An interdisciplinary, interagency, primary care approach to case management of the dually diagnosed patient with HIV disease.

The epidemic of dually diagnosed patients with HIV disease (HIV disease coexisting with substance abuse and/or mental illness) has become increasingly recognized. This phenomenon poses potential threats to the effectiveness of HIV primary care, even when delivered by expert clinicians. This article describes implementation strategies for the provision, documentation, and third party billing of interdisciplinary, interagency HIV primary care case management within the context of an academic medical center. Our approach, which is specific to our setting, has evolved as we have attempted to define an active role for the primary care physician as a member of the case management team.