1、The History of Program Integration in Missouri: “A Series of (mostly) Fortunate Events”,Brad Hall Missouri Department of Health & Senior Services,Early History: Some Very Smart People!,Integrated STD and HIV Prevention (DIS), Community Planning, and Surveillance Named HIV Reporting All HIV and STD t
2、ogether in one structure,1998-2000: From Crisis Comes Creativity,Rebuilt HIV Care system and community trust Coordinated and Integrated HIV Care client services statewide across all titles/grantees,1994: Care moved out (separate divisions) 1995: Care system blew up financially 1996: Clean up the mes
3、s 1997: Rebuild and start fresh!,The “Dark Period” for some of us.,2001 Reorg: Prevention and Care Reunited; Lost Surveillance,Began integrating planning groups, processes,2003 Reorg & ELC Grant: Added Immunizations, Hepatitis to the Mix,Hep C (the Parasite Program) = Integrated training, education,
4、 and outreach testing Imms Carryover = Hep A/B Vaccines in STD Clinics and for HIV Care Clients,2004: AMCHP/NASTAD Perinatal HIV Prevention Consultation,“HIV People” = Perinatal HIV/HepB/Syphilis Prevention Integration Stakeholder Education, but we do all the work Used MCH and CD as referral sources
5、 Title 4 case management system,2005: AMCHP/NASTAD Prevention Education Consultation,Integrated STD/HIV/Teen Pregnancy Education programs, mostly school-based,Late 2005 Reorg: Major Changes!,Added All Communicable Disease, Surveillance, and Environmental Health to my world! Finally reunited HIV/STD
6、Prevention and Care with Surveillance, added Hepatitis Now that Surveillance is mine. Sick of STD-MIS, sick of HARS, sick of CTS database, sick of PEMS, love FACTORS Can we get one system that shows me the big of the client (data system integration)?! Surveillance staff a speed bump, but not a barri
7、er. More to come in 2008!,2006: Lets Learn About TB,Similar surveillance, contact investigation, risk populations, case management, testing push, disease interactions, meds program, contractors So, what about Integrating TB with HSH? TB Staff supportive, TB manager not my first roadblock to integrat
8、ion! New proposal for Director next week,2006: More Nutty Ideas or Steppin It Up a Notch?,KC Free Health Clinic ARTAS demonstration project is a huge success lets go statewide! Lets aim for true HIV prevention/care integration at the client level (DIS/Case Mgr) 2007 Ryan White funding increase = mor
9、e staff to focus on multi-level linkages to care Pilots underway, working out the details Ultimate Goal: No more “prevention” staff and “care” staff, just HIV/STD/Hep staff,So, get to the point Brad!,What prompted integration? Putting a crazy, big-mouthed, competitive idea guy who never sleeps in ch
10、arge of programs and letting him out of the office! Having staff that truly care, dedicated to excellence. Focus is on constantly improving for the clients. Perceptions = Cautiously excited; HIV prevention folks particularly protective, but have built trust. Internal barriers = Staff time/drive, foc
11、us, energy, process/task oriented, early fear that HIV Care would take over everything. Barriers CDC could have removed = ? Wins? Getting to come here today!,Advice for Others?,Learn from others the little guys have to be creative! Find and empower your visionary. Dedicate the resources (staff, time
12、, money) to make it happen. Find the right people to be the cheerleaders and to make it happen! (It wont happen if someone isnt pushing it along and supported from the top!) Engage the right people in the process up front (and get buy-in). Start with small wins where you can get them and build from
13、there. Keep the focus on the client. Celebrate your successes!,Advice for CDC?,Learn from others the little guys have to be creative! Find and empower your visionary. Dedicate the resources (staff, time, money) to make it happen. (Both at CDC and for the states.) Find the right people to be the chee
14、rleaders and to make it happen! (It wont happen if someone isnt pushing it along and supported from the top!) Engage the right people in the process up front and get buy-in. (This meeting is a very good start!) Start with small wins where you can get them and build from there. Keep the focus on the client. Celebrate your successes!,Brad Hall, Administrator Section for Communicable Disease Control & Environmental Epidemiology Missouri Department of Health & Senior Services 573-751-6141 brad.halldhss.mo.gov,
