Medical Case Management (MCM) Curriculum

Overview:

The purpose of this training is to improve providers’ health literacy and optimize client-centered communication through improved understanding of the unique structural barriers faced by people with HIV.

Learning Objectives:

Describe attributes of a health literate organization
List and describe the stages of the Motivational Interviewing process
Discuss how healthcare teams can assist retention in care for patients who experience stigma, aggression, anger, depression, anxiety and other difficult emotions
Define common mental illnesses in people with HIV and describe the impact of mental illness on HIV care

CME Offered:

CE is not offered for this course.

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Course Instructors

Lynn Deitrick, RN, PhD
Clinical Educator

C. Ann Gakumo, PhD, RN
Assistant Professor, University of Alabama at Birmingham School of Nursing
Robert Wood Johnson Foundation Nurse Faculty Scholar

Debbie Cestaro-Seifer, MS, RN
Education and Training Specialist
North Florida AIDS Education and Training Center
University of Florida, College of Medicine

Marisa Echenique, PsyD
Assistant Professor
Department of Psychiatry and Behavioral Sciences
Miller School of Medicine
University of Miami

Nicole Ennis Whitehead, PhD and Vaughn E. Bryant, ScM
North Florida AIDS Education and Training Center
Southern HIV Alcohol Research Consortium (SHARC)
Department of Clinical and Health Psychology
College Public Health and Health Professions
University of Florida

Jennifer Janelle, MD
North Florida AIDS Education and Training Center
Gainesville, FL

Zoe Muller, MD
North Florida AIDS Education and Training Center
Clinical Assistant Professor, Division of Infectious Diseases and Global Medicine
University of Florida, Gainesville

Joanne J. Orrick, PharmD, BCPS, AAHIVP
Clinical Pharmacist
North Florida AIDS Education and Training Center
University of Florida, College of Medicine

Anna K. Person, MD, FIDSA
Associate Professor
Vanderbilt University Medical Center

Sonya O. Brown-Boyne, LMHC
Mental Health Counselor
South Florida AETC Faculty

Kara Schickowski, Esq.
Legal Aid Service of Broward County, Inc.

Jessica Castilho, MD, MPH
Assistant Professor of Medicine
Vanderbilt University Medical Center

Aging with HIV: Improving Both Healthspan and Lifespan

Objectives:

Background and epidemiology
Clinical challenges:
- Non-communicable diseases & multimorbidity
- Functional decline & frailty
- Clinical challenges and important role of case managers
Preventive health & geriatric medicine principles
- Examples of screening and vaccination
- 5 Ms of geriatric medicine
“Healthspan” & resilience

Duration: 45:58

An Introduction to Substance Use Disorders in People Living with HIV

Objectives:

Describe the epidemiology of SUD in the U.S. and among PLWH
Review theories for conceptualizing and strategies for addressing SUD
Review common signs, symptoms and assessment of SUD
Define Substance Use Disorders among PLWH

Duration: 52:00

Antiretroviral Therapy Part 1: Focus on Treatment Guidelines and Regimens

Objectives:

Explain the benefits of antiretroviral therapy (ART) and the goals of treatment
Describe regimen options and the factors involved in selecting an ART regimen for an individual patient
Discuss the importance of adherence and strategies to promote treatment success

Duration: 42:18

Antiretroviral Therapy Part 2: Focus on Side Effects and Drug-Drug Interactions

Objectives:

Describe the mechanisms, potential consequences, and most commonly encountered drug-drug interactions
Discuss strategies for identifying, managing, and minimizing potential side effects and drug-drug interactions

Duration: 49:39

Antiretroviral Therapy: Keys to Success

Objectives:

Discuss initial antiretroviral therapy (ART) options according to the most recent Department of Health and Human Services (DHHS) Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV
Utilizing patient case scenarios, discuss initial regimen options taking into account co-morbidities, drug-drug interactions, and patient preferences
Identify resources to assist patients in maintaining access to ART and other medications

Duration: 45:29

Barriers and Facilitators for Engaging Latinx in HIV services

Objectives:

Identity, demographics, and diversity.
What’s up with the X in Latinx?
Successes and challenges engaging Latinx.
Building trust with your Latinx clients.
Creating a culturally competent organization that Latinx would want to attend.

Duration: 45:33

Case Management 101: The Essentials of Time Management, Care Coordination and Documentation

Objectives:

Examine the core components of time management
Identify the key elements of care coordination
Discuss the importance of timely, concise, accurate, and standardized case notes as “best practice” in client care

Duration: 51:37

Common Mental Health Disorders in People Living with HIV

Objectives:

Describe the prevalence of mental illness among the adult HIV population
Identify common mental health issues among adults living with HIV
Discuss the impact of mental illness on HIV care
Recognize signs and symptoms of mental illness
Discuss the appropriate referral of patients for mental health treatment

Duration: 52:49

Cultural Awareness Basics

Objectives:

Define culture
Describe how an understanding of Complementary and Alternative Medical (CAM) practices can enhance cultural awareness
Discuss how cultural practices can impact a patient’s HIV treatment adherence
Describe how to create a welcoming environment for all patients.

Duration: 1:02:00

Health Literacy and HIV Care – A Practical Guide for Medical Case Managers

Objectives:

Identify tools that can be used to measure health literacy
Describe attributes of a health literate organization
Discuss examples of low health literacy in HIV treatment and care
Apply health literacy-based approaches in optimizing client-centered, effective communication

Duration: 47:51

HIV & Homelessness: Risks & Survival Behaviors in an Ecology of Desperation

Objectives:

Discuss a theoretical framework for understanding shared risks of HIV and homelessness.
Review demographics of HIV and homeless populations.
Examine impact of chronic homelessness on HIV care delivery and outcomes/
Explain the difference and similarities between poverty and homelessness
List common health issues associated with homelessness and the increased risk for contracting HIV
Identify the cycle of chronic homelessness and its impact on the care of an HIV positive patient
Describe the approach to care and the struggles associated with retaining a homeless HIV patient in care

Duration: 55:32

HIV and Opportunistic Infections

Objectives:

Recognize the most common opportunistic infections (OIs)
Discuss prophylaxis and treatment of common OIs
Describe types of exposures and ways to prevent OIs

Duration: 31:05

Identifying Substance Use Disorder and Problematic/Episodic Substance Use Among People Living with HIV

Objectives:

Define substance use disorder and problematic/episodic substance use
Discuss known consequences of substance use disorder and problematic/episodic substance use among PLWH
Review best practices for assessment of substance use disorder and episodic/problematic substance use PLWH

Duration: 40:20

Linkage and Retention in Care: Creating a Culture of Engagement

Objectives:

Define and describe the terms “linkage,” “engagement” and “retention” in care as they relate to the care of people who are HIV-positive.
Explain the HIV Care Continuum and reflect on the challenges that healthcare professionals and systems face in increasing the number of persons with HIV infection who are virally suppressed.
Discuss how healthcare teams can assist patients who experience stigma, social determinants of health, depression, anxiety and other difficult emotions remain in care.
Identify communication strategies that help healthcare professionals “connect” with patients who are experiencing difficult emotions.
Describe strategies and interventions that are successful in retaining and engaging patients with HIV in care.

Duration: 1:41:00

Legal Services in the HIV Care Continuum

Objectives:

Define HRSA Ryan White Legal Services
Describe the intersection of legal services and medical care in the overall care continuum
Identify potential legal issues with clients
Provide appropriate referrals to local legal service agencies/effectively connect clients to legal resources

Duration: 45:33

Mental Health and HIV Treatment and Care Part I – Screening for Improved Health Outcomes

Objectives:

Explain the HIV Care Continuum and reflect on the challenges that healthcare providers and systems face in increasing the percentage of persons with diagnosed HIV infection who are virally suppressed to at least 80%, percent.
Discuss how healthcare teams can assist patients who experience stigma, aggression, anger, depression, anxiety and other difficult emotions remain in care
Describe strategies and interventions that are successful in retaining patients living with HIV in care.

Duration: 1:01:00

Mental Health & HIV Part 2: Ensuring Quality Behavioral Health Treatment and Care for Individuals Living with HIV

Objectives:

List two facilitators and two barriers to providing behavioral health treatment and care to people living with HIV (PLWH).
Describe the process used to identify and assess individuals living with HIV who are experiencing difficult emotions and/or demonstrating at-risk behaviors for behavioral health disorders.
Identify communication strategies and techniques that assist medical case managers talk about behavioral health issues with individuals in a culturally conscious manner.
Identify several pharmacologic and non-pharmacologic therapeutic treatments that are most frequently prescribed as a first line treatment for individuals with HIV who are diagnosed with Major Depressive Disorder (MDD) or General Anxiety Disorder (GAD).
Discuss one strategy for each juncture of the HIV Care Continuum that demonstrates how to integrate behavioral health screening, assessment, treatment and care to reduce viral load and optimize wellness.

Duration: 56:03

Mental Health & HIV Part 3: Stress, Trauma and Distress

Objectives:

Discuss how stress can be a positive and a negative factor in regards to physical, social and emotional health.
List two screening instruments that assist in the identification of individuals living with HIV who may have experienced interpersonal violence (IPV) and other traumatizing events.
List some of the potential psychosocial outcomes of HIV stigma.
Explain the meaning of the term trauma-informed care and give an example of a strategy that integrates trauma-informed care into the healthcare setting.
Identify and discuss how to implement a best practice approach to recognize suicidal thoughts and behaviors in individuals living with HIV.
Describe two clinical interventions that may help to prevent suicide in people living with HIV (PLWH).

Duration: 1:41:24

Motivational Interviewing Basics

Objectives:

Name the three core elements that comprise the spirit of Motivational Interviewing (MI) and explain how these elements support the delivery of person-centered care in healthcare settings.
Identify closed and open-ended questions and discuss how best to utilize both types of questions when communicating with people living with HIV (PLWH).
List and describe the four stages of the MI process.

Duration: 1:12:00

Motivational Interviewing: Part 1

Objectives:

Explain the meaning of the term “person-centered care.”
Name the four “Cs” that are involved in providing person-centered care.
Describe the negative outcomes of HIV stigma as it relates to the HIV Care Continuum.
Discuss verbal and nonverbal communication strategies that can be used by the medical case manager to develop partnerships with their patients.
Describe the spirit of motivational interviewing.

Duration: 56:03

Motivational Interviewing: Part 2

Objectives:

Name the stages of the Transtheoretical Model of Change.
List the four core MI communication skills and discuss their role in the MI process.
Provide one example of each of the four core MI communication skills.
List the four components of the MI process.
Describe the MI process and provide examples to demonstrate how the core communication skills facilitate the process.

Duration: 1:41:00

Nutritional Mangement for HIV

Objectives:

Nutrition in HIV
- Undernutrition
- Overnutrition
- Fat redistribution
Medical Nutrition Therapy (MNT)
- Nutrition Assessment
  - BIA
- Nutrition Education
  - Supplements

Duration: 49:30

Pre-Exposure Prophylaxis in HIV

Objectives:

Identify what pre-exposure prophylaxis (PrEP) is
Identify patients at risk for HIV acquisition who may benefit from (PrEP)
Discuss steps for counseling and providing PrEP to patients at high risk for HIV
Discuss indications for stopping PrE

Duration: 37:40

Striving to do Better: A Clinician’s Approach to Caring for Transgender PLWHA

Objectives:

Terminology
Risk
Testing (peter’s paper)
Linkage
Front desk
In the exam room
- Mental health
- IPV
- Hormones
- DDI
- Housing
- Importance of primary care medical home
After they leave you
- Research related harms
- Policies as harm
- Stigma

Duration: 32:53

Understanding Lab Values

Objectives:

Communicate the rationale and importance of laboratory testing in the course of medical care for a person with HIV infection
Describe routine laboratory studies used in evaluation and management of patients with HIV infection
Recognize the role of a Medical Case Manager in counseling patients on laboratory testing

Duration: 43:12

Understanding the Impact of Mental Health: Basics for Medical Case Management

Objectives:

Discuss the prevalence of mental illness among the adultHIV population.
Identify how mental health issues impact care and treatment among adults with HIV.
Identify indicators of common mental health issues using basic Medical Case Management (MCM) assessments.

Duration: 53:20

HIV and Opportunistic Infections

Objectives:

Recognize the most common opportunistic infections (OIs)
Discuss prophylaxis and treatment of common OIs
Describe types of exposures and ways to prevent OIs

Duration: 31:05

Antiretroviral Therapy Part 1: Focus on Treatment Guidelines and Regimens

Objectives:

Explain the benefits of antiretroviral therapy (ART) and the goals of treatment
Describe regimen options and the factors involved in selecting an ART regimen for an individual patient
Discuss the importance of adherence and strategies to promote treatment success

Duration: 42:18

Antiretroviral Therapy: Keys to Success

Objectives:

Discuss initial antiretroviral therapy (ART) options according to the most recent Department of Health and Human Services (DHHS) Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV
Utilizing patient case scenarios, discuss initial regimen options taking into account co-morbidities, drug-drug interactions, and patient preferences
Identify resources to assist patients in maintaining access to ART and other medications

Duration: 45:29

Antiretroviral Therapy Part 2: Focus on Side Effects and Drug-Drug Interactions

Objectives:

Describe the mechanisms, potential consequences, and most commonly encountered drug-drug interactions
Discuss strategies for identifying, managing, and minimizing potential side effects and drug-drug interactions

Duration: 49:39

An Introduction to Substance Use Disorders in People Living with HIV

Objectives:

Describe the epidemiology of SUD in the U.S. and among PLWH
Review theories for conceptualizing and strategies for addressing SUD
Review common signs, symptoms and assessment of SUD
Define Substance Use Disorders among PLWH

Duration: 52:00

Mental Health and HIV Treatment and Care Part I – Screening for Improved Health Outcomes

Objectives:

Explain the HIV Care Continuum and reflect on the challenges that healthcare providers and systems face in increasing the percentage of persons with diagnosed HIV infection who are virally suppressed to at least 80%, percent.
Discuss how healthcare teams can assist patients who experience stigma, aggression, anger, depression, anxiety and other difficult emotions remain in care
Describe strategies and interventions that are successful in retaining patients living with HIV in care.

Duration: 1:01:00

Common Mental Health Disorders in People Living with HIV

Objectives:

Describe the prevalence of mental illness among the adult HIV population
Identify common mental health issues among adults living with HIV
Discuss the impact of mental illness on HIV care
Recognize signs and symptoms of mental illness
Discuss the appropriate referral of patients for mental health treatment

Duration: 52:49

Mental Health & HIV Part 2: Ensuring Quality Behavioral Health Treatment and Care for Individuals Living with HIV

Objectives:

List two facilitators and two barriers to providing behavioral health treatment and care to people living with HIV (PLWH).
Describe the process used to identify and assess individuals living with HIV who are experiencing difficult emotions and/or demonstrating at-risk behaviors for behavioral health disorders.
Identify communication strategies and techniques that assist medical case managers talk about behavioral health issues with individuals in a culturally conscious manner.
Identify several pharmacologic and non-pharmacologic therapeutic treatments that are most frequently prescribed as a first line treatment for individuals with HIV who are diagnosed with Major Depressive Disorder (MDD) or General Anxiety Disorder (GAD).
Discuss one strategy for each juncture of the HIV Care Continuum that demonstrates how to integrate behavioral health screening, assessment, treatment and care to reduce viral load and optimize wellness.

Duration: 56:03

Mental Health & HIV Part 3: Stress, Trauma and Distress

Objectives:

Discuss how stress can be a positive and a negative factor in regards to physical, social and emotional health.
List two screening instruments that assist in the identification of individuals living with HIV who may have experienced interpersonal violence (IPV) and other traumatizing events.
List some of the potential psychosocial outcomes of HIV stigma.
Explain the meaning of the term trauma-informed care and give an example of a strategy that integrates trauma-informed care into the healthcare setting.
Identify and discuss how to implement a best practice approach to recognize suicidal thoughts and behaviors in individuals living with HIV.
Describe two clinical interventions that may help to prevent suicide in people living with HIV (PLWH).

Duration: 1:41:24

Nutritional Mangement for HIV

Objectives:

Nutrition in HIV
- Undernutrition
- Overnutrition
- Fat redistribution
Medical Nutrition Therapy (MNT)
- Nutrition Assessment
  - BIA
- Nutrition Education
  - Supplements

Duration: 49:30

Pre-Exposure Prophylaxis in HIV

Objectives:

Identify what pre-exposure prophylaxis (PrEP) is
Identify patients at risk for HIV acquisition who may benefit from (PrEP)
Discuss steps for counseling and providing PrEP to patients at high risk for HIV
Discuss indications for stopping PrE

Duration: 37:40

Linkage and Retention in Care: Creating a Culture of Engagement

Objectives:

Define and describe the terms “linkage,” “engagement” and “retention” in care as they relate to the care of people who are HIV-positive.
Explain the HIV Care Continuum and reflect on the challenges that healthcare professionals and systems face in increasing the number of persons with HIV infection who are virally suppressed.
Discuss how healthcare teams can assist patients who experience stigma, social determinants of health, depression, anxiety and other difficult emotions remain in care.
Identify communication strategies that help healthcare professionals “connect” with patients who are experiencing difficult emotions.
Describe strategies and interventions that are successful in retaining and engaging patients with HIV in care.

Duration: 1:41:00

Cultural Awareness Basics

Objectives:

Define culture
Describe how an understanding of Complementary and Alternative Medical (CAM) practices can enhance cultural awareness
Discuss how cultural practices can impact a patient’s HIV treatment adherence
Describe how to create a welcoming environment for all patients.

Duration: 1:02:00

Striving to do Better: A Clinician’s Approach to Caring for Transgender PLWHA

Objectives:

Terminology
Risk
Testing (peter’s paper)
Linkage
Front desk
In the exam room
- Mental health
- IPV
- Hormones
- DDI
- Housing
- Importance of primary care medical home
After they leave you
- Research related harms
- Policies as harm
- Stigma

Duration: 32:53

HIV & Homelessness: Risks & Survival Behaviors in an Ecology of Desperation

Objectives:

Discuss a theoretical framework for understanding shared risks of HIV and homelessness.
Review demographics of HIV and homeless populations.
Examine impact of chronic homelessness on HIV care delivery and outcomes/
Explain the difference and similarities between poverty and homelessness
List common health issues associated with homelessness and the increased risk for contracting HIV
Identify the cycle of chronic homelessness and its impact on the care of an HIV positive patient
Describe the approach to care and the struggles associated with retaining a homeless HIV patient in care

Duration: 55:32

Barriers and Facilitators for Engaging Latinx in HIV services

Objectives:

Identity, demographics, and diversity.
What’s up with the X in Latinx?
Successes and challenges engaging Latinx.
Building trust with your Latinx clients.
Creating a culturally competent organization that Latinx would want to attend.

Duration: 45:33

Health Literacy and HIV Care – A Practical Guide for Medical Case Managers

Objectives:

Identify tools that can be used to measure health literacy
Describe attributes of a health literate organization
Discuss examples of low health literacy in HIV treatment and care
Apply health literacy-based approaches in optimizing client-centered, effective communication

Duration: 47:51

Legal Services in the HIV Care Continuum

Objectives:

Define HRSA Ryan White Legal Services
Describe the intersection of legal services and medical care in the overall care continuum
Identify potential legal issues with clients
Provide appropriate referrals to local legal service agencies/effectively connect clients to legal resources

Duration: 47:10

Motivational Interviewing Basics

Objectives:

Name the three core elements that comprise the spirit of Motivational Interviewing (MI) and explain how these elements support the delivery of person-centered care in healthcare settings.
Identify closed and open-ended questions and discuss how best to utilize both types of questions when communicating with people living with HIV (PLWH).
List and describe the four stages of the MI process.

Duration: 1:12:00

Motivational Interviewing: Part 1

Objectives:

Explain the meaning of the term “person-centered care.”
Name the four “Cs” that are involved in providing person-centered care.
Describe the negative outcomes of HIV stigma as it relates to the HIV Care Continuum.
Discuss verbal and nonverbal communication strategies that can be used by the medical case manager to develop partnerships with their patients.
Describe the spirit of motivational interviewing.

Duration: 56:03

Motivational Interviewing: Part 2

Objectives:

Name the stages of the Transtheoretical Model of Change.
List the four core MI communication skills and discuss their role in the MI process.
Provide one example of each of the four core MI communication skills.
List the four components of the MI process.
Describe the MI process and provide examples to demonstrate how the core communication skills facilitate the process.