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