The San Francisco Community Health Center wanted to integrate three distinct programs serving people living with HIV: (1) the Tenderloin Area Center of Excellence (TACE), which provided drop-in services for people living with HIV who are affected by homelessness, including support groups, meals, case management, and HIV medical care in collaboration with the Tom Waddell Urban Health Center; (2) Getting to Zero Intensive Case Management (GTZ-ICM), a program offering short-term navigation and mobile medical intensive case management for people living with HIV/AIDS, especially Black and Latino men who have sex with men (MSM), people experiencing homelessness, people who inject drugs (PWID), women, and transitional age youth (TAY); and (3) HIV Homeless Outreach and Mobile Engagement (HHOME), which provides connections to primary care and long-term housing for people living with HIV who are unhoused, pregnant, or are experiencing imminent eviction, and have a CD4 count less than 200.
Facente Consulting facilitated a series of planning meetings with key staff and leadership to develop a new program workflow that would integrate these programs, including a centralized intake assessment and case manager assignment process, the development of a care plan driven by client acuity, and a plan for expanding access to drop-in services.