The document provides guidance for navigators in the CLUB 1509 program on linkages, coordination of services, progress notes, and providing ongoing therapeutic support. It outlines that linkages require direct contact with service providers, documentation, and follow up. Coordination of services involves identifying resources, referrals, linkage assistance, information, coaching, and managing the process. Progress notes should document every client contact and include updated contact information, referrals made and follow up, mood, adherence to PrEP/HIV medication. Examples are provided for navigating discussions around PrEP and addressing low literacy.

1. P H I L A D E L P H I A D E P A R T M E N T O F P U B L I C H E A L T H
A I D S A C T I V I T I E S C O O R D I N A T I N G O F F I C E
C L U B 1 5 0 9 N A V I G A T O R S
PRACTICE AND SERVICE TRAINING
UNIT: 2
Linkages & Progress Notes

2. LINKAGES
• Linkages will include direct contact between the navigation team and
the service providers to which the client is being referred.
• All linkages need to be documented
• A linkage is defined as one service visit.
• Follow-up with the client and agency on linkage.
• As often as possible, a member of the navigation team accompanies
the client to the first contact between services providers and the client.
• The client is linked to all services identified in the CLUB 1509 Action
Plan, including Ryan White Case management, social services and
PrEP services, as soon as possible.

3. COORDINATION OF SERVICES
• Process of connecting client to needed services and programs.
• Services should be timely, appropriate and of high quality.
• Process involves:
– Identifying resources
– Providing referrals
– Aiding linkage
– Giving information
– Coaching
– Managing the overall process

4. PROGRESS NOTES
• Produce a progress note for every contact.
• Always ask the client if the contact information is
still the same.
• Has the client had contact with the assistant
navigator? When?
• Did the client follow-up on a referral? What were
the results of the referral?
• What is the clients mood?
• Is the client still taking PrEP?
• Is the client still taking their HIV medication?

5. PROVIDING ONGOING THERAPEUTIC
SUPPORT >>>>>>>>>>>
• Using your Motivational Interviewing and Integrative Next Step
Counseling (iNSC) skills
• When a client no longer interested in program
• Client may not be taking their PrEP or ARV medication
• Client may not have stable housing.
It when you are have situations such as the ones
above you can use these short-term therapeutic
techniques

6. EXAMPLE CASE
James and John have been in a long term
relationship for 5 years. James expresses to you he
would like to be on PrEP but is nervous about having
the discussion with John.
• What can you do as the navigator support his
choice to be on PrEP?
• How can you help James have the conversation
with his paramour about PrEP?
• How can you best support James in the referral to
PrEP?
• What aspects of Jame’s Bio-Psycho-Social
Assessment would be most pertinent to consider?
• How should this progress note be written out?

7. EXAMPLE CASE
After testing negative Julio expressed an interest
in the CLUB 1509 program. When speaking to your
assistant navigator you find out he cannot read
English well. As a result, you have to read
everything to him.
• How can you support Julio once he decides to be
in the CLUB 1509 program?
• Does a referral need to be made?
• How can you address the issue of literacy in
future documentation?
• How could his low English proficiency impact
linkage into services?

8. PLEASE BE BACK BY 1:30 PM