In collaboration with the ID Provider, HIV Specialist/Family Medicine provider, Community Health Worker, Case Manager, Clinical Pharmacist, other Providers, patient and family formulate a plan of care that supports best practice and guides the patient in achieving identified/revising Self-Management goals. Participate in direct and indirect patient care for patients who have HIV, and/or HCV and/or TB or LTBI and/or Sexually Transmitted Infections, and/or Hepatitis A or B, including in-person visits, telephone triage, assessment, wound assessment, intervention, health maintenance, health education, health counseling, and planning activities.