Navigator Case Management
Resource updated 09/14/2023
Resource updated 09/14/2023
Managing the needs of people with HIV can be difficult and intensive. The importance of caring for oneself is often overlooked by program staff and can threaten their well-being. Staff who provide non-medical case management and assistance in finding employment and housing were interviewed to determine key areas of concern.
Resource (Conference Presentation) updated 09/14/2023
Prism Health North Texas will share the challenges and successes of integrating non-medical case management workflow processes into an integrated electronic health record system. The presenter will discuss workflow processes, assessments that allow non-medical case managers to gather required information and determine outcomes and identify patients appropriate for program graduation.
Resource (Conference Presentation) updated 09/14/2023
The Los Angeles County Department of Health compared change in acuity level from initial assessment to reassessment among Los Angeles County Medical Care Coordination (MCC) clients. At reassessment, 2,361 clients (50%) had a significant reduction in acuity. MCC is an effective strategy to reduce medical and psychosocial acuity in addition to improving HIV care continuum outcomes.
Resource (Conference Presentation) updated 09/14/2023
Modernizing acuity scales in provision of services to clients allows for those with the greatest need to achieve improved health outcomes in a health equity approach.
Resource (Conference Presentation) updated 09/14/2023
This workshop describes the implementation and evaluation framework for Care and Treatment Interventions (CATIs), offers key results and outcomes, and provides points for replication and integration.
Resource (Conference Presentation) updated 09/14/2023
Resource (Conference Presentation) updated 09/14/2023
Boston Healthcare for the Homeless Program uses an innovative care model, designed from the margins, to meet the complex needs of people living at the intersections of HIV, homelessness, substance use disorder, and incarceration. Such models hold promise for closing HIV care and prevention equity gaps for this hyper-vulnerable group.
Resource (Conference Presentation) updated 09/14/2023
This session will discuss engagement and re-engagement of newly diagnosed clients and clients lost to care through the provision of personalized assistance and support designed to increase access to specialty care.
Resource (Conference Presentation) updated 09/14/2023
Establishing an opt-out HIV screening program in the emergency department has almost quadrupled HIV screening rates and has identified new and out-of-care cases. Utilizing a continuous quality improvement approach has allowed it to become a catalyst to improve workflows for other gaps in University Medical Center of Southern Nevada's HIV care continuum process.
Resource (Conference Presentation) updated 09/14/2023
This peer-led workshop will include skills-building interactive sessions about two evidence-informed interventions that address trauma and addictions among people with HIV, specifically Trauma-Informed Approach & Coordinated Assistance and Navigation for Growth and Empowerment (TIA/CHANGE) and Seeking Safety.
Resource (Conference Presentation) updated 09/14/2023
This 101 session will provide a broad overview of unstable housing, homelessness, and their impact on health outcomes. Participants will gain a basic understanding of why and how RWHAP recipients should consider integrating housing resources into their systems of care.
Resource (Conference Presentation) updated 09/14/2023
This interactive panel describes and discusses the development of comprehensive-care models that provide high-quality, coordinated team-based care with sustained improvements in health outcomes. Participants will leave with Ryan White-compliant strategies for 340B and other resources to develop innovative and integrated solutions that improve patient outcomes and engaged teams.
Resource (Conference Presentation) updated 09/14/2023
The New York City Department of Health and Mental Hygiene designed an HIV self-management protocol for the Ryan White Part A care coordination program. Through the protocol, staff and patients systematically identify and address patient strengths and challenges, focusing activities on building patients' capacity to manage their care.
Resource (Conference Presentation) updated 09/14/2023
The New York City Health Department has scaled up The Undetectables Viral Load Suppression Program, in collaboration with the program developer (Housing Works) and other stakeholders, by integrating the program into existing HIV medical case management service delivery.
Resource (Conference Presentation) updated 09/14/2023
Prism Health North Texas will share the challenges and successes of adapting Ryan White case management tools and strategies to a pre-exposure prophylaxis (PrEP) program for behavioral intervention. Panelists will detail how they took lessons learned from case management to HIV prevention to become status neutral.
Resource (Conference Presentation) updated 09/14/2023
This workshop will present the 6Ms, a simplified approach to geriatric principles for HIV care: Mobility, Mentation, Medications, Matters Most, Multicomplexity, and Modifiable. The role of the 6Ms in clinical care and identification of older adults at greatest need will be considered; clinical models of geriatric care with potential for widespread implementation will be presented.
Resource (Conference Presentation) updated 09/14/2023
The PATHways Program at Vanderbilt Comprehensive Care Clinic is an interdisciplinary, nursing-led program designed to reach people who are traditionally challenging to engage in care. We have helped over 80% of participants achieve viral suppression. We offer our approach as a case study of a successful innovative model of care.
Resource (Conference Presentation) updated 09/14/2023
This session will highlight the adoption of a systems-level intervention aimed at identifying and addressing special causes variations in patient and client outcomes. Multidisciplinary case review team members will discuss their experiences with this intervention and how they leverage data and tailored services to improve outcomes.
Resource (Conference Presentation) updated 09/14/2023
This session will cover Ryan White-supported clinics and services that needed to be adapted and tailored to address the unique needs of young people with HIV, particularly mental health services, to optimize their retention and viral suppression. Innovative research and community projects in New York City, Philadelphia, and Atlanta will be presented.
Resource (Conference Presentation) updated 09/14/2023