History of HIV/AIDS Case Management in Metropolitan Chicago

In 1989, with funding from the federal Health Services and Resources Administration (HRSA), the AIDS Foundation of Chicago's Service Providers Council convened a task force to review the status of HIV case management in the Chicago area. The model that emerged over the following months of discussion and debate called for a consortium of case management providers, linked by central administration and support, and governed by providers and consumers.

In July 1989, the proposed consortium was formally established as the Northeastern Illinois HIV/AIDS Case Management Cooperative. Administered and supported from the beginning by AFC, the system began with four case managers at three local agencies. Over the next two years, it doubled in size -- to eight case managers.

In 1990, Illinois obtained a waiver from the federal government enabling the state to receive Medicaid reimbursement for in-home services provided to people seriously disabled by HIV disease. AFC was asked to administer the program, which now provides case management and homemaker assistance to over 800 people within the Chicago metropolitan area each year.

Reflecting the rapid growth of the epidemic, the number of funded case management positions grew from 8 to 82, and the number of agencies involved in the network grew from 4 to over 30 from September 1991 to September 1999. Today, 157 case managers at 50 agencies are funded by AFC to provide case management services across the metropolitan area.

In 1992, AFC assumed responsibility for establishing and administering a central transportation system for case managed clients, and in 1994, for managing and distributing funds available for emergency financial assistance. In 1996, AFC took on central administration of resources available for long-term rent subsidies for people with HIV.

Responding to an increase in the number of HIV-positive individuals released from correctional facilities each year, AFC applied for and received funding in 1999 to coordinate intensive case management services for formerly incarcerated men and women. Six agencies began providing services to these individuals in April 2000.

AFC's principal role in managing the system includes:

• developing and implementing program policies and procedures aimed at ensuring equitable access to services and consistent, high-quality service delivery across funded agencies;
• providing extensive training, technical assistance, and support to case managers, case management supervisors, and funded agencies;
• maintaining a staffed, bilingual information and referral service for clients and case managers;
• maintaining a central registry of clients receiving case management services in order to avoid duplication of service and monitoring service utilization and effectiveness;
• establishing quality assurance standards and mechanisms and evaluating funded agency performance;
• administering a region-wide system of transportation and direct emergency assistance services for case managed clients based on individualized assessment of each client's need for such services; and
• establishing contractual agreements with funded agencies and reimbursing them for case management services provided.