The HIV/AIDS Services Administration (HASA) is a program of the New York City Human Resources Administration (HRA) that serves low-income persons living with HIV in New York City. HASA provides public benefits, case management, housing, and other services to its clients. HASA clients face barriers to effective care that can result in high utilization of health care services yet poor health outcomes. New collaborations among HASA and community-based partners offer the opportunity for integrated care planning and differentiated service delivery (DSD) strategies designed to better coordinate existing HASA resources with housing, health care, and psychosocial services to achieve improved HIV and housing outcomes for all HASA clients. HASA, in collaboration with community partners, has developed three demonstration projects that incorporate DSD principles in order to improve the experience of clients who move through the HASA system and to make HASA services more efficient and better aligned with health care integration. Each demonstration project will run for three years.
The pilot projects feature specialized units of HASA caseworkers whose caseloads are determined based on client acuity, as determined by housing status. Many clients living in emergency single room occupancies (ESROs) and transitional supportive housing units (TSHs) tend to have more complex needs stemming from mental health and substance use disorders. The pilots are designed around the hypothesis that residents of ESRO or TSH would benefit from more intensive HASA intervention, while clients living in permanent supportive housing, particularly durably virally suppressed clients, could tolerate a less intensive intervention from HASA.
The evaluation of the HIV/AIDS Services Administration (HASA) pilots was supported, in part, by a grant from the New York City Council and with institutional support from the City University of New York, Institute for Implementation Science in Population Health. The pilot would not be possible without the dedication of HASA caseworkers and housing providers and involvement of HASA clients.