E. FAQs on screening, enrolling, and assessing clients

Q: Can I make referrals, even if the individual is not eligible or ready for CRCS?
A: Yes, you are encouraged to make referrals for all clients, regardless of whether or not they are eligible or enroll in CRCS.

Q: If the person doesn’t know their HIV status, are they eligible?
A: If the person meets your agency’s eligibility criteria, they are eligible to enroll in CRCS. However, you should also encourage clients to be tested and discuss with them the importance of knowing their status. In some agencies, knowledge and evidence of serostatus is a prerequisite for enrolling in CRCS. You should help a client locate an appropriate HIV counseling and testing site if they want to be tested.

Q: The person is in crisis – they have severe mental health or drug treatment needs – should I enroll them?
A: Probably not at this time. You should definitely refer them for appropriate treatment and follow up to see how the treatment is going. When this is the case, build the relationships so that these clients can begin to work on risk-reduction after they have taken care of their more immediate or pressing needs.

Q: Do I need to collect demographic information (or any information) on those people who are not eligible for the program but do not enroll?
A: Yes! There are several ways this information can be used in program evaluation.

• Compare eligible to non-eligible people to see if you can more efficiently target your outreach or screening efforts.
• Among the eligible people, compare those who enroll in CRCS with those who do not. Using this information can help you describe the people who are not enrolling in CRCS and adapt your recruitment or other service delivery techniques for them.
• Follow-up with those screened if they do not enroll in the program. During the follow-up, you can determine why they did not enroll (if eligible) and use this information to improve your program.
• Finally, some of this information will be required by PEMS, and we have indicated PEMS-related information or data points on the sample data collection formats included in this manual.

Q: What date do we enter for initial assessment data that has taken more than one session with the client to obtain?
A: Your agency should determine its policy for this, based on how the information will be most useful to you. But in any case, the policy should be consistently applied in order to be able to evaluate progress that your clients make.

Q: Are newly diagnosed persons eligible for CRCS?
A: Depending on your agency’s policy, CRCS may not be the best intervention for some newly diagnosed individuals. We know that many individuals reduce their risk after a positive diagnosis, at least for some period of time. Also, newly diagnosed individuals may not be ready for intensive intervention activities. However, for those newly diagnosed individuals who do not have access to case management services, CRCS may be an important resource for them, as well as a tool for them to deal with risk issues when they are prepared to do so.

Q: How can we get the assessment done early if the client is reluctant to discuss their risk right away? We’re worried that we’ll lose clients if we press them about risk early in their relationship with us.
A: It’s true that counselors have to be good at balancing building a trusting relationship with clients while assessing the factors that make them at risk for HIV/STD transmission or acquisition. CRCS counselors are assessing clients from the minute they start talking with them. If the assessment is seen as naturally flowing out of the counselor’s concern for the client, the client will be more open to discussing the assessment topics. Again, this is a skill that takes some training and practice.

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