Integrating Health Services

Over the next three years, CDC will award almost $6.2 million to health departments in six demonstration project areas to accelerate prevention through program collaboration and service integration (PCSI) for HIV/AIDS, viral hepatitis, STDs, and TB. PCSI is a critical strategic priority for CDC, and we are working through this strategy to improve the health of those suffering from more than one of these diseases.

We know that the same behaviors that put people at risk of HIV also put them at risk for STDs and hepatitis; that STDs can facilitate HIV transmission; and that HIV increases the risk of TB. We know too that there are myriad social and personal factors that function as determinants for health and health outcomes. Because similar risk, socioeconomic, and behavioral factors fuel the spread of these infections, we must address them collectively.

Organizing and blending interrelated health issues, activities, and prevention strategies can facilitate a comprehensive delivery of services to prevent, diagnose, and treat interconnected diseases. In communities that are considered “hard to reach,” even small changes in the way prevention services are delivered can make a dramatic difference by reaching a larger population, providing a single point of entry for multiple services, and improving efficiency, cost-effectiveness, and health outcomes.

Eligible funding jurisdictions had high burden of disease and represented 80% of the disease burden for AIDS, TB, Hepatitis B, syphilis, and gonorrhea in the Unites States in 2007. Out of the 40 organizations eligible for funding, we received 26 high quality applications. All of these went through CDC’s objective review process, after which six state and city health departments were chosen to receive funding. They are New York City Exit Disclaimer, North Carolina Exit Disclaimer, Philadelphia Exit Disclaimer, San Francisco Exit Disclaimer, Texas Exit Disclaimer, and Washington, D.C. Exit Disclaimer

Funding for this type of approach is still limited, but CDC is hopeful that by implementing this approach in the areas with the highest disease burden, adequate data can be gathered to build evidence for the PCSI strategy, and build opportunity for more extensive implementation nationwide. As funding allows in Fiscal Year 2011, NCHHSTP intends to fund more jurisdictions from the pool of applications based on the scores from the CDC objective review process.

I would like to thank all of you who support program collaboration and service integration, those who applied for funding, and those who are interested in learning more. Please stay in touch – I know there will be much more to share as this effort moves forward.


  1. It is so exciting to see that integration work is receiving such support and attention! Our program, SPHERE, has been working with drug and alcohol treatment providers in Massachusetts to integrate HIV/AIDS, viral hepatitis, STI/STD, harm reduction and overdose prevention into their work with clients for over 10 years in Massachusetts.
    Provider capacity-building services (training, TA, tools) are an essential piece of integration implementation – whether it’s in a health care delivery system or a health and human service program that reaches folks at risk. We shouldn’t assume that health and human service providers don’t need or want this support. They clearly benefit from it, and in our experience, use and appreciate it. Integration also contributes to fighting the stigma that can still exist in some of these settings.
    Our work in and out of Massachusetts has shown the importance of – and success in – integrating these issues into client education, assessment and support in behavioral health and recovery settings. Our sister program, SH/HIP (The Statewide Homeless/HIV Integration Project) has had similar experiences working with homeless service providers in homeless shelters on these same issues. But ultimately, it’s the program participants of both drug and alcohol treatment programs and homeless shelters who benefit from the increased access to HIV/AIDS-related information, education, services, medical care, support and referrals.
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