The New Order

Regional planning process to be phased out starting in October

Michigan HIV News Summer 2002

Few were prepared for the announcement by MDCH at the April Michigan HIV/AIDS Council (MHAC) meeting in Lansing. Major change is coming to the way HIV/AIDS business will be done here in Michigan. The regional community planning process – a grass roots method of assessing needs and allocating resources for both prevention and care – will be phased out starting October 2002 and a new HAPIS directed RFP process will be fully implemented by April 2003. MHAC will take on a whole new look by January 2003.

The reality is, Michigan must plan for a future of shrinking funding for HIV/AIDS work. And, according to the preliminary results of three recent MDCH planning processes, the costs of regional planning outweighed the benefits. So, the best way to start economizing it was decided, is to take the $889,000 (FY ‘02) allocated to the regional planning process and put it directly into providing prevention and care services.

MDCH Division of HIV/AIDS and STDs (DHAS) Manager Loretta Davis-Satterla outlined the three processes that led to the decisions. First there was an internal MDCH audit, then a strategic plan led by Chris Ameen, a consultant to DHAS (and former interim Michigan AIDS Fund Executive Director) and finally a systems analysis and planning process led by Patrick Yankee (former executive director of the HIV/AIDS Resource Center in Region 2) now also a consultant to DHAS. “These three processes have led to decisions to make us strong now and in the future,” said Davis-Satterla.

This news was a lot to absorb for MHAC members at the meeting, some of who have been involved in the community planning process for the full six years it has been evolving. For those who have become professional regional planners this meant a pink slip. Many others have devoted their time and energy to regional planning and the initial reaction was shock and betrayal.

Yankee laid out the plan and the transition process. No alterations will be made to service delivery, only the planning system. MHAC and The Michigan Persons Living with HIV/AIDS Needs Task Force will remain as primary planning groups to reflect the HIV epidemic in Michigan. The Department of Corrections project will not be impacted by the change. A transition team will be formed and given specific task to revise and define how this will be implemented he said.

“MHAC will be smaller,” said HAPIS Manager Deb Szwejda. “more representative of the epidemic with ad hoc committees advising us.” “I am committed to community input, but I am also committed to putting more money into providing services.”

The transition team convened on May 24. Forty individuals attended, including DHAS staff and consultant Patrick Yankee, and selected MHAC and Task Force members and regional representatives, who made recommendations for the new and improved MHAC. The repeating quandary: how to make this a more efficient and also more inclusive advisory body – committee skills and expertise vs. PIR (The Centers for Disease Control and Prevention (CDC) mantra: Parity, Inclusion and Representation). How do you get everyone to the table with, geographic representation, rural inclusion, racial and risk-behavior parity? And if you can get them there how do you keep it of manageable size? Answer: assign this implausible task to another committee.

Three committees actually, was the consensus, to struggle with the tasks and make recommendations on: structure of the new committee; and a more formal document for the needs assessment process. They will report back at the next meeting of the transition team. To be continued…….

Meanwhile, what has been established by DHAS-HAPIS, the new MHAC will convene in January 2003. It will have an advisory role to HAPIS for the distribution of funding for both prevention and Ryan White Title II care dollars, but the final decisions will be through an RFP process to HAPIS.

According to the HAPIS Summary of Systems Planning Re-Configuration for HIV Prevention and Care Services in Michigan presented at the MHAC meeting, “HIV care fiduciary/lead agency contracts will continue through 3/31/03 only for the purposes of purchasing care services at the local level. MDCH-DHAS-HAPIS will contract for all local and statewide HIV care services after 4/1/03.”

“Contracts with local health departments for the purpose of HIV Prevention Planning will continue to be supported…through 12/31/02” after which “HAPIS assumes the management and coordination of centralized structure.”

According to the Transition Principles and Methodology, HAPIS will contract with an ombudsperson. Acting as a community liaison, this ombudsperson will “assist in sharing information, resolving disputes and act as an advocate for service recipients.” In addition HAPIS will “establish a group of liaisons, assigned to specific geographic areas, and with specific expertise, which will convene meetings of local care services recipients.” The Task Force will take on more of a role in needs assessment statewide and will continue to advise MHAC.

All of this for “the goal of having a more streamlined and efficient system, and to help facilitate a more cost-effective and accountable system for administering vital HIV care and prevention resources,” states the HAPIS Summary.

In his introduction to the announcement at the MHAC meeting, Sammye Stamper, Care Co-Chair said, “This is what I believe is the most singularly important item that has been brought to us and it’s going to be a challenge and an opportunity.”

Many acknowledged that thus far Michigan has been a leader nationally in the planning for and execution of prevention and care services for HIV/AIDS. Time will tell if data continues to reflect that those most in need are indeed being served. And we can always count on Michigan’s Persons Living with HIV/AIDS Needs Task Force to let HAPIS know if it doesn’t.

Questions? See the questions asked at both the MHAC and Task Force meetings and the official response: www.mihivnews.com/transition.htm.