Enhanced Case Management
The Pediatric AIDS Chicago Prevention Initiative offers a specialized case management program designed for pregnant, HIV-positive women who need extra support during their pregnancies. The program serves women in the Chicago and collar county area, including Cook, Lake, McHenry, DeKalb, Kane, DuPage, and Will counties. Through the 24/7 Perinatal HIV Hotline, clients from other counties can be linked with a qualified case manager trained in pregnancy and HIV issues.
Coordinated services ensure that HIV-positive pregnant women will get the help and support they need to ensure a healthy pregnancy and delivery, as well as postpartum care for both mother and her HIV-exposed infant.
PACPI collaborates with the Ryan White-funded AIDS Foundation Case Management Cooperative and the Illinois 24/7 Illinois Perinatal HIV Hotline to link HIV-positive mothers and their infants to a safety net of services both during and after pregnancy.
For more information about enhanced case management, contact pacpi2000@aol.com.
Clients can be referred:
- Through the Illinois 24/7 Perinatal HIV Hotline (800-439-4079)
- Directly from a HIV/OB clinics
- Through the AFC Case Management Cooperative (312-922-2322)
- Directly from a community-based or social service agency (either through calling the hotline or AFC telephone numbers)
Please download the appropriate referral form and have it signed by the client. Please fax the form to our secure machine at 312-334-0974 to make a referral. It’s important to include a telephone number of either the client or the referring agency to help establish contact with the client.
Jay's Story LeSherri’s Story Rebecca’s Story
Jay’s Story:
“[After getting diagnosed with HIV] I didn’t want to talk to anyone. I didn’t want to do anything. I just went in, got my medicine and went home.”
Shortly thereafter, she went in for another appointment. That’s when she found out she was pregnant.
“I kept asking myself, ‘How am going to do this? Where am I going to live? I don’t even make $100. How am I going to bring my son up in nice, safe environment?’”
Her case manager called a PACPI case manager, to see if she could help secure permanent housing.
“I was on the street because I couldn’t go home to my mother. So I was just walking up and down the street. That’s all I did all day, just walk up and down the street.”
Jay was already seven months pregnant and needed stable, permanent housing quickly. Through a partnership with Christian Community Health, PACPI was able to fast track Jay into a permanent apartment on a quiet, tree-lined street in a nice neighborhood of Chicago.
On moving into her new place, Jay said, “I don’t know how to thank [PACPI] for finding me an apartment. They bent over backwards to help me. At first I was in the dark. I didn’t know what I was going to do. I sat at a bus stop crying my eyes out thinking ‘I don’t deserve this. I already have a disease I can’t get rid of and what am I supposed to do now, pregnant and without a place to stay?”
“I opened my apartment door and I already had two couches and a bed. It was amazing. I’m really blessed. It’s so good to wake up with peace of mind in my own apartment that’s in a nice, safe neighborhood. Not having to worry about where I’m going to eat.
"I’ve been blessed with the best case managers in the whole world. They’re my angels. It’s not in their job description to get up at 1 a.m. to just talk to you, but they do. I can call in the middle of the night and they guide me and tell me ‘Don’t worry about it, everything will be alright. We’ll help you.’”
LeSherri’s Story:
"It was the longest doctor appointment of my life. I was pregnant. The doctor was extremely upset. He didn't know how I could be HIV-positive and have a baby. He couldn't give me prenatal care. My baby's dad was really upset too. He didn't want us to leave until we were referred to a doctor who would help me. We were there for six hours until they referred me to someone who would help."
"I didn't know I could have an HIV-negative baby. PACPI eased my mind. I realized 'Okay, I can do this. I can have this baby and have it be healthy.' I did everything the doctor told me. I went to every appointment; I took my medicine. That year, I think there were only one or two babies born HIV-positive to women in the group."
LeSherri is now back in college and, after seeing the amazing difference her case manager made in her life, studying social work so she can do the same for others. Her daughter is a typical precocious five-year-old and most importantly, she is HIV-negative!
"I'm thinking about the future and going on with life. I'm not the only 26-year-old woman who is HIV-positive. Everything happens for a reason and I wouldn't change anything."
"I love my case manager. It's an experience I'll never forget. She was with me the whole time. If my mom couldn't go to the doctor with me, she would go. And, towards the end of my pregnancy, I was on bed rest for two months. My only excitement was when she visited. She even called me on my first Mother's Day."
Rebecca’s Story:
Rebecca, a woman who had previously managed two HIV+ pregnancies on her own, found herself overwhelmed, without a job, without a home, and without the support of her family when she became pregnant with her third child. Struggling with depression and newly diagnosed bipolar disorder, she found herself too stressed out and weighed down to maintain her health and to take the medications needed for the safety of her new baby. In her words, she had “hit rock bottom.” It was at this pivotal time in her life that Rebecca met Dolores, her PACPI case manager.
In the past, Rebecca had experiences with case workers who she described as demeaning and unkind, saying of one previous worker, “Her face showed me that she didn’t like her job. She looked like she didn’t really want to help me, and that she felt like she was wasting her time. I got away from her right quick!” With those negative experiences in her past, it took some time for Rebecca to open up. However, she eventually did, because she could feel how sincerely Dolores wanted to help and that this case manager would be dedicated to her through thick and thin.
As their relationship deepened, a true friendship developed. “She really listens to me, and she is the only person I can really talk to. When I’m feeling depressed or hopeless, she always talks me through it. There are times when I wanted to give up, and she’s always there to support me. She knows me so well, and I really feel like I can trust her.”
Part of that trust is built on Dolores’ willingness to talk and to listen, but another equally meaningful component is the functional day to day support and the above and beyond actions that Dolores does for Rebecca. “Dolores is really good. I don’t know where we’d be at without her! She helped me get an apartment, get things for the baby, helped me with cab rides for the doctor. She made things easy for me, helping me get around and helping me to find a home.”
Rebecca describes feeling blessed by having Dolores and PACPI by her side. “There is nothing that Dolores doesn’t do to help me. Even if she is supposed to be strictly business with me, she lets me talk about my personal stuff too. She makes me feel like I can go ahead. I really feel like I’m getting everything I need. Right now, it is the happiest time ever for me. She has already done enough for me by getting me an apartment. She got me off the streets with my kids. Now, all of the little extra things she is doing, they make me feel like someone really loves me. Cares about me. Trusts me. Respects me. Dolores really believes in me.”
PACPI enhanced case management services are tailored to individual client/family needs. Services provided may include:
- Assist clients in applying for benefits
- Facilitate access to emergency funds
- Identify medical and social service needs
- Facilitate appropriate referrals to meet the client's specific needs
- Escort clients to clinic appointments
- Family counseling (partners, parents, etc.)
- Linkage for testing of partners and other children
- Development of a birth plan with specialty HIV/pregnancy (OB) providers
- Primary and secondary HIV prevention planning
- Linkage for specialty pediatric care
- Bilingual services in Spanish
- Linkage to prenatal classes and support groups
- Immediate assistance for women with a preliminary positive rapid HIV test at labor and delivery
- Adherence support for pregnant women and their newborns
- Adherence support for prenatal and HIV medical visits
- Assistance with transportation, food vouchers, housing, WIC, etc.
- Community and home-based services
The Enhanced Case Manager will assist hospital staff caring for women with preliminary positive rapid HIV tests. In most cases, an Enhanced Case Manager will visit the mother in the hospital within hours of the test being reported to the hotline and offer counseling and support during the sensitive time between the preliminary test and the confirmatory result.
The case manager will also work with the mother and her family to help ensure that she receives her confirmatory Western Blot result and is linked to appropriate care and follow up services based on her ultimate diagnosis.
Standing appointments have been made at each of the six HIV/OB specialty care hospitals in the Chicagoland area to allow a maximum of choice for each newly diagnosed or newly referred client. The case managers will work with the mother to make sure she is referred to the programs that best suit her individual needs.