The AIDS/HIV Services Group, now in its 28th year of operations, is currently undergoing a transition from a grants-driven AIDS Service Organization to a fee-for-service integrated medical practice. Like many non-profit organizations focusing on the AIDS epidemic, we began as a volunteer-driven program responding to local need. At the height of the epidemic in the 1980’s the medical community was slow to react and was able to provide little in terms of treatment or therapies. Community-based organizations provided the necessary social, psychological and, often, spiritual support to members of our community impacted by the disease. Many of our funding streams were aimed at palliative services allowing individuals to die in dignity. With medical advances in the treatment of HIV and AIDS, our organization has remained responsive and nimble to the surfacing needs of those individuals and families we serve. In the 1990’s with the advent of the federal portfolio of AIDS funding collected under the Ryan White program, ASG began to focus on a case management system aimed at providing subsidies for medical care, housing, transportation and additional services to a community of individuals who primarily classified by the disabling nature of advanced AIDS while working to prevent new infections. In the first decade of the new century, ASG began to focus on the drivers of the epidemic including behavioral health disorders, substance use, lack of access to stable or appropriate housing, incarceration and other social determinates of health. In 2010, we again revisioned our organization in anticipation of the impact of the Affordable Care Act (ACA) and three years later, the Board of Directors approved the formation of Thrive Healthcare an integrated medical and behavioral practice aimed at offering newly insured individuals primary care services in a responsive environment well engrained in the community and experienced with managing complex social and medical conditions.