Data | Forms | Handbook | Monitoring Tools | Reports | Standards of Care | Websites

Data

• HIV/AIDS Epidemiology in TGA (.pdf)

Forms

• Case Management Assessment Form (.doc)
  For use only if provider is providing Case Management Services.
   
• Case Management Intake Form (.doc)
   
• Certified Referral Form (.doc)
  For use in referring clients to Friendship Trays for food. This form is also used when an agency is providing a service for a client, but has no direct contact with that client. In cases of no direct contact this form must be maintained in the client's record for billing and monitoring purposes.
    
• CAREWare Agency Agreement (.pdf)
     
• CAREWare User Account Request (.pdf) 
   
• Client Eligibility Requirements (.doc)
   
• Client-Level Data: Certified Referral Form (.xls)
   
• Client Individualized Care Plan (.doc)
   
• Client's Rights and Responsibilities (.doc)
   
• Federal Poverty Level (.xls)
   
• General Consent Form (.doc)

Handbook

• Case Management Handbook (.pdf)
   

Monitoring Tools

• Ambulatory Care (.xls)
   
• Case Management (.xls)
   
• EIS Tool (.xls)
   
• Fiscal (.xls)
   
• Food Service (.xls)
   
• Health Insurance (.xls)
   
• Housing (.xls)
   
• Legal Services (.xls)
   
• General Monitoring Report (.xls)
   
• Medical Nutrition Therapy (.xls)
   
• Medications - Drug Reimbursement Program (.xls)
   
• Mental Health (.xls)
   
• Oral Health Care (.xls)
    
• Outreach Tool (.xls)
   
• Psychosocial Support (.xls)
   
• Substance Abuse (.xls)
   
• Transportation - Contracted (.xls)

Standards of Care

• Case Management (.pdf)
   
• Food Service (.pdf)
   
• Housing (.pdf)

Reports and Spreadsheets

Effective April 1, 2008, the following forms must be used otherwise reimbursement requests will be returned to your agency.

• Quarterly Report (.doc)
   
• MAI Quarterly Report (.doc)

Website Links

• The Body, HIV/AIDS Resources, www.thebody.com
   
• Centers for Disease Control, www.CDC.gov
   
• Health Resources and Services Administration, www.HRSA.gov
   
• Kaiser Family Foundation, HIV/AIDS Research & Analysis, www.kff.org/hivaids/index.cfm