This article focuses on case management service providers under the Ryan White CARE Act (Ryan White), a federal program that makes available high-quality, comprehensive services for people with HIV, including case management. Unlike many other Ryan White services, the effectiveness of HIV case management is difficult to assess given its multifaceted nature, and little is known about case managers’ professional attributes. The authors surveyed 122 case managers in Florida, focusing on their characteristics, training, and barriers to practice. They found that case managers are a diverse population who often rely upon on-the-job training to prepare them for their work. Most case managers surveyed felt inadequately prepared at the start of practice and continue to struggle years later. The most common barriers to successful practice include lack of experience and knowledge around administrative processes and access to external programs for clients. Financial constraints within case managers’ agencies and at the state and federal levels were barriers, as well. Almost all case managers reported excessive caseloads and inability to serve client needs as sources of job stress. Nearly all case managers surveyed proposed greater inclusion of case management-specific coursework in their education and a wider availability of on-the-job training specific to these areas.
The authors note the study’s limitations in scope and generalizability, and recommend that randomized clinical trials of case management interventions be performed. They also recommend further research to determine optimal training for case managers.