Evelyn Torres from AACO presented on a new medical case management model at the June 2017 meeting of the Philadelphia HIV Integrated Planning Council.

1. FUTURE DIRECTIONS IN MEDICAL CASE
MANAGEMENT
PLANNING COUNCIL
JUNE 8, 2017

2. WHAT?
• Currently, one model of Medical Case Management (MCM) is
supported by AACO
• AACO is proposing a binary system consisting of:
 SHORT-TERM MCM, in which clients immediate needs are addressed and
and/or are medically stable
 LONG-TERM MCM, when a more intense and ongoing intervention is
necessary to address retention in HIV medical care, treatment
adherence and/or unsuppressed viral load

3. WHY?
• A survey of MCM providers, review of Ryan White MCM in other
cities (Baltimore, Boston, Chicago, Newark, New York City and State,
and Washington DC), and internal Health Department analysis found
that changes to Philadelphia’s approach to MCM is warranted
 AACO analysis shows that over the past 5 years, more clients used
MCM services sporadically, versus continuously
 Medical sites have larger client caseloads that need to be managed
differently

4. NEED FOR FLEXIBILITY IN THE MCM SYSTEM
• More flexibility is needed to reach groups such as:
• People newly diagnosed with HIV
• People in HIV care who are not yet virally suppressed
• People in HIV care who are not adherent to treatment
• People in HIV care who are not retained in care

5. CHANGING REQUIREMENTS
• Enrollment criteria
• Documentation
• Caseloads
• Monitoring standards
• Performance Measures

6. THE NEW MODEL AND MCM
• Implementation of the new model must be within the framework of the HRSA
definition of medical case management that includes :
• Treatment adherence services
• A defined set of activities
• Service care plans
• Improved health outcomes as the stated goal
• Retention in medical care
• Undetectable viral load
HIV/AIDS Bureau Policy 16-02

7. WHO AND WHEN?
• All MCM service providers in the Philadelphia
EMA including medical care settings and
community-based sites
• Target date for implementation of the new
model is March 1, 2018

8. INPUT
• AACO is currently holding informational sessions on
these proposed changes with:
• MCM providers
• Clients
• Planning Council