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SPNS Initiative: Building a Medical Home for Multiply-Diagnosed HIV-positive Homeless Populations, 2012-2017

Background

The Special Projects of National Significance (SPNS) Program Building a Medical Home for Multiply Diagnosed HIV-positive Homeless Populations initiative was a multi-site demonstration project funded during fiscal years 2012-2017. The nine demonstration sites designed, implemented, and evaluated innovative interventions to improve the timely entry, engagement, and retention in HIV care and support services for homeless and unstably housed people living with HIV with co-occurring mental illness and/or substance use disorders. The interventions employed models of care focused on the development of sustainable linkages to mental health, substance abuse treatment, and HIV primary care services for homeless or unstably housed people living with HIV. The transient and unstable lives of homeless people living with HIV and co-occurring mental health or substance use disorders required coordinated efforts to engage and retain them in care by addressing their complex service needs and to ensure their adherence to treatment.

Therefore the interventions adopted a set of organizational structures characterized by integrated or co-located strategies for service provision by each demonstration site. Demonstration sites also provided intensive coordination of care and service needs to ensure retention and adherence to treatment. Integrated services were defined as the management and delivery of HIV primary care, substance abuse and mental health treatment. Demonstration sites also included access to housing resources and services for their target population through the co-location of services within an HIV primary care clinic, within a public housing facility that serves the target population, or by building a network of providers through the execution of memoranda of understanding or contracts.

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