Visit housingworks.org, our parent site, to learn more about our relentless advocacy to end the dual crises of homelessness and AIDS, and the entrepreneurial businesses that sustain our efforts.

We know navigating the healthcare system can feel overwhelming.

That’s why our Case Management Program is devoted to helping you achieve great health on your own terms, with a little guidance to get you going in the right direction.

With a case manager on your side, you can rest assured that your voice will always be heard and your health will be taken care of.

Case Management Services


  • Health Home Care Coordination

    Housing Works Health Home Care Coordination Programs provides comprehensive care for clients with chronic conditions in the areas of Primary and specialty medical care, substance use treatment, mental health treatment, and other supportive social services. Health Home removes barriers to quality care, improves positive health outcomes, and reduces life-threatening conditions due to delayed doctor visits. We help Medicaid-eligible clients find the right services at the right time, by coordinating with the right healthcare providers.

    We help Medicaid-eligible patients with chronic illness, and Medicaid recipients with one or more of the following:

    • HIV/AIDS
    • Hypertension
    • Heart Disease
    • Diabetes
    • Asthma
    • Mental Health
    • Substance Use

    Services include:

    • Patient and family support
    • Referrals and support for community and social services including housing, legal services and food assistance programs

  • Re-Entry

    The Housing Works Community Healthcare Re-entry program uses a holistic approach and advocates for individualized services to assist clients to successfully reintegrate back into the community. Our comprehensive model connects individuals to medical, dental, mental health, and case management services, including substance use programs. We also connect clients to vocational training, entitlement services, and refer them to long term housing placement. We assist clients by helping them find their way back home and develop healthy everyday routines to a successfully reintegrate into society. We can equip our clients’ with the necessary skills needed to navigate the social service system and find new opportunities to achieve success.


  • Medical Case Management

    The Medical Case Management (MCM) program connects HIV-Positive individuals with medical and behavioral health services to achieve and maintain a healthy lifestyle. Case Managers empower clients with resources, education, and the tools they need to become their own health advocates.


  • Legal Services

    All clients enrolled in Housing Works Community Healthcare’s case management services are eligible for free legal services. Our legal experts can help you with housing, public assistance, family law, wills, and consumer laws. We also take on cases that are important to the HIV-Positive community, and have the power to change precedents for all.


  • Housing Support

    Our mission is to provide safe, secure, and stable housing support for individuals in need, regardless of their HIV status. We can help connect you to housing resources while coordinating with your healthcare providers to ensure your needs are always met. Housing is available to eligible people living with HIV, transgender individuals, and formerly incarcerated members of the community.

95%

of patients would recommend our primary care to a friend.

LEARN MORE ABOUT OUR IMPACT

Questions

What kind of housing resources do you have?

Once you enroll in a program, you'll be assigned a Care Manager. You and your Care Manager will meet to discuss housing options and the types of housing support you can apply for.

Can you help me find a doctor?

Yes, our role is to coordinate care with medical providers and make referrals to community and social support services.

Locations

Looking for a healthcare provider? Visit us at one of our locations below or reach out now to connect with us.