Topic: Case Management

Case management is a service category with varied models and definitions that is designed to link clients to medical and support services. Ryan White defines medical case management (including treatment adherence) as a range of client-centered services that link clients with health care, psychosocial, and other services provided by trained professionals, including both medically credentialed and other health care staff.  Medical case management is considered to be a core medical service for purposes of Ryan White funding requirements to allocate a set percentage of funds to core medical services.

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Guidelines and Manuals

Webinars and Training

Tools and Job Aids

  • ACE TA Center
    July 2015

    This resource guide is for anyone helping Ryan White HIV/AIDS Program (RWHAP) clients apply for health insurance, particularly RWHAP staff who are helping clients through the entire enrollment process. The guide lists the enrollment steps and has links to resources, tips, and tools to help enrollment assisters with each step.

  • Philadelphia Office of HIV Planning
    May 2014

    This is a brief assessment tool for counselors and testing staff to use with persons newly-diagnosed with HIV to assess their linkages to care in terms of health coverage, finances, housing, and social supports.

  • Oregon Health Authority
    October 2012

    Series of care plan forms to assess clients in terms of intake, assessment, and care. Forms include: intake, eligibility determination, residency verification, screening for care and psychological services, client rights and responsibilities, nursing assessment, and a care plan.

  • Iowa Department of Public Health
    September 2011

    Tool for clients to use in recording weekly goals as part of their overall care plan to outline goals and objectives for HIV/AIDS care.

  • Iowa Department of Public Health
    September 2011

    Care plan agreement form between a client and case manager on the goals and objectives of care (Who, What, Where, How, When, How Often, Progress/Outcome/Date).

  • HRSA HIV/AIDS Bureau
    January 2011

    Guide presents a rationale for why Ryan White clinics should play a greater role in HCV treatment and steps they can take in deciding how to integrate HCV treatment within their HIV/AIDS primary care services.

  • Dallas EMA
    January 2011

    Program and service monitoring tools developed by a Part A grantee.

  • Hartford Department of Health and Human Services
    February 2010

    Form for staff to assess care plan needs of clients, every 6 months, in terms of case management, home health, respite, housing, mental health, substance abuse treatment, legal, and financial assistance.

  • Face to Face
    January 2010

    Code of Conduct policy for clients to reinforce value and importance of respectful behavior toward staff and other clients.

  • January 2009

    Series of one-page surveys to assess client understanding of each of the following: medications, health maintenance, HIV and transmission, lab tests/health problems, information.

  • Ohio Department of Health
    January 2006

    Form developed by Ohio Department of Health to collect information needed to assess how helpful the case management program is to clients.

  • HRSA HIV/AIDS Bureau
    June 2004

    Collection of tools (e.g., client interview form, outreach encounter, chart review, evaluation questions) for collecting information on contacts with clients enrolled in a SPNS supported multi site evaluation on outreach.

  • HRSA HIV/AIDS Bureau
    January 2003

    Capacity building ideas for agencies seeking to expand their work into HIV/AIDS care, particularly for racial and ethnic minority communities. 

  • HRSA HIV/AIDS Bureau
    January 2001

    Guidance on conducting outcomes evaluation focusing on case management, including specific outcome indicators and data elements that can be collected by providers, obtained and reported by the grantee, and analyzed and used to make decisions regarding case management models, priorities, and fundi

Reports and Best Practices

Websites