1. Critical Program Movement: Integration of STD Prevention with Other Programs Kevin Fenton, MD, PhD, FFPH Director National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention 2008 National STD Prevention Conference March 13, 2008

2. Objectives Provide an update on progress toward Program Collaboration and Service Integration (PCSI) Describe ways we are changing NCHHSTP culture to promote program integration Reflect on steps we can take to accelerate our progress and achieve greater health impact

3. Framework for Successful Change Management Identify articulate and disseminate a clear vision Develop a clear pathway, key steps and milestones Enlist the support of willing partners and coalitions. Identify barriers and opportunities for execution. Codify, disseminate and encourage the uptake of best and promising practices Evaluate, evaluate, evaluate.

4. Identify, articulate and disseminate a clear vision

5. Program Collaboration and Service Integration (PCSI) Operating Definition:  A mechanism of organizing and blending inter-related health issues, separate activities, and services in order to maximize public health impact through new and established linkages between programs to facilitate the delivery of services

6. Program Collaboration and Service Integration (PCSI) Goal:  Provide prevention services that are holistic, science based, comprehensive, and high quality to appropriate populations at every interaction with the health care system. Vision:  Remove barriers to and facilitate adoption of service delivery integration at the client level by aligning NCHHSTP activities, systems, and policies with this goal.

7. Program Collaboration and Service Integration (PCSI) Integration should be focused at the field or client level where the interface between the system and the consumer takes place. Integration should result in more holistic services for clients, regardless of the agency structure. Key Principles of PCSI:  Appropriateness  Effectiveness  Flexibility  Accountability  Acceptability

8. Develop a clear pathway, key steps and milestones for achieving the vision

9. Program Collaboration and Service Integration: NCHHSTP green paper, July 2007  Green paper: a discussion document intended to stimulate debate and launch a process of consultation Paper describes how NCHHSTP will work with partners to advance PCSI strategic priority url: http://www.cdc.gov/nchhstp/programintegration

10. Consultation on PCSI Held August 21-22, 2007 in Atlanta Attended by more than 70 partners and 50 NCHHSTP staff members Purpose:  To advise NCHHSTP on the development PCSI activities over the next 5 years

11. PCSI Priorities arising from the August 2007 CDC Consultation 1. Focus efforts and opportunities for promoting integrated surveillance 2. Focus efforts on training on PCSI and integrated training opportunities 3. Accelerate the use of program announcements to support and enhance funding for PCSI.

12. 1.Integrated Surveillance Key Priorities and Needs for PCSI Integrated surveillance reports Standards for sharing of data Guidelines for integrated data with common demographics, variables, and definitions Address confidentiality issues – create a gold standard Surveillance systems that work with and across programs

13. 2.Integrated Training efforts Key Priorities and Needs for PCSI Flexible funding for training Integrated and comprehensive guidelines Program announcements that include common language and objectives to address Center’s diseases Training centers required to have integrated training curricula

14. 3.Integrated funding Key Priorities and Needs for PCSI Integrative program announcements (PA’s) (leverage integration through PA’s) Collaboration on program announcements and post award management Incentives for state and federal funding to support integration Incentives for “in-kind funds” and/or require matching funds Reprioritization of funds at CDC level Reporting and evaluation components Fund pilots or demonstrations

15. Enlist the Support of Partners and Coalitions in the Journey

16. Identify Barriers and Opportunities for Implementation

17. Barriers and Opportunities Lack of national guidelines Administrative requirements Data collection and surveillance systems not integrated Lack of integrated prevention guidelines Insufficient translation and integration of science and program Insufficient support for cross training, evaluation and dissemination of best practices Increased efficiency and reduced redundancy Increased flexibility by enabling partners to adapt, implement, and modify integrated services to increase responsiveness to evolving epidemics or changing contexts Increased control over operations, using local information from surveillance and key performance indicators Barriers Opportunities

18. Identify, Disseminate and Encourage Best and Promising Practices

20. 2008 National STD Prevention Conference Collaboration and Integration Sessions PCSI Specific Sessions A5 Workshop – The Power of Many Voices B5 Symposium – Collaboration for STD, HIV and Teen Pregnancy Prevention B6 Oral Presentations – Issues in Integration of STD Prevention B8 Oral Presentations – Alternative Venues; STD Prevention Outside the STD Clinic

21. 2008 National STD Prevention Conference Collaboration and Integration Sessions Population Focus A4 Symposium – Implementing and Sustaining a School based STD Screening Program B5 Symposium – Collaboration for STD, HIV and Teen Pregnancy Prevention B1 Symposium – Chlamydia screening in Indian Country

22. 2008 National STD Prevention Conference Collaboration and Integration Sessions Partner Notification D8 Symposium – Promising Practices: Integrating STD and HIV Partner Services Guidelines Surveillance D6 Workshop – Contemporary Issues for Data Integration and Dissemination

23. Evaluation

24. What You Can Do? Be committed to:  Service  Action  Evidence-based public health practice  Partnerships  Timely implementation

25. PCSI Program Collaboration and Service Integration