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Life Care Services
and Early Intervention
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HIV Life Care Services and Early Intervention are two programs for
persons living with HIV disease. They are funded by the Division of Public Health with
state general purpose revenue (GPR) dollars and are operated by AIDS Service Organizations
(ASOs). The Division contracts with ASOs to provide these programs directly or through
subcontracts with other community service providers in their respective regions.
Life Care Services
Life care services is the term the Wisconsin AIDS/HIV Program uses to identify case
management and supportive services for persons with HIV disease. Case management is a
method of service delivery striving to ensure that clients with complex health and social
service needs receive timely, coordinated, and cost effective services. Case management
involves the active participation of the case manager and the client (or his or her
designated representative). The key role of the case manager is to coordinate or arrange
needed services for clients across a range of service providers and settings. Case
managers help clients obtain services such as medical, dental and mental health care;
financial assistance; legal assistance; practical and emotional support; and housing
assistance.
The AIDS/HIV Program intends that life care services be available and
reasonably accessible to all Wisconsin residents with HIV infection who request services.
To accomplish this, the Division funds an ASO in each of five Department of Health and
Family Services (DHFS) regions. Designated ASOs must collaborate with local health departments, county human services departments and other community
agencies, including minority community-based organizations to plan and coordinate case
management and support services within their DHFS region. Designated ASOs may use life
care service funds to support and staff a case management program or may subcontract with
other community agencies to provide case management and/or related supportive services.
Life care services funds support, in whole or part, over 40 case
management staff positions statewide. Currently, case managers assist over 2,000 clients
annually. Clients access case management services through referral from a variety of HIV
service providers including physicians, counseling and testing sites, and partner
counseling and referral staff. Clients may also access case management by contacting an
ASO or CBO directly.
Goals for life care services include:
- To provide cost efficient case management services.
- To help clients obtain HIV-related medical care through effective case management.
- To help clients obtain appropriate benefits through effective case management.
- To help clients, their family members and friends obtain supportive services through
effective case management.
- To provide quality case management services in a timely manner.
Ryan White Title II funds supplement life care services funds in many
areas of the state.
In 1992, the AIDS/HIV Program convened a case management workgroup to
develop case management practice standards and forms to formalize the Life Care Services
program throughout the state. The Program published Practice Standards and Administrative
Guidelines for HIV-related Case Management in January 1993. The Program revised the
standardized case management forms in December 1994. The Practice
Standards and Administrative Guidelines were further revised in 2003. All agencies funded by the AIDS/HIV
Program to provide HIV case management must implement these standards and forms.
Case management is a formal process that includes:
- intake;
- assessment;
- service plan development;
- ongoing monitoring and evaluation;
- reassessment;
- discharge.
The AIDS Resource Center of Wisconsin (ARCW) and a private vendor
developed a computerized case management system that is consistent with the approved
practice standards and forms. The system assists case managers to coordinate client
services, and to manage time and record keeping more effectively and efficiently. All
designated ASOs are implementing the computerized case management system. The system will
also enhance the capacity of ASOs to collect and analyze case management data.
Advances in treatment of HIV disease, including combination therapy,
have had a significant impact on HIV case management. Now more than ever, it is crucial
that persons with HIV have access to treatment. Case managers continue to play an
important role in linking clients to medical care and to programs such as Medical
Assistance, the AIDS/HIV Health Insurance Premium Subsidy Program and the AIDS/HIV Drug
Assistance Program. Case managers also have a role in helping clients to adhere to
their treatment regimens, in part by addressing underlying needs such as housing,
transportation and child care. As persons with HIV live longer, healthier lives, issues
surrounding prevention of transmission of HIV may resurface. Case managers can assist
clients with prevention information, and when appropriate, refer clients to more intensive
services through prevention case management. Finally, case managers continue to assist
clients who cannot tolerate or do not benefit from new therapies.
The AIDS/HIV Program ASOs, CBOs and the clients they serve must
continue to work together to ensure that the life care services case management program
continues to effectively address the changing needs of persons living with HIV disease.
For more information about HIV life care services, contact Michael
McFadden at 608/266-0682 or the local ASO office.
Practice Standards &
Administrative Guidelines for HIV Related Case Management
(PDF, 121 KB)
Early Intervention
Authorization for HIV early intervention grants was included in the Wisconsin state fiscal
year (SFY) 94/95 biennial budget. Early intervention funds, which are part of the State's
life care services appropriation, are awarded to the five regional Wisconsin ASOs. The
Wisconsin ASOs have been selected to provide HIV early intervention services because they
provide a strong link to life care services, the AIDS Drug Assistance Program, AIDS/HIV
Health Insurance Premium Subsidy Program, and other supportive services.
The Wisconsin AIDS/HIV Program recognizes that there are a variety of
service delivery models for HIV early intervention programs. These models vary in many
ways, including the type and scope of services provided, the target populations served,
and the manner in which services are delivered. State general purpose revenue (GPR) funds
for early intervention services are limited and are targeted for services which can
effectively and efficiently reach those in greatest need. Because not all early
intervention services and service delivery models can be funded with GPR funds, grantees
are encouraged to seek other sources of funding to increase the capacity and the scope of
early intervention services in local communities. This includes collaborating with local
community health centers, the Ryan White Title III program, the University of Wisconsin
Department of Family Medicine-Family Practice Residency Program, local health departments,
and private physicians.
Agencies receiving GPR HIV early intervention funds are expected to
integrate and coordinate state funded early intervention services with related HIV
programs and resources. Such programs include but are not limited to case management, the Wisconsin HIV Drug
Assistance Program, the AIDS/HIV Health Insurance Premium Subsidy program, and partner
counseling and referral services. Services are coordinated by the ASOs and provided by
local physicians, ASO nurses, and case managers.
The primary objective for state-funded HIV early intervention programs
is to ensure early and prompt access to needed HIV-related health services for HIV
positive persons. This includes:
- prompt referral to a primary care physician;
- providing risk reduction counseling to support HIV-related risk-reducing behaviors, and;
- providing mental health screening to ensure prompt referral to mental health
professionals as indicated.
HIV early intervention funds support the following early intervention
services:
1. Primary health care services for HIV positive persons to
include:
- verification/confirmation of HIV status
- comprehensive history and physical assessment
- immunizations
- ongoing immune status monitoring
- referral to primary care physician
- referral for specialized medical services
2. Risk reduction counseling and education for HIV positive persons
- referral for substance abuse counseling
- referral for counseling related to high risk sexual behavior
Mental health screening and/or assessment for HIV positive persons to include:
- referral for specialized mental health services
- referral to community mental health services
Agencies receiving state HIV early intervention funds are required to
ensure that the following services are provided to all HIV early intervention clients
either directly or through subcontracts with health care providers:
- comprehensive history, physical assessment
- T cell subsets
- viral load testing
- TB skin test
- appropriate vaccines
- lab tests indicated by history and physical
Program Priorities
The following areas are priorities for HIV early intervention programs:
- Increased TB screening and follow-up
- Increased STD screening and follow-up
- Increased utilization of partner counseling and referral services
- Integration of early intervention services with prevention case management
For additional information regarding HIV early intervention, contact
Michael McFadden at 608-266-0682. For more information about HIV early intervention
services available in an area, contact the local ASO office. Last Revised:
October 16, 2007 |
