Workbooks describing ways to help connect people living with HIV/AIDS to medical care. Estos cuadernos describen la manera de asistir a conectar personas que viven con VIH/SIDA con el sistema médico.
Approaches to providing and linking to housing services and serving homeless and unstably housed clients.
Spotlight: See resources developed by The HIV, Housing & Employment Project, a HRSA SPNS initiative.
Best Practices and Emerging Models
- AIDS Action Foundation
- IHIPHHOME is a mobile care and systems intervention that helps connect vulnerable and homeless individuals in San Francisco to rapid HIV treatment.
- IHIPKC Life 360 is an employment-focused intervention that utilizes the intersection between employment services, HIV care and treatment, and housing to improve health outcomes of people with HIV.
- Center for Innovation and EngagementCollection of implementation guides on evidence-informed best practices in HIV care delivery.
- The HIV, Housing & Employment ProjectCOVID-19 adjustments developed by Ryan White HIV/AIDS Program recipients.
- Boston University School of Social Work Center for Innovation in Social Work and Health, The HIV, Housing & Employment Project
Best practices (and extensive resource links) for integrating into medical care teams the non-medical staff called Navigators.
- The HIV, Housing & Employment Project
Review of strategies for housing vulnerable populations in tight housing markets.
- Center for Advancing Health Policy and Practice
Insights from a HRSA SPNS initiative on care coordinator/patient navigation interventions for vulnerable populations.
- U.S. Department of Health and Human Services
Study examining models of integration and coordination of housing assistance services and HIV care.
- The HIV, Housing & Employment ProjectAvenue 360 Health & Wellness offers a medical home for patients and AIDS Foundation Houston coordinates employment training and resources. These agencies believe that coordination is the key to breaking down barriers to health care in their community.
- The HIV, Housing & Employment ProjectSSRP is a client, provider, and system levels intervention to rapidly connect PLWH recently released from jail/prison to medical, housing, and employment services using a Peer Community Reengagement Specialist model.
- The HIV, Housing & Employment ProjectCoordination of client services for six months and transitioning clients to the jurisdiction's case management system after completion of the program. Acuity scores determine clients’ case management paths.
- The HIV, Housing & Employment ProjectShort-term intensive case management services to link clients to housing, employment, and health care services provided by a team comprised of a Peer Care Navigator, Housing Navigator, and an Employment Navigator.
- The HIV, Housing & Employment ProjectSmart Care Management data-driven/IT model (e.g., patient portal, real-time dashboard for agencies) to enhance utilization of existing health, housing, and employment services.
- The HIV, Housing & Employment ProjectCoordination of health care with housing and employment services through regular meetings, formal agreements, and a Linkage Coordinator.
- The HIV, Housing & Employment ProjectPartnership between employment services and Ryan White HIV/AIDS Program providers to foster case coordination among medical care and social service providers, including a screening and referral system for housing and employment needs and services individualized for specific patient needs.
- The HIV, Housing & Employment ProjectCare coordination to link clients to services by assessing client needs, barriers, and stages of change, guided by electronic health records and a modified stages of change tool used to assess housing & employment stages of change.
- The HIV, Housing & Employment ProjectKC Life 360’s same-day intake, informed consent, and one-on-one with an Employment Career Specialist generates awareness of services and benefits across provider networks.
- Center for Innovation and EngagementThe Leveraging Housing Opportunities to Promote Retention in Care for People with HIV program in New York City offers three types of housing-related supportive services.
- The HIV, Housing & Employment ProjectHousing first model to help people with HIV address their housing instability while working towards obtaining employment and maintaining consistent medical care. Every patient completes an individual service plan, developed in partnership with their case manager.
- The HIV, Housing & Employment ProjectClients are enrolled into a low barrier program that provides immediate and critical housing crisis intervention, including in-housing employment services and ongoing intervention services to secure permanent housing and maintain access to HIV primary care.
- The HIV, Housing & Employment ProjectHousing and employment services include a Job Club to provide a supportive environment and training for participants.
- IHIPIntervention using three interconnected approaches to improve retention in HIV care: housing first, harm reduction, and Motivational Interviewing.
- U.S. Department of Housing and Urban Development
Information and training resources for various community development programs under the auspices of HUD, including HOPWA, Housing Opportunities for Persons with AIDS.
- Massachusetts Department of Public Health
Medical case management acuity tool to assess severity of needs of clients living with HIV in various areas of functioning and categories of severity.
- HIV Care Continuum: The Connection between Housing and Improved Outcomes along the HIV Care ContinuumU.S. Department of Housing and Urban Development
Review of the impact of unstable housing and homelessness on each step of the HIV care continuum and insights on improving care engagement and health outcomes at each stage.
- The HIV, Housing & Employment ProjectWebinars and briefs on delivery of HIV care to persons with unstable housing.
- SPNS Housing Data Integration
- Sharing and Integrating HIV Client Data Across Provider Organizations to Improve Service CoordinationSPNS Housing Data Integration
Webinars and Training
- HRSA HIV/AIDS Bureau (HAB)
Webinars on HRSA HAB policy notices and program letters for RWHAP recipients.
- IHIPWebinar series featuring HIV care innovations developed under the HRSA HIV/AIDS Bureau’s Special Projects of National Significance (SPNS) program. Sessions share insights on how to replicate SPNS interventions.
- HRSA HIV/AIDS Bureau (HAB)Highlight of two programs that successfully engaged in HIV care clients who are hard-to-reach and serve via delivery of HIV primary care, behavioral health, and housing.
- HRSA HIV/AIDS Bureau (HAB)Learn how two successful programs are addressing homelessness and housing instability and behavioral health disorders, improving client engagement and retention in care, and observing improved rates of viral suppression.
- HRSA HIV/AIDS Bureau (HAB)
Insights on understanding and leveraging of existing housing service systems to better serve people with HIV experiencing unstable housing.
- National Center for Innovation in HIV Care
Review of research on the impact of unstable/lack of housing on HIV care outcomes.