At the Collaboration in Care Conference 2026, held September 15–16 in Anaheim, I was asked to close two days of conversation about HIV and healthy aging. By the end, we had heard compelling reasons to connect care across organizations. I wanted to ask what would happen when we returned to the rules, budgets, and divisions of responsibility that had not changed while we were away.
Leanne Clark-Shirley, president and CEO of the American Society on Aging, opened the conference on the afternoon of September 15 with a distinction that stayed with me. People need connection with one another. They also need the systems serving them to be connected. She described fragmentation as a form of disconnection. Her point made me consider how an organization can help people form relationships while leaving them to navigate disconnected services on their own.
A support group, for example, can offer friendship, recognition, and relief from isolation. Those benefits are real. But someone who finds community there may still have to coordinate a case manager, a clinic, and a housing program alone. The relationships among people cannot, by themselves, supply the coordination missing among organizations.
In the panel that followed that afternoon, moderator Juan Michael Porter II, communications director for Positive Women’s Network–USA and communications officer for the HIV Caucus, pressed us to ask what constitutes a high-quality life, beyond a longer one. Tim Vincent, a Pacific AIDS Education and Training Center training consultant and co-founder of Brothers of the Desert, spoke about being seen, having relationships, and breaking isolation. I spoke about people who recognize their aging needs but cannot see themselves in the settings meant to address those needs. Together, we were describing a life in which care, belonging, and agency could coexist. I wondered how an organization would know whether its services helped make that life possible.
The next morning, Dr. Jerry Abraham, director of public health, integration, street medicine, and workforce development at Kedren Community Health Center, described how his team changed COVID-era service delivery when people could not drive to a mass vaccination site, use an app, or wait in line for hours. The team took care into shelters and community settings, bringing different professionals together. He described the patient as the driver and the team as the GPS: the person determined the destination, while the team helped make the route possible. That approach asked the providers to coordinate their work instead of giving someone another set of tasks.
But bringing care closer did not settle every question. Dr. Abraham also described the fear that a medication delivery in a shared setting could disclose someone’s HIV status. A service can be within reach and still feel unsafe to use. The person receiving care must be able to shape how that care is delivered.
Across those sessions, I kept hearing a question about what happens on the organization’s side of the encounter. Who is recognized? Who can use the usual route to care? And who changes that route when it excludes people? The harder question was what would make those changes last.
At the luncheon panel on September 16, which I moderated, another question came into view. Before the conference, Patrice Dickerson, senior equity strategy director at the American Society on Aging, helped shape the panel by asking what each sector needed from another that it could not provide itself. That question asks aging, HIV, healthcare, workforce, and community organizations to name their limits and identify the partners they need. During the discussion, I was also struck by the need to remain focused on people amid organizational upheaval, budget cuts, and uncertainty. Those pressures shape what organizations can do. They can also tempt us to solve an institutional problem by asking the person seeking care to take on more work.
By the time I gave my closing call, I was thinking about what would become of the ideas we had heard once everyone returned to work. An organization can endorse person-centered care and still leave the same intake form in place. It can promise better connections between services without finding out whether people reached the help they needed. It can invite people with lived experience to speak while keeping them outside decisions about funding and practice.
Changing an intake form, checking whether someone received a service, and giving community members a role in funding decisions require different kinds of authority. No single participant could promise all three on behalf of an organization. But each could return knowing which decision was within reach, where a partner was needed, and who would have to be involved next.
My closing call used three verbs: Name it. Build it. Share it. They gave us a way to ask where a commitment would have to appear in an organization’s work.
Name it asks whether the people a system says it serves are recognizable in its plans and practices. Leanne’s attention to ageism and HIV stigma sharpened this question: an age or diagnosis alone cannot stand in for someone’s needs. Naming people aging with HIV matters when it leads to more precise questions about eligibility, data, staff preparation, and the assumptions made at intake.
Build it asks whether connection depends on a particular helpful person or exists in the organization’s way of working. Jerry’s account made that distinction concrete. Not every service can travel in a van, but organizations can decide together how a person reaches care, who handles a problem, and what happens when the usual route cannot be used. A partnership becomes more durable when the people doing the work can rely on a process, not solely on a contact saved in a phone.
Share it asks what happens to the knowledge people gain by living with the systems we design. Tim’s emphasis on being seen and having relationships mattered to our discussion of quality of life. But recognition alone cannot tell an organization whether its services work as intended. People with lived experience need access to the information behind decisions and a role in interpreting what that information misses. Sharing authority means their analysis can affect policy and practice, not only describe how those choices feel.
At the close, I asked participants to identify one place where a person has to hold disconnected systems together. Then I asked them to choose a change within their reach and name someone in another sector they would need to work with. The exercise could not resolve the structural questions raised over two days. It asked each person to leave with a change they could pursue and a partner they would need to involve.
What happens next? The answer will be found in the plans and procedures organizations change, the responsibilities they take on together, and the decisions they allow people with lived experience to shape.