September 8, 2006

An ASC Case Manager (at right) works with a client to develop an action plan that prioritizes service needs.

"I was very ill, with only 15 T-cells and Hodgkin's lymphoma. I'd been drug-free for six months and was struggling with recovery. ASC's case management team supported my recovery, helped me get my own apartment, and connected me with ASC's counseling services, support groups, harm reduction services, and food pantry. Today, I have over 500 T-cells, my HIV is undetectable, and my lymphoma is in remission. Coming to ASC turned my life around."

—Nate, ASC case management client

With the advent of better treatments, connecting HIV-positive people with medical care and helping them stay in care has become a primary goal in the HIV field. But achieving this is easier said than done.

Enter case management—a deceptively bland term for one of the most dynamic, life-enhancing services available for people living with HIV/AIDS.

"Case management is the glue that connects people to services and keeps them engaged in care," explains Assistant Director of Client Services Jonathan Reade. "Clients come to us distraught, upset, and unwell. They are often unable to jump through bureaucratic hoops to access services—the paperwork alone can overwhelm them. We facilitate this process."

Dr. Peter Gordon, Medical Director for New York Presbyterian System Select Health, an HIV Special Needs Plan (SNP), concurs. "ASC has been instrumental in helping my patients navigate a complicated care system with a thoughtful advocate on their side. My appreciation for these services comes primarily from working with ASC's COBRA case management program—exceptional care coordination for populations challenged with medical, mental, financial, and substance abuse issues. The breadth and depth of case management services helps greatly with total integration in care."

Case management is a collaborative venture that supports people living with HIV while helping them move toward self-sufficiency. ASC's nine case management teams carry out numerous activities, including developing tailored service plans, identifying appropriate services, teaching clients how to navigate New York City's expansive service system, advocating to ensure access to key services and benefits, escorting clients to appointments, and following up to see that clients obtained services and achieved desired results.

This goes beyond simply making sure a person living with HIV/AIDS sees a doctor, observes Kim Atkins, ASC's Deputy Executive Director for Planning. "Did the client understand what the doctor said to them? Are they keeping up with their medical treatments? Are their lives stabilized enough to remain in care? What services do they need to maintain their health and manage their lives? By simultaneously addressing many different aspects of a person's life, case management promotes the level of stability required to make HIV medical care an attainable goal."

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