Analysis of Integrated HIV Housing and Care Services. E. Client Intake, Enrollment, and Care Planning

02/01/2014

Let’s discuss the program’s intake, enrollment, and care planning processes.

  1. Please describe the intake and enrollment process.
  2. How do staff members determine whether an individual is eligible to enroll in the program?
  3. Please describe the client assessment and care planning process. Which staff lead the care planning process? For example, can a social worker or nurse or case manager work with the client to create a care plan?
  4. What issues or topics are included in the client assessment and care plan development?

    • Housing stability barriers
    • Other basic needs, including food insecurity
    • Employment, income, or self-sufficiency barriers
    • Health insurance issues
    • Behavioral health issues
    • Mental health status
    • HIV transmission risks
    • Barriers to accessing and staying in HIV clinical care
    • Anti-retroviral therapy medication adherence issues
    • Other? Please specify.
  5. What formal assessment and care planning tools (if any) are used? Please describe.

    [INTERVIEWER SHOULD ASK FOR A COPY OF THE TOOL(S), IF APPLICABLE]

  6. What program requirements or rules are clients expected to follow? Please explain.
  7. From your observation, what are the clients’ greatest service needs?

    • Do the needs of people living with HIV/AIDS differ from other clients you serve? Please explain.
  8. How does the program address those needs?

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