All care and prevention services are coordinated into a "continuum of care" - recognizing that there are a variety of services that a person needs simultaneously, and that some services are needed all of the time and some services are needed only sporadically. Therefore services are often offered in a "one-stop-shopping model" and are advertised to those in need in a variety of ways.

Care Services for People Living with HIV/AIDS

Care services center around medical care at an array of sites across the city including the City Health Centers, local hospitals, federally qualified community health centers, HIV specialty clinics, etc. Federally approved standards of care are required to be followed at all of these sites. Other services are provided to those living with HIV/AIDS to help in maintaining medical care, including:

• Medications - Financial assistance in purchasing medications for those that are un- or under-insured. This system has been centralized through CVS so that qualifying patients can present their prescriptions at any CVS and have their prescriptions filled and delivered to their home, doctor, etc. within 24 hours free of charge.
  
• Case Management - For those who desire case management and desire such assistance, specialized HIV case management is provided by professional social workers to assist patients in accessing the variety of services and benefits available to them.
  
• Housing - In cooperation with OHCD, AACO coordinates the HIV housing vouchers system that is federally funded and pays for the vast majority of rent and utility expenses for those who qualify. Several hundred individuals benefit from this program. Additionally, AACO funds a hospice for those living with AIDS, nursing care facilities, and specialized personal care facilities for those who require supportive living arrangements.
  
• Emergency Financial Assistance - Those living with HIV who qualify can receive up to $1500 a year in federally funded cash assistance to pay for rent, utilities, and medical expenses.
  
• Home Health Care - Provided in addition to that offered through Medicaid and other insurance, if medically indicated, to assist with the sometimes intense home health care needs of those with HIV/AIDS.
  
• Dental care for those that are un- or under-insured. Often people with HIV have not only the standard dental issues to deal with, but also issues that are also specific to HIV disease. Therefore providing quality dental care is urgent to assure health and quality of life.
  
• Care Outreach - Linked to HIV testing sites (over 40 funded by AACO across the City) to immediately introduce medical care and other services, including assistance in making appointments, to those testing positive to HIV antibodies. Linked to medical care sites to find those who were in medical care but lost to care, and assist those individuals in overcoming barriers and re-entering medical care.
  
• Food - HIV food banks provide groceries, congregate meals are provided to patients in a social and learning atmosphere, and home delivered meals are provided across the city to people with AIDS.
  
• Nutritional Counseling - provided to assist consumers in making good nutritional decisions and meeting the special nutritional needs often associated with HIV.
  
• Transportation - provided round trip (via van, taxi, public transportation, and/or mileage reimbursement) to people with HIV to the locations where they can access all of the care services listed.
  
• Information and Referral - in the form of mass media, toll-free hotline, internet, pamphlets, billboards, posters in SEPTA, etc. - to advertise the availability of services and explain HIV disease and care to patients.
  
• Day and Respite Care - To provide temporary care for people with HIV at home to relieve or assist the primary caregiver.
  
• Translation and Interpretation - in both written and oral form - provided to people with HIV as it relates to all care services listed.
  

Prevention Services

Prevention services are centered around testing and referral for HIV.  Testing is provided in a variety of settings through the city Health Centers and through a variety of community based organizations.  A variety of other prevention services are also funded with the goal of educating persons and feeding them into counseling and testing.  These services include:

• Group Level Intervention (GLI) - Group education series using curriculum from education interventions that have been scientifically proven to be effective (Evidenced Based Interventions).
  
• Community Level Intervention (CLI) - Group education series using curriculum from education interventions that have been scientifically proven to be effective with the goal of spreading prevention messages throughout an at risk community.
  
• Comprehensive Risk Counseling and Services (CRCS) - A one on one intervention whose goal is to help HIV-positive and HIV-negative persons who are at high risk for HIV transmission or acquisition to reduce risk behaviors and address the psychosocial and medical needs that contribute to risk behavior or poor health outcomes.
  
• Partner Services - Services with the goal of assisting persons with HIV contact their at-risk partners and refer them to HIV testing.
  
• Health Communications/Public Information (HC/PI) - Services whose goal is to increase community wide awareness of HIV risk through media and other related venues.
  

Special Initiatives

AACO has several Special Initiatives that are funded under the various funding categories.  These initiatives include:

Rapid Testing in Emergency Rooms
Through this initiative we fund several hospitals to place staff in their emergency rooms to provide rapid testing to those that are waiting to be seen in their emergency rooms.  Often persons who are at highest risk yet unaware of their status access emergency rooms as their primary point of care.  Through this initiative we are able to reach this population which often avoids traditional counseling and testing venues due to their perceived lack of risk.

Ex-Offender Re-entry
Through this initiative, we fund several agencies to connect HIV positive persons being discharged from state and county prisons with primary HIV care upon release.  This program also ensures that persons released receive enough medication to carry them until such time as they are able to make an appointment with a medical provider on the outside.  Case managers further assist the returning person in making the various other supportive social service connections that will ensure their ability to adhere to medical care.

High Risk Youth
Through this initiative we fund a variety of agencies to provide education and testing services on site at places where high risk youth congregate.  These sites include youth detention facilities, group foster care and foster care supportive agencies, and community centers with a focus on drop out youth and youth on probation.  At these agencies, a variety of services are provided including case management, rapid testing, GLI, CRCS, and partner notification.

Faith Based
AACO, through a contract with Circle of Care, provides technical assistance to churches throughout the Philadelphia area who wish to conduct community level events such as health fairs and testing days.  Through this initiative, churches have been able to reach out to the community to provide education and encourage the practice of HIV testing as a regular part of ongoing healthcare.  This has worked to greatly reduce stigma as it relates to taking the test as well as HIV/AIDS in general.

In-Home Medical Services
Through this initiative, AACO funds several hospital providers to provide "house calls" to medically fragile and at risk for non-adherence patients.  Physicians, nurses, and physician assistants have been dispatched into high risk neighborhoods to do in home assessments of patient medical status.  This provides an invaluable assist to patients who are unable to make it out to the clinic.  Further, for those newly in care or having other markers for risk of non-adherence to medical regimen, these medical professionals are able to observe their taking of their medications while assessing for the environmental barriers to adherence with medical plans.