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Focus on: The Continuum of Care Unit
The goal of the MDCH, Division of HIV/AIDS-STD (DHAS) HIV care programs is to
improve the health status and quality of life for Michigan residents who are
living with HIV infection. The primary focus is to ensure that persons living
with HIV (PLWH) have access to and are sustained in primary care. To this end,
DHAS supports a comprehensive continuum of care throughout the state, including
a drug assistance program, a dental program, medication adherence programs, and
a full range of community-based care services including services targeted to
minority populations.
The Continuum of Care (CoC) Unit, which has been operating since 1990, oversees
policy development for continuum of care programming, monitoring and quality
assurance for care programs operating in local health departments and
non-governmental and community-based agencies. Staff supports coordination and
technical assistance for the Michigan HIV/AIDS Council (MHAC), evaluation of
care programming and management of the Drug Assistance and Dental programs.
 CoC
Staff from upper left clockwise: Stephanie Tate, Belinda Chandler, Traci
Goulding, Jane DuFrane, Debbie Cornell, Don Calhoun, Merry Donn Gastambide, Deb
Champan Cooper, Sam Burke, Patrick Yankee Brenda Behm, Chris Hanson, Diane
Rydahl, Ron Hanson, Becki Bishop
AIDS Drug Assistance Program and Michigan Dental Program
A critical component of the CoC is making combination medication therapies
available to those who can’t afford them. The AIDS Drug Assistance Program (DAP)
has been a successful program in Michigan since 1992. Supported through
DAP-earmarked Ryan White Title II CARE Act funds and centrally managed by DHAS,
DAP provides reimbursement to pharmacies for HIV/AIDS medications and other
prescription drugs to eligible persons with HIV, who would otherwise be unable
to afford these lifesaving treatments. The DAP earmark also supports the Bureau
of Laboratories for DAP approved testing including CD4, viral load and genotype
tests. These CARE funds also cover the cost of insurance premiums for the
previously insured, and provide for adherence programs designed to support
treatment therapies.
Dental Care is also very important to the health of PLWHs. The Michigan Dental
Program (MDP) was initiated in May, 2000. Administered by DHAS and also
supported by Title II funding, MDP is a comprehensive dental access program for
uninsured persons with HIV. It enables them to obtain dental care services and
maintain optimal oral health. In 2003, there were 1,300 eligible PLWH enrolled
in the DAP and more than 300 enrolled in the MDP.
Case Management and Other Services
Other CoC services supported by Title II and the Michigan Health Initiative
(MHI) resources are administered by DHAS and provided by HIV/AIDS service
organizations, some local health departments and some universities. These are
distributed in communities throughout the state through a competitive RFP
process based on the identified need as well as the ability and competency of
the provider to deliver the services. Title II and MHI resources are allocated
to approximately 20 local health departments and community agencies to provide
quality services to PLWH. In addition to Title II and MHI funding, DHAS also
awards funds directly to several non-profit agencies or universities to provide
certain services statewide or to selective populations, e.g. legal advocacy,
provider education and outreach to African American clients through the
Congressional Black Caucus Minority AIDS Initiative earmark.
Additional CoC Services supported through DHAS include, but are not limited to,
provider education on HIV disease and prevention of perinatal transmission of
HIV, ambulatory medical care, case management, client advocacy, mental health
services and psychological support, emergency financial assistance, food banks,
and transportation services.
The largest single service category is case management. Around the state case
managers coordinate care services to increase service access and promote
efficient, cost-effective service delivery. HIV/AIDS care programs supported by
MDCH are required to participate in a client-level uniform reporting system (URS)
to document program activity and confirm that services are reaching the intended
population. Each year, according to URS data, community-based care providers and
the DAP and MDP serve between 5,000 and 6,000 HIV-infected individuals.
People Living with or Affected by HIVAIDS Advisory Group
The People Living With or Affected by HIV/AIDS Advisory Group was convened
by DHAS/HAPIS, with the intention of being greater number of people that have
not been active in prior PWA activities. See the Calendar for upcoming meetings.
Assessing the Need
Assessing the need for services in Michigan requires collaboration among
MDCH divisions and community participation. DHAS supports the Michigan HIV/AIDS
Council (MHAC), a state-wide group that advises MDCH on HIV prevention and care
issues. DHAS provides staffing to MHAC and coordinates its many committees and
workgroups. See the Calendar for upcoming meetings.
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