapeutics, resulting in avoidable hospitalizations and deaths and widening equity gaps[3].

"Test to treat" pathways streamline the key elements of assessment and treatment (i.e., (1) testing, (2) prescribing, and (3) dispensing medication). With the advent of at-home antigen tests, telehealth, and mail-order medications, expedited test to treat may not necessarily mean patients will have access to all three elements in a single encounter or at a physical site, leading to tremendous opportunity to make each step more accessible and streamlined for patients.

For more information, please refer to the CDPH Therapeutics Playbook that provides information about several different aspects of COVID-19 therapeutics and Test to Treat systems, including clinical guidance and tools, distribution and logistics information, data applications and availability, and best practices for extending a provider network. The California Department of Public Health (CDPH), Physicians for a Healthy California (PHC) and Center for Care Innovation (CCI) has established the COVID-19 Test to Treat Equity grant program to improve access to COVID-19 therapeutics in communities disproportionately affected by COVID-19 and with the greatest barriers to care. 

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Funding Opportunities

Grant participants will be selected with the goal of expanding access to COVID-19 therapeutics to communities disproportionately impacted by the COVID-19 pandemic. 

Eligible organizations include California-based:

  • Federally Qualified Health Centers (FQHCs) and FQHC Look-Alikes.
  • Community clinics, rural health clinics, and free clinics.
  • Regional clinic networks (aka Consortia)
  • Clinics operated by county or city hospitals
  • Clinics operated by Public Health Care Systems
  • Indian Health Services (IHS)/Tribal Health clinics
  • Provider not listed above but is recommended by their Health Department. Applicants should contact T2T@phcdocs.org and include the contact information for the Health Department reference


Below are the grant opportunities based on the applicant’s provider type:

Category 1: Safety Net Clinics

Grants between $50,000-$500,000 offered to eligible community clinics including FQHCs, FQHC Look-alikes, regional clinic networks (aka Consortia), community clinics, rural health clinics, and free clinics, IHS/tribal health clinics, and providers not listed but are recommended by their Health Department.

Category 2: Clinics Operated by County or City Hospitals or Public Health Care Systems

Grants between  $250,000-$1,000,000 offered to eligible clinics operated by County or City Hospitals or Public Health Care Systems

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Technical Assistance

In addition to funding, grantees can receive technical assistance (TA) and coaching provided by CDPH through the Center for Care Innovations. This will include access to monthly coaching, participation in a peer learning community with other clinics launching and improving COVID-19 therapeutics services, and support with designing systems that will augment care for non-COVID-19 conditions as well. Grantmaking priority will be given to organizations that propose more substantive practice changes and/or practice changes that will impact more patients.

In addition to the grantee requirements listed above, grantees who receive this additional TA are expected to:
  • Identify a project lead that is responsible for day-to-day activities and can coordinate the work of the organization’s project team.** This individual will:
    • Participate in monthly coaching sessions to support their team.
    • Participate in three program Share and Learn sessions where the individual may be asked to present on promising practices or shared challenges for troubleshooting.
  • Develop a core project team (~4 people) that will be responsible for developing, implementing and improving the organization’s COVID-19 test-to-treat program. (The project team is invited and encouraged to participate in coaching and Share and Learn sessions, but we realize that not every member will join all sessions.)

*Please refer to the grant guidelines for additional details on eligibility and grant requirements.
**Organizations with multiple clinics should appoint a lead from each clinic to participate in monthly coaching and Share and Learn sessions.

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Objectives

Consistent with the California SMARTER Plan, the California Department of Public Health (CDPH) is launching the “COVID-19 Test to Treat Equity” grant program to improve access to COVID-19 therapeutics in communities disproportionately affected by COVID-19 and with the greatest barriers to care.

  • Increase the number of safety net providers that provide access to COVID-19 therapeutics for eligible patients within 48 hours of patient presenting to care.
  • Increase utilization of COVID-19 therapeutics by communities disproportionately impacted by COVID-19.
  • Strengthen multi-sector partnerships between safety-net health care providers and community-based partners that test for COVID-19 (e.g., CBOs, FBOs, shelters, assisted living, etc.) to increase access points to treatment.  
  • Create a “Test to Treat Learning Community” where best practices are shared, challenges are jointly worked on, and partnerships and coordination are strengthened across programs.  
  • Leverage solutions to strengthen the safety-net systems beyond COVID-19 care such as offering other timely assessments or chronic care interventions at points of care.
  • Reduce morbidity and mortality from COVID-19 especially among communities disproportionately impacted by COVID-19.

The grant funds and accompanying technical assistance will support safety net providers to develop workflows, processes, and communications to expedite each step of COVID-19 care delivery regardless of where the care occurs – in the home, at a clinic/pharmacy, or in the community.

Areas of focus include and are not limited to:

  • Development of workflows and processes to ensure patients who are eligible for outpatient COVID-19 therapeutics will receive pre-exposure prophylaxis or treatment in accordance with evidence-based guidelines.[4] This includes but is not limited to:
    • Expanded ability to dispense medications on site or via outreach teams
    • Expanded telehealth capabilities including advice call line triage
    • Developed surge capacity
    • Support of mobile clinics and home visits, including street medicine providers.Partnerships are encouraged.
    • Developed infusion capabilities 
    • Expanded urgent care and/or same day appointment capacity
    • Coordination of care and services, including ensuring prescription receipt by patient (at preferred pharmacy where medications are available, mail order or courier)
  • Enhanced health information technology and data tools in order to better serve and understand the needs of vulnerable populations
  • Care coordination, outreach, and member education that facilitates access to pre-exposure prophylaxis medication (Evusheld).
  • Providing non-emergency transportation as needed.
  • Maintained and tracked utilization data reporting that includes race/ethnicity, zip code, age, primary language, and gender to look for and address disparities in access.
  • Review and updating of educational content and materials for providers, patients, and community members, such as clinical advice phone lines, online content, and mailed content and internal policies. This content might encourage testing of those with COVID-19 symptoms, share methods to access COVID testing kits, and outline treatment eligibility with appropriate connection to applicable resources.
  • Facilitation of provider education on indications and availability of testing and outpatient pre-exposure prophylaxis and treatment for COVID-19 and how to access it, including information on the NIH COVID Treatment Guidelines[5]
  • Support for the registration of Test to Treat providers and sharing of information about incentives, communications, awareness campaigns, and COVID-19 therapeutics directly from respective local health jurisdictions.

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Office Hours

PHC will also be hosting weekly office hours where applicants can ask questions about the application or program requirements in a collaborative setting. Office hours are held via Zoom from 12 to 1 p.m. Pacific time on the following dates:

 


Additional Information

Depending on the grant threshold, awardees may be required to:

  • Participate in informational webinars
  • Engage with technical assistance programming, if applicable
  • Create project plan to increase access to COVID-19 therapeutics 
  • Develop an approach to track utilization of therapeutics to include patient demographics and equity impact, including but not limited to: Number of patients treated with COVID-19 therapeutics, stratified by race/ethnicity, age group, HPI quartile; average length of time from patients testing positive to: meeting with a physician and starting treatment; Average completion rate of patients getting from testing positive to starting medication
  • Submit an Interim and Final Report, within the time allocation identified in the Grant Agreement

The grant timeline is for 10 months, from September 2022 through June 2023. Though grant recipients will be awarded on a continuous basis starting in September, grantees can use funds to cover qualified expenses from August 1, 2022 - June 30, 2023

  • From $50,000 - $200,000
    • Milestone 1 (September 2022): Signed Grant, 90% of grant total
    • Milestone 2 (January 2023): Interim Report
    • Milestone 3 (June 2023): Final Report, 10% of grant total
  • From $200,000 - $1,000,000
    • Milestone 1 (September 2022): Signed Grant, 75% of grant total
    • Milestone 2 (January 2023): Interim Report, 20% of grant total
    • Milestone 3 (June 2023): Final Report, 5% of grant total

Add Your Organization

Providers not listed and believe they may be an eligible organization should contact PHC at t2t@phcdocs.org and include the name of their organization, contact information and a short explanation of why they believe they are eligible. If your organization was recommended by the local Health Department, please and include the contact information for the Health Department reference.

Contact PHC

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