The Department of Health of Puerto Rico established in 1990 a system of Regional Immunology Clinics (RICs) under the Office for AIDS and Communicable Diseases Affairs (OCASET) to serve the multiple needs of persons infected with HIV through a comprehensive service model based on the Bio-Psycho-Social Model. Each of the eight RICs offers complete medical, psychological, social, and case management services. OCASET is requesting funds to add certain basic services that in the past have been offered through referrals to separate public and/or private organizations in order to establish a complete one-stop service model. This model proposes to integrate mental health social work, additional psychological and psychiatric services, mental health outreach, and consultation to one of our RICs located in the Bayamon Health Region. This RIC has an active patient population of 1,277 persons. Of these, over 200 persons received close to 1,000 hours of psychotherapy and/or psychiatric consultation in the past 12 months. Many are medically indigent and depend entirely on public health services for their care. Through Ryan White C.A.R.E.Act funds and private consortia, the RIC has been able to supply many of their needs. However, hospitalization and neurological consultation have been difficult to obtain, and psychological/psychiatric services have been overloaded since the beginning. Due to the number of patients, Case Managers have caseloads that limit their number of visits to patients' homes. However, the RIC has been able to meet the demand and at the same time maintain detailed statistics of the services offered. Further development of the RIC Surveillance system is expected to include data that will determine the effectiveness of the services offered and the benefits for the quality of life of the clientele.
