Care Services at LAAN
LAAN case managers provide initial and ongoing client needs assessment. They are involved with the development, implementation, and evaluation of health and support service plans; and are also responsible for locating, coordinating, and monitoring cost-effective, timely delivery of quality services. Case managers also act as advocates for clients. They serve as a central point of access for the needs of people living with HIV/AIDS in this region.
EARLY INTERVENTION SERVICES (EIS)
The focus of the Early Intervention Services Program at LAAN will be to: provide intensive
case services to HIV positive individuals who are newly diagnosed, who have not received care within three months of diagnosis, who have fallen out of care, who have been lost to follow-up in health care and/or are facing barriers to obtaining health care and treatment.
As with all care services at LAAN, early intervention services focus on the identification of needs, the development and implementation of an individualized care plan, intensive support and guidance, patient navigation services, and issues related to adherence. Barriers to care are identified and endeavors are made to resolve those barriers. Upon the successful completion of EIS services, individuals can choose to be referred to continuing medical case management services.
MEDICAL CASE MANAGEMENT
Medical Case Managers (MCM) are responsible for providing continuum of care coordination services to PLWH (persons living with HIV.) MCM assess client needs initially and in six months intervals, implement plans to meet those needs, provide psychosocial support, and coordinate related services. They are responsible for identifying needs, educating clients relative to care, wellness, and risk reduction issues, linking clients with other services through a network of various providers and systems, assisting in community training and HIV education and awareness, and assessing requests for client emergency assistance. Possible areas of support, guidance, coordination, and direct client assistance are identified and discussed here.
LAAN MCM will work in collaboration with EIS to identify and initially link newly diagnosed and “out-of-care” clients into care.
NON-MEDICAL CASE MANAGEMENT
The provision of non-medical case management is designed to provide situational assistance or support services to individuals who may not require a full spectrum of care services. These services are primarily of an information and referral type and do not involve the coordination of medical care and treatment. Such services are provided by each of the case managers.
LAAN provides information and referral services and financial assistance to PLWH in need of mental health services. Financial assistance will be in the form of co-payments of payments of services for the uninsurable or those who might be underinsured. LAAN will provide these services in collaboration with various community partners. As with all areas of support, mental health services will be a component of the individualized service plan for each client.
LAAN has initiated the Positively Healthy adherence program for those clients with complex adherence issues. The program has been very effective at engaging and empowering PLWH. The interactive workshop focuses on various adherence related topics including; Starting HAART, Barriers to Adherence, developing a Support Team, and Understanding your Labs. Adherence issues are addressed at each assessment, reassessment, and generally during each client engagement.
Healthy Relationships is a small-group, skills-based behavioral intervention for men and women living with HIV. The intervention focuses on skills building, self-efficacy, and positive expectations about new behaviors. Through group discussions, role plays, videos and skill-building exercises, the intervention helps persons living with HIV develop skills to cope with HIV-related stressors and risky sexual situations. Intervention sessions also enhance decision-making skills for self-disclosing HIV-serostatus to sex partners, and help participants develop and maintain safer sex practices. Participants receive personalized feedback about their own risk practices, and with the help of the intervention group, develop strategies to maintain satisfying relationships while protecting both themselves and their partners. Intervention sessions are conducted separately for men and women in groups of 6–10 participants.
HEALTH INSURANCE PREMIUM AND COST-SHARING ASSISTANCE
Health insurance premium and cost-sharing assistance is provided for the purpose of assisting with health insurance premiums, medical care co-payments or for the payment of services for the uninsurable. As a “Payer of Last Resort” LAAN must ensure that all other financial possibilities have been considered. MCM are tasked with engaging individuals towards possible assistance and guidance. Discussions relative to prevailing insurance matters, including the lack thereof, will provide guidance toward securing possible insurance coverage. LAAN has no set limit for the provision of cost-sharing assistance, with each case being decided on an individual basis.
Housing assistance is provided to eligible clients through the Housing Opportunities for Persons living With AIDS program (HOPWA). Through several different categories of housing services, eligible individuals can be provided assistance with housing placement, rent and utility assistance, and emergency housing placement.
EMERGENCY FINANCIAL SERVICES
Emergency financial services are provided to assist with incidental short-term co-payments for prescriptions or the payment of emergency prescriptions for the uninsurable. Such services may also be provided to ensure that various barriers that might impact care and treatment might be removed. There is no stated limitation for this service.
MEDICAL TRANSPORTATION SERVICES
Medical transportation assistance is provided to those individuals who may not otherwise be able to get to medical care and treatment related appointments. Such services might be provided through the provision of bus passes, Spec-Tran passes, bus tokens, gas cards, or volunteer divers. There is no stated limitation on this service.
Linguistic services are provided either internally by a bi-lingual case manager or board member (Spanish, Swahili, and French) or by securing translation services through an outside vendor. In a similar manner services would also be secured for the deaf or hard of hearing by an approved vendor. There is no stated limitation for this service. By removing such barriers to treatment adherence and care compliance, retention in care and improved health outcomes are enhanced.
FOOD BANK SERVICES
Food Bank services are made available to all eligible LAAN clients. The LAAN Food pantry is made available to individuals twice each month or as arranged with MCM. There is no stated limitation for this service. Proper nutrition and grocery supply is critical to medical well-being and quality of life. The food pantry serves to remove financial barriers to treatment adherence and care compliance, retention in care and improved health outcomes are enhanced.
Proof of HIV Status
Financial eligibility requirements - at or below 500% of federal poverty line
LAAN funds are to be considered last resort funding. All other forms of assistance must be explored. Referrals to other service providers must be followed by client. These referrals could include, but are not limited to: Department of Human Services, Drug Assistance Program, American Red Cross, and Capitol Area Community Services
Basic living expenses are higher than income during period for which assistance is requested
Guidelines are subject to change