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Slide Set D: The History of Program Integration in Missouri

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 The History of Program Integration in Missouri: “A Series of (mostly) Fortunate Events”
Brad Hall
Missouri Department of Health & Senior Services
Slide 1

The History of Program Integration in Missouri: "A Series of (mostly) Fortunate Events"
PDF File or PPT File


Early History: Some Very Smart People!
Integrated STD and HIV Prevention (DIS), Community Planning, and Surveillance
Named HIV Reporting
All HIV and STD together in one structure

The “Dark Period” for some of us….
1994: Care moved out (separate divisions)
1995: Care system blew up financially
1996: Clean up the mess
1997: Rebuild and start fresh!

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
Slide 2

Early History: Some Very Smart People!
PDF File or PPT File


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, and outreach testing
Imms Carryover = Hep A/B Vaccines in STD Clinics and for HIV Care Clients
Slide 3
2001 Reorg: Prevention and Care Reunited; Lost Surveillance -
2003 Reorg & ELC Grant: Added Immunizations, Hepatitis to the Mix
PDF File or PPT File


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
Title 4 case management system

2005: AMCHP/NASTAD Prevention Education Consultation
Integrated STD/HIV/Teen Pregnancy Education programs, mostly school-based
Slide 4
2004: AMCHP/NASTAD Perinatal HIV Prevention Consultation -
2005: AMCHP/NASTAD Prevention Education Consultation
PDF File or PPT File


Late 2005 Reorg: Major Changes!
Added All Communicable Disease, Surveillance, and Environmental Health to my world!
Finally reunited HIV/STD 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 barrier…. More to come in 2008!
Slide 5
Late 2005 Reorg: Major Changes!
PDF File or PPT File


2006: Let’s 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 integration!
New proposal for Director next week…
Slide 6
2006: Let's Learn About TB
PDF File or PPT File


2006: More Nutty Ideas or Steppin’ It Up a Notch?
KC Free Health Clinic ARTAS demonstration project is a huge success – let’s go statewide!
Let’s aim for true HIV prevention/care integration at the client level (DIS/Case Mgr)
2007 Ryan White funding increase = more 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
Slide 7
2006: More Nutty Ideas or Steppin' It Up a Notch?
PDF File or PPT File


So, get to the point Brad!
What prompted integration? 
Putting a crazy, big-mouthed, competitive idea guy who never sleeps in charge 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, focus, energy, process/task oriented, early fear that HIV Care would take over everything.
Barriers CDC could have removed = ???
Wins? Getting to come here today!
Slide 8
So, get to the point Brad!
PDF File or PPT File


Advice for Others?
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.
Find the right people to be the cheerleaders and to make it happen!  (It won’t happen if someone isn’t 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 there.
Keep the focus on the client.
Celebrate your successes!
Slide 9
Advice for Others?
PDF File or PPT File


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 cheerleaders and to make it happen!  (It won’t happen if someone isn’t 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!
Slide 10
Advice for CDC?
PDF File or PPT File


Brad Hall, Administrator Section for Communicable Disease Control & Environmental Epidemiology Missouri Department of Health & Senior Services 573-751-6141 - brad.hall@dhss.mo.gov
Slide 11
Brad Hall, Administrator Section for Communicable Disease Control & Environmental Epidemiology Missouri Department of Health & Senior Services 573-751-6141 - brad.hall@dhss.mo.gov
PDF File or PPT File

 

 
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