How One State Has Operationalized Program Collaboration and Service Integration (PCSI)

Background: CDC encourages STD, HIV, viral hepatitis and TB Programs to collaborate to ensure comprehensive client services. This collaboration may include state or local health jurisdictions and community partners. Complete adoption of PCSI can be problematic for these agencies due to such barriers as separate data systems, discrete funding streams, lack of role definition, inadequate resources, and apathetic leadership.

Objectives: To describe challenges and successes of integration of HIV Prevention, STD Control, HIV Services, HIV Surveillance, and Viral Hepatitis programs in Indiana state government and one local health department partner.

Methods: The Indiana State Department of Health, Division of HIV/STD/Viral Hepatitis launched an Integration Committee to ensure cross-training of all staff and coordinated planning between programs, including a journal club and “Hot Topics” lectures. Cross-training was extended to local health departments and community-based organizations through webinars pertaining to syphilis testing and hepatitis awareness; a statewide meeting to facilitate local networking among STD DIS, HIV care coordinators, HIV prevention agencies, and HIV test sites, and other methods.

Results: Many successes and challenges of this coordinated effort at integration will be described. One specific initiative to be highlighted will be the partnership between HIV Surveillance, STD Control Program, and HIV Services to create a DIS position at the Marion County Health Department (Indianapolis) to target all newly-diagnosed HIV positive persons for linkage to care and partner services. This DIS manages co-infections (syphilis and HIV) and utilizes Marion County’s Ryan White EIS Program staff in conjunction with the DIS to ensure clients are linked to medical and social services.

Conclusions: Indiana’s methods for operationalizing PCSI throughout state, local, and community-level agencies may provide assistance to other jurisdictions in implementing PCSI. Although challenges to integration exist, Indiana has experienced success in efforts to ensure comprehensive client service delivery.

Implications for Programs, Policy, and/or Research: Programs may benefit from Indiana’s experience.