Comprehensive Risk Counseling and Services (CRCS)

The purpose of this website is to provide information to CBOs and health departments that are or will be implementing CRCS (formerly known as Prevention Case Management or PCM) – an intensive, individual level, client-centered risk reduction intervention for people at high risk for HIV infection or transmission.

The website contains information such as the CRCS Implementation Manual and sample data collection templates (in the appendices), news and updates concerning the intervention, links to CRCS training centers, and other relevant information. You will also be able to communicate with a CDC representative concerning CRCS. Don’t forget to check out the Questions and Answers below.

This information has been developed and reviewed by staff at CDC – and specifically, the CRCS work group in the Division of HIV Prevention.

We want this website to be a convenient resource for you, so please feel free to offer suggestions. Bookmark us, so you can easily find your way back. But above all, welcome!

Questions and Answers

Are we required to use the data collection forms included in the manual?

No – The sample data collection templates are provided in the Manual for your agency’s convenience, but CDC does not require their use. Note however, that CDC may require some of the items indicated on the templates. We have provided the templates in Word format so that your agency can change them as necessary to fit the agency’s needs and resources. We believe the templates can help CRCS managers and counselors keep track of CRCS activities, client progress and challenges, and needed program changes.

Can CRCS risk reduction sessions be conducted in a group context?

CRCS is by definition a client-centered intervention. This means that a counselor’s work with a client to determine primary risk issues and challenges and determine best approaches to meeting those challenges is done at the individual level. However, your client and counselor may also determine that specific group activities, such as group-based behavioral interventions or support groups, could be a useful component of the client’s intervention plan.

For what kind of client is CRCS intended?

CRCS is designed to provide intensive, client-centered risk reduction counseling to persons for whom risk reduction is difficult to achieve or maintain but who also are willing to work on these issues. These clients may not benefit from less intensive risk reduction interventions until after psychosocial needs (e.g., mental health, substance abuse, or housing) that interfere with risk reduction are addressed.

How soon should we begin risk reduction counseling with CRCS clients?

You should begin risk reduction counseling as soon as possible with CRCS clients. First, during screening and enrollment, clients should learn that the primarily purpose of CRCS is risk reduction. Some agencies even begin risk reduction discussions during initial outreach to potential clients. During the initial assessment conversations, it is necessary to discuss risk reduction desires, goals, and needs. Focused risk reduction counseling depends on a good assessment of risk and risk-related issues with each client. After assessment activities, formal risk reduction begins. But it is important to remember that every interaction with a client is a chance to provide risk reduction messages and support.

We have CRCS staff who work on CRCS as part of their work load, but do other tasks to fill their work load. For agencies such as ours with few resources and a lot to do, is this a good approach to CRCS?

CRCS counselors need to be available to meet the prevention needs of their clients. Prevention for CRCS clients tends to be intensive and complex. We have found that counselors have lots of difficulty maintaining an on-going and consistent relationship with their clients if they are also working with other interventions or program activities at the same time. Unless the CRCS workload is exceptionally small (fewer than 10 clients) or the other activities can fit well into the CRCS flow of activities (e.g., counselors are also responsible for providing HIV testing to their enrolled CRCS clients), we recommend that CRCS counselors be full time.

What do we have to report about CRCS in PEMS?

The sample data collection forms do include some PEMS items, as indicated on each form by R or *; however, note that PEMS reporting requirements are currently (05/2006) being reviewed. Please address specific questions about PEMS, including questions about up-to-date reporting requirements, to or to your Project Officer.

Additional Resources

Training Centers for CRCS

CDC Resources

HIPAA Regulations and Requirements

REMEMBER to make certain to check with other HIPAA sources such as well as your local or state health department regarding any individual state requirements regarding privacy and security and electronic data interchange of Protected Health Information.