Social Work Case Manager

AIDS Medi-Cal Waiver Program


Social Work Case Manager (SWCM) is an individual licensed by the State of California as an LCSW, MFT, or Psychologist; an individual who has a Master’s Degree in Social Work, Counseling, or Psychology; or an individual with similar degree qualifications approved by the Department. The SWCM serves as a member of the core case management team and provides case management services. The SWCM does not perform the functions of the Psychotherapist.

Case Management is the process through which a Nurse Case Manager (NCM) and SWCM coordinate a core case management team to accomplish the functions of initial and ongoing client assessment; development, implementation and evaluation of a service plan; and the location, coordination and monitoring of cost-effective, quality services provided in accordance with the client’s needs as set forth in a comprehensive service plan. Case management incorporates a collaborative, interdisciplinary team approach. Case management includes: 1) client eligibility and enrollment; 2) comprehensive client assessment and reassessment; 3) resource identification and service planning; 4) service delivery; and 5) evaluation. The NCM and SWCM both perform the functions of case management, as identified in the service plan.

Targeted Case Management (TCM) consists of case management services that assist Medi-Cal eligible individuals within specified targeted groups to access needed medical, social, educational, and other services. TCM service components include needs assessment, setting needs objectives, individual services planning, service scheduling, crisis assistance planning, and periodic evaluation of service effectiveness.


  • Community outreach to expand the client base; specifically, to reach populations and/or groups in the community disproportionately affected by HIV/AIDS;

  • Eligibility screening to identify appropriate clients for intake and case management; assist with institutional discharge planning to ensure the transition of qualified individuals into MCWP, if needed;

  • Comprehensive assessment of the client’s physical, psychosocial, environmental, financial, and functional status;

  • Identification and proposed resolution of problems in the utilization and delivery of client services and any special client preferences and desires regarding service providers;

  • Development, implementation, monitoring, and modification of a comprehensive individual service plan through an interdisciplinary team process in conjunction with the client and his/her caregivers;

  • Coordination of the provision of services to the client including but not limited to: in-home skilled nursing care, in-home attendant care, homemaker services, nutritional counseling and supplements, psychotherapy, durable medical equipment, housing assistance, food subsidies, and transportation;

  • Reassessment of the client’s physical, psychosocial, financial, and functional status at regular intervals and as needed;

  • Evaluation of the service plan and specific services through reassessments and case conferences;

  • Transition to less intensive case management services when health and functional status improves and stabilizes; and

  • Linking the client with the most appropriate resources and advocating for the best interests of the client


About Us:

AIDS Project of the East Bay is a community based organization, dedicated to preventing the spread of HIV and supporting individuals infected with the virus through programs geared towards some of the most vulnerable and marginalized individuals in Alameda County. APEB ensures that individuals and communities beyond reach of other agencies receive professional services of the highest standard.  Founded in 1983, AIDS Project of the East Bay has been serving the community of the San Francisco East Bay Area for over 30 years with a particular focus on Alameda and Contra Costa Counties. AIDS Project of the East Bay was originally a project of Berkeley’s Pacific Center for Human Growth and Development and began as a response to the need for services for People Living with HIV/AIDS (PLWHA) in the bay area outside of San Francisco. Since that time, the epidemic has grown and changed and APEB has strived to keep up with the changing tides of HIV/AIDS.



Conditions of Employment:

It is the policy of APEB to require all new employees to satisfactorily complete a probationary period as a prerequisite to continued employment in his/her position.

Non-discrimination Clause:

AIDS Project of the East Bay does not discriminate against any employee, client, volunteer, or vendor on the basis of race, color, religion, gender, sexual orientation, gender expression, national origin, age, disability, marital status, familial status or any other characteristic protected by Federal or State law. AIDS Project of the East Bay will make reasonable accommodation in compliance with the Americans with Disabilities Act of 1990.


David Hillary, NCAC I,  CADC II, CRPS

Care Services Department Manager