Linking to Care

What exactly are the differences between a Case Manager and a Client Advocate?

Client advocates work under the direction of a State Licensed Case Manager who has specific university training. You may think the person you talk with, and who helps you access services, is your case manager, when in fact that person may be a Client Advocate, and your affairs are under the direction of that person’s boss. Each agency receives funding from Ryan White based on the number of anticipated clients it will be serving.


Case management is an agreement between a client and a case manager for a definite period based on the client’s assessed needs. To assist clients with HIV/AIDS to get into care and/or remain in care by the coordination and/or procurement of needed services so that the problems associated with living with the disease are mitigated. [Ryan White Council]

Agencies will be responsible for the provision of advice and assistance obtaining medical, social, community, legal, financial, and other needed services. Advocacy does not involve assessment, coordination, and/or follow-up on medical treatment, as case management does.

Agencies must ensure the following is being provided and available:

  1. A coordinated information and referral system for the San Antonio HSDA that includes all the appropriate HIV/AIDS services, as well non-HIV/AIDS services needed.
  2. Individualized client advocacy in overcoming barriers to accessing care.
  3. Publications distributed to the HIV/AIDS community containing current information on HIV/AIDS services and access to those services.
  4. A current database of basic information about medical and social services available throughout the San Antonio HSDA. The database must be produced and distributed in a directory form to all clients at least once each contract year.

Agencies ensure and maintain documentation that employed client advocates:

  1. Have at least two years of HIV experience.
  2. Have at a minimum of eight (8) hours of training for a client advocate that covers the HIV/AIDS community and the local HIV/AIDS Continuum of Care. This training must include: Full compliment of services available within the San Antonio HSDA, How to access such services, Bexar County HIV Services Standards of Care, Consumer Rights & Responsibilities, Consumer Grievance and Compliant Processes.
  3. Have, within the first thirty (30) days of employment, an additional sixteen (16) hours of training related to the HIV/AIDS community and specific knowledge, skills, and techniques necessary to provide advocacy services. This training must include understanding of:
    • Demographics of the disease, HIV 101, Insurance, disability, and financial access issues
    • Psychosocial issues of the HIV infected client
    • Entitlement and benefits programs
    • Resource identification
    • Interviewing, counseling, and interpersonal skills
    • Date management and record keeping

Agencies must ensure the following is documented and maintained in each clients file:

  1. An intake appointment scheduled within three (3) working days of direct client contact presenting for individualized information and referral and/or individualized client advocacy services.
  2. Client intake according to accepted intake policy in the San Antonio HSDA.
  3. Information and Referral provided on an individual basis to include the provision of information, referrals and service linkages in accordance with client’s individual identified needs.

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