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SPNS Initiative: SURE Housing Initiative (2022-2026)
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Innovative HIV Care Strategies to Support Individuals Who Are Unstably Housed
Two interventions (KC Life 360 and HHOME) that provide layers of supportive services for people with HIV who are unstably housed.Resource updated 05/15/2024
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Completing the RWHAP Parts C and D Allocations and Expenditures Reports
Instructions for completing the PTR/Allocations Report and Expenditures Report.Resource updated 05/09/2024
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Project CORE: Coordination of Resources and Employment
Avenue 360 Health and Wellness, a Federally Qualified Health Center, and AIDS Foundation Houston, a community-based AIDS Service Organization, implemented Project CORE. This intervention aimed to improve health outcomes for people with HIV through the coordination of supportive employment and housing services. Through Project CORE, 39% of participants were placed in housing and 39% gained employment.Resource from the RWHAP Best Practices Compilation updated on 01/03/2024
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No Wrong Door for High-Acuity Care
Fenway Health, Fenway AIDS Action Committee, and MassHire Downtown Boston provided housing and employment supports to clients who were unstably housed and were un- or under-employed, in order to improve health outcomes as part of the RWHAP Part F SPNS initiative Improving HIV Health Outcomes through the Coordination of Supportive Employment and Housing Services. Almost 70 percent of clients who participated in this intervention and received medical care at Fenway Health were virally suppressed, despite facing considerable barriers to care.Resource from the RWHAP Best Practices Compilation updated on 11/14/2023
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Pay it Forward Transitional Care Coordination
One Stop Career Center of Puerto Rico (OSCC-PR) implemented Pay it Forward to increase workforce capacity to connect Puerto Ricans with HIV to community-based HIV care and social supports following release from jail. Pay it Forward included training of OSCC-PR staff in the Transitional Care Coordination model. Eighty percent of clients who were supported by Pay it Forward in Puerto Rico were still in HIV care 12 months after release.Resource from the RWHAP Best Practices Compilation updated on 05/07/2024
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Beyond the Walls: Building Foundation for Jail Linkage Programs
Effective models and best practices for connection to care for justice-involved individuals.Resource updated 05/15/2024
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Transitional Care Coordination: From Jail Intake to Community HIV Care Intervention
Transitional Care Coordination (TCC) connects people with HIV who are incarcerated with a transitional care coordinator to facilitate access to HIV primary care and other community-based services and supports, following their transition from jail back to the community. TCC aims to establish vital linkages between jail-based and community-based HIV care, and may be implemented by community-based organizations, clinics, health departments, or jails.Resource from the RWHAP Best Practices Compilation updated on 02/02/2024
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HOME: Homeless Health Outreach Mobile Engagement
HHOME is a mobile care and systems intervention that helps connect vulnerable and homeless individuals in San Francisco to rapid HIV treatment.Resource updated 02/12/2024
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KC Life 360: Employment-Focused Intervention to Link Clients to Support Services and Housing
KC 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.Resource updated 10/13/2023
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Maricopa County: Expanding Jail Services & Improving Health for Incarcerated People with HIV
The Maricopa County Jail Project was implemented by five jails and uses a nurse practitioner to manage service access and case management across the jail system.Resource updated 10/13/2023
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LINK LA
LINK LA is a 12-session, 24-week peer navigation intervention for people with HIV who are scheduled to be released from incarceration. LINK LA peer navigators focus on behavioral changes that promote medication adherence and retention in care, while providing social support and facilitating communication with medical providers. LINK LA showed improvements in linkage to and retention in HIV care and viral suppression among people with HIV re-entering the community after incarceration.Resource from the RWHAP Best Practices Compilation updated on 01/03/2024
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Maricopa County Jail Project: Providing HIV Service to People Who Are Incarcerated
Partnership between jail staff and public health prevention staff created new data communication systems and bundled services for clients upon release.Resource updated 05/15/2024
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The Time is Now: Implementing Innovative Housing Model for People with HIV to Improve Health Outcomes
Review of a SPNS data integration project that opened the door for innovating how people with HIV are being prioritized through the new HUD housing prioritization mandates.
Resource (Conference Presentation) updated 09/14/2023
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Housing, Employment, and HIT Improve Access for Vulnerable Populations in Paterson, New Jersey, and Puerto Rico
Discussion of a holistic process and a health information technology solutions-based approach for increasing access to housing and employment services for vulnerable populations, including people with a history of incarceration.
Resource (Conference Presentation) updated 09/14/2023
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Improving HIV Health Outcomes through Coordinated HIV Care, Housing, and Employment Services
Results of a study demonstrating the impact that coordinated care, housing, and employment can have on the HIV health outcomes of unstably housed and under/unemployed people with HIV.
Resource (Conference Presentation) updated 09/14/2023
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HIV Outbreak in West Virginia: The Importance of Collaboration and Partnerships
Discussion of diverse partnerships developed to successfully treat a homeless population with addiction and newly diagnosed HIV as well as the service delivery challenges faced by an out-of-state Part C clinic.
Resource (Conference Presentation) updated 09/14/2023
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Cultivating Growth: Home-based Behavioral Health and Supportive Housing across Oregon's Balance of State
Review of the Oregon model of integrating intensive case management, behavioral health, in-home and other wrap-around services with housing assistance and its replication potential in other jurisdictions.
Resource (Conference Presentation) updated 09/14/2023
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Leveraging Data to Care Models to Respond to an HIV Outbreak among People Who inject Drugs and Are Experiencing Homelessness
Review of data-to-care Hennepin County, Minnesota data-to-care models to address an HIV outbreak among people who inject drugs within a housing-first, cross-sector framework.
Resource (Conference Presentation) updated 09/14/2023