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State-Level Reality on
 PCSI Implementation
         Michigan Department of
   Community Health, Division of
   Health, Wellness and Disease
                         Control
Location of Disease Areas
                            Michigan Department of Community Health (MDCH)


                                    Public Health Administration (PHA)




   Bureau of Health Promotion and Disease Control                        Bureau of Epidemiology




 Division of Health, Wellness and Disease Control (DHWDC)      Division of Communicable Disease




                                                                  HIV/VH/TB Epidemiology Section
Location of Disease Areas

                                                 Division of Health, Wellness and Disease Control (DHWDC)


HIV/AIDS Prevention and Intervention Section (HAPIS)       Sexually Transmitted Disease Section (STD)       Health Disparities Reduction and Minority Health


                             Education, Training and Resource Development Unit (ETRDU)


                                           Community Partnerships Prevention Unit


                                                       Continuum of Care Unit
Overview of DHWDC
   The Division of Health Wellness and Disease
    Control (DHWDC) is comprised of 3 sections
       The HIV/AIDS Prevention and Intervention
        Section (HAPIS)
       The Sexually Transmitted Disease Section (STD)
       The Health Disparities Reduction and Minority
        Health Section (HDRMH)
           Incorporated into DHWDC in 2006
The HIV/AIDS Prevention and
Intervention Section (HAPIS)
   Three units
       Education, Training and Resource Development
        (ETRDU)
       Community Partnerships Prevention (CPU)
       Continuum of Care (COC)
Integration of Cross-sectional
Information in Training Curriculum
   Training historically focused on HIV information only
   Increased collaboration between sections and units
    has led to integration of significant information
    regarding:
       STDs – including prevalence, signs/symptoms and
        treatment;
       Drugs – including meth, ecstasy, heroin, cocaine/crack,
        alcohol, etc.
       Hepatitis C – including co-infection, and prevalence
       Health Disparities – including disproportionate impact of
        HIV and other illnesses on POC; institutional, cultural,
        internalized oppression and privilege.
Level of Organization
Integration
   Collaboration within DHWDC
       CTR Quality Assurance Project (CTRQA)
       Case Management Training
       Partner Services Guidance
       The Cross-Training Committee
       Coordination of the Positive Perspectives PWA
        Speakers Bureau
       Provider Education on HIV with Health Disparities
        Section
Level of Organization
Integration
   With other Divisions
       Adaptation of HCV curriculum
       Participation on STD & HIV Annual conference
        committee with Michigan Department of
        Education and Office of Drug Control Policy
        (ODCP)
       ODCP
       MDHS
       MDOE
       MDOC
CTR Quality Assurance Project
   Implemented in 2006
   Collaboration between ETRDU and CPU
   Project entails conducting site visits to funded
    agencies for direct observation of CTR
    sessions and chart review
   A tool for improvement for both HAPIS and
    funded agencies
Challenges the CTRQA
   Internal
       Agency anxiety
       Scheduling
       Logistics
   Agency Challenges
       Perception of process as punitive
       Lack of some agencies having enough staff for
        observation in order to present aggregate data
       Supervisors feeling unable to give feedback to
        staff for improvement
PS: Broader Division
Collaboration
   PS offers far reaching opportunity for
    collaboration within division
   PS guidance has sparked rigorous internal
    conversation on integration
   Opportunity for division examination of
    philosophy vs. practice of PS
   Still too new to discuss thoroughly
PCSI Next Steps in Michigan
   Establish and formalize mechanisms for regular
    discussion about program service integration to:
       Facilitate development of policy and program standards
        that facilitate and support service integration;
       Support identification of program priorities (including
        challenges and strategies to respond to program priorities);
       Promote resource coordination/collaboration (including
        training).
       This must be intra- and inter-departmental (e.g., MDOE,
        MDOC); engage decision-makers at the upper levels of
        management; and be supported with appropriate
        agreements (e.g., Memoranda of Agreement).
PCSI Next Steps in Michigan
   Coordination of data systems and evaluation
    methodologies to support evaluation of the
    effectiveness and efficiency of integrated
    services at the client, agency, and state
    levels
Advice to Others about PCSI
   Have patience and flexibility in working with
    partners toward integration
   Acknowledge that change is sometimes
    difficult
       skepticism of your motives (turfism);
       everybody believes their disease is the most
        important; and,
       finally, in public health, we are now dealing with
        serious workforce issues resulting in ongoing
        need for training and education
Contact Information
   Debra L. Szwejda, Manager
    HAPIS/DHWDC/MDCH
    Washington Square Building
    109 W. Michigan Ave., 10th Floor
    Lansing, MI 48913
    (517) 241-5904
    szwejdad@michigan.gov

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Program Collaboration & Service Integration Michigan Nhpc

  • 1. State-Level Reality on PCSI Implementation Michigan Department of Community Health, Division of Health, Wellness and Disease Control
  • 2. Location of Disease Areas Michigan Department of Community Health (MDCH) Public Health Administration (PHA) Bureau of Health Promotion and Disease Control Bureau of Epidemiology Division of Health, Wellness and Disease Control (DHWDC) Division of Communicable Disease HIV/VH/TB Epidemiology Section
  • 3. Location of Disease Areas Division of Health, Wellness and Disease Control (DHWDC) HIV/AIDS Prevention and Intervention Section (HAPIS) Sexually Transmitted Disease Section (STD) Health Disparities Reduction and Minority Health Education, Training and Resource Development Unit (ETRDU) Community Partnerships Prevention Unit Continuum of Care Unit
  • 4. Overview of DHWDC  The Division of Health Wellness and Disease Control (DHWDC) is comprised of 3 sections  The HIV/AIDS Prevention and Intervention Section (HAPIS)  The Sexually Transmitted Disease Section (STD)  The Health Disparities Reduction and Minority Health Section (HDRMH)  Incorporated into DHWDC in 2006
  • 5. The HIV/AIDS Prevention and Intervention Section (HAPIS)  Three units  Education, Training and Resource Development (ETRDU)  Community Partnerships Prevention (CPU)  Continuum of Care (COC)
  • 6. Integration of Cross-sectional Information in Training Curriculum  Training historically focused on HIV information only  Increased collaboration between sections and units has led to integration of significant information regarding:  STDs – including prevalence, signs/symptoms and treatment;  Drugs – including meth, ecstasy, heroin, cocaine/crack, alcohol, etc.  Hepatitis C – including co-infection, and prevalence  Health Disparities – including disproportionate impact of HIV and other illnesses on POC; institutional, cultural, internalized oppression and privilege.
  • 7. Level of Organization Integration  Collaboration within DHWDC  CTR Quality Assurance Project (CTRQA)  Case Management Training  Partner Services Guidance  The Cross-Training Committee  Coordination of the Positive Perspectives PWA Speakers Bureau  Provider Education on HIV with Health Disparities Section
  • 8. Level of Organization Integration  With other Divisions  Adaptation of HCV curriculum  Participation on STD & HIV Annual conference committee with Michigan Department of Education and Office of Drug Control Policy (ODCP)  ODCP  MDHS  MDOE  MDOC
  • 9. CTR Quality Assurance Project  Implemented in 2006  Collaboration between ETRDU and CPU  Project entails conducting site visits to funded agencies for direct observation of CTR sessions and chart review  A tool for improvement for both HAPIS and funded agencies
  • 10. Challenges the CTRQA  Internal  Agency anxiety  Scheduling  Logistics  Agency Challenges  Perception of process as punitive  Lack of some agencies having enough staff for observation in order to present aggregate data  Supervisors feeling unable to give feedback to staff for improvement
  • 11. PS: Broader Division Collaboration  PS offers far reaching opportunity for collaboration within division  PS guidance has sparked rigorous internal conversation on integration  Opportunity for division examination of philosophy vs. practice of PS  Still too new to discuss thoroughly
  • 12. PCSI Next Steps in Michigan  Establish and formalize mechanisms for regular discussion about program service integration to:  Facilitate development of policy and program standards that facilitate and support service integration;  Support identification of program priorities (including challenges and strategies to respond to program priorities);  Promote resource coordination/collaboration (including training).  This must be intra- and inter-departmental (e.g., MDOE, MDOC); engage decision-makers at the upper levels of management; and be supported with appropriate agreements (e.g., Memoranda of Agreement).
  • 13. PCSI Next Steps in Michigan  Coordination of data systems and evaluation methodologies to support evaluation of the effectiveness and efficiency of integrated services at the client, agency, and state levels
  • 14. Advice to Others about PCSI  Have patience and flexibility in working with partners toward integration  Acknowledge that change is sometimes difficult  skepticism of your motives (turfism);  everybody believes their disease is the most important; and,  finally, in public health, we are now dealing with serious workforce issues resulting in ongoing need for training and education
  • 15. Contact Information  Debra L. Szwejda, Manager HAPIS/DHWDC/MDCH Washington Square Building 109 W. Michigan Ave., 10th Floor Lansing, MI 48913 (517) 241-5904 szwejdad@michigan.gov