SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements:
Volume 2, Issue 12 (June 13, 1997)

This document has been superceded by our Online Knowledge Base on Innovative Models of HIV/AIDS Care. Click here to access the Knowledge Base. Click here to access descriptions of 27 Innovative Models of HIV/AIDS Care and the lessons learned from these projects. SPNS/Fax was written, published, and distributed by fax by The Measurement Group between 1995 and 1998.

Information dissemination from 27 Innovative Models of HIV Care projects funded as Special Projects of National Significance by the HIV/AIDS Bureau (HAB) of the Health Resources and Services Administration (HRSA).

Introduction

Welcome to SPNS/Fax: An Electronic Report from HRSA/HAB's SPNS Cooperative Agreements. In each issue of SPNS/Fax, we will highlight findings from the HRSA Special Projects of National Significance Program Cooperative Agreements. The projects have been funded to develop innovative models of HIV/AIDS care. SPNS/Fax reports are distributed every two weeks by fax machine to all subscribers. All issues of SPNS/Fax are also available at this Web site. Due to slight differences in the media, issues distributed by fax machine may appear slightly different from those posted on this Web site, but the content is identical.

Missouri Department of Health’s Integrated Care Program

The Missouri Department of Health, Division of Environmental Health and Communicable Disease Prevention, provides numerous services statewide for people living with HIV/AIDS through its Bureau of HIV/AIDS Care. The goals of the project are: 1) to develop and evaluate the effectiveness of a coordinated system of care; 2) to initiate collaboration between the Department of Health and the Department of Mental Health to create and implement a comprehensive Integrated Model of Care consisting of both health and mental health services for poly-diagnosed individuals living with HIV/AIDS, mental illness, and/or substance-related disorders; and 3) to establish advisory committees of service providers to identify and evaluate the training needs of their communities and the service needs of poly-diagnosed individuals.

Customized Regional Models. The map to the right displays three regions of Missouri—Kansas City, St. Louis, and a rural Southeast or "bootheel" area—that were chosen to allow for the development of a broad range of models and philosophies. Three models of care were developed:

  • Kansas City provides direct referrals for automatic linkage of clients to mental health and substance abuse services; comprehensive case management; and cross-training curriculum for mental health/addictions professionals and HIV service coordinators.
  • St. Louis, a Core Implementation Team (CIT), consists of a broad range of health care professionals who developed an Integrated Care Review Team Model to establish treatment plans of action for people with HIV, mental illness, and substance abuse issues.
  • Outstate (rural) Southeast developed a "one-stop shop," which provides HIV service coordination and a comprehensive mental health and substance abuse facility; and formed an advisory committee to assist in training and model development simultaneously.

 

Implementation. In order to create a comprehensive integrated model of care, collaborative efforts between the Department of Health and the Department of Mental Health were forged. These two departments work together to identify agencies interested in participating in an integrated system of care, and collaborate in developing cross-training curricula on HIV service coordination for mental health, addictions professionals and HIV service coordinators. In addition, HIV service coordinators are trained in the following areas: recognizing signs and symptoms of mental illness and substance-related disorders; clinical impressions, medical issues of multi-dimensional diagnoses; and the public mental health service delivery system to facilitate enhanced assessment ability and more appropriate referrals to mental health and substance abuse treatment agencies.

Training as a Change Agent. Training is a key component of the Missouri Department of Health’s project. The HIV Service Coordination Instructional Program is designed to: increase the skills and knowledge of service coordinators in assessing and screening multiple-diagnosed clients; enhance multiple service provider coordination; and address problems resulting from the interaction medications, multiple diagnosis, and the progression of AIDS. The curriculum is self-instructive and allows immediate evaluation of what has been learned. The manual is made up of five modules, including objectives and learning activities, and data on the perceived usefulness and effectiveness of the program.

For more information, contact Mary T. Menges, Chief, Bureau of HIV/AIDS Care and Prevention Services, 930 Wildwood Drive, P.O. Box 570, Jefferson City, MO 65102-0570; 573.751.6439 (phone); 573.751.6447 (fax); or email at mengem@mail.health.state.mo.us.

To view the Missouri Department of Health Integrated Care Program presentation, click here.

SPNS/Fax is produced by The Measurement Group–PROTOTYPES Evaluation and Dissemination Center (EDC). Editorial comments should be made to The Measurement Group at 5811A Uplander Way, Culver City, California 90230, 310.216.1051, 310.670.7735 (fax).
 

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