Post on 12-Jan-2016
description
To protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts.
Division of Disease Control and Health Protection
Florida Department of Health: Corrections Programs
Florida Department of Health: Corrections Programs
Prison Pre-Release Planning and Jail Linkage
Prison Pre-Release Planning and Jail Linkage
Division of Disease Control and Health Protection
IntroductionIntroduction
• HIV Care Continuum
• Prisons vs Jails
• Counseling and Testing
• Prevention and Linkage
• Collaboration and Challenges
Division of Disease Control and Health Protection
HIV Care Continuum Cascade
HIV Care Continuum Cascade
cascade source: www.aids.gov
Division of Disease Control and Health Protection
Socioeconomic Factorsand HIV
Socioeconomic Factorsand HIV
• Poverty
• Discrimination, stigma
• HIV Prevalence
• Undiagnosed/untreated STDs
• Language barriers
• Incarceration
Division of Disease Control and Health Protection
Differences: Prisons vs Jails
Differences: Prisons vs Jails
• Prisons
• Funded/operated by state
• Length of stay between 3 - 5 years
• Level of care similar to community standards
Division of Disease Control and Health Protection
HIV-infected InmatesHIV-infected Inmates• HIV/AIDS rates in corrections settings
are 3 - 5 times higher than general population
• Over 95% of inmates will return to their communities
• Appx 100,000 inmates in FL prison system ... about 3,000 have HIV/AIDS
• Appx 100 HIV-infected inmates leave prison each month
Division of Disease Control and Health Protection
Pre-Release Planning Program (PRPP)
Pre-Release Planning Program (PRPP)
• DOC mandated to test for HIV within 60 days of inmate's release
• DOH contracts with DOC to provide PRPP services to HIV-infected inmates
• Contract totals $450,000
• PRPP includes all DOC institutions and some transitional programs
• Funded by Ryan White Part B
Division of Disease Control and Health Protection
Pre-Release Planning Program (PRPP)
Pre-Release Planning Program (PRPP)
• Five PRPP planners employed by DOC - divided among 5 regions
• Planner coordinates with CBO or medical providers to link inmate to care
• Inmates given copies of med record if requested and 30-day supply of meds
Division of Disease Control and Health Protection
PRPP Inmates ServedCY 2012-13
(n=1,618 thru Oct 2013)
PRPP Inmates ServedCY 2012-13
(n=1,618 thru Oct 2013)
Division of Disease Control and Health Protection
PRP Map
Community Linkage Coordinators (CLC)Community Linkage Coordinators (CLC)
• More intensive services in Broward, Miami-Dade and Orange counties
• PRPP and CLC coordinate inmate appointments upon release from prison
• Medical appointment within one week of release
• Linkages to medical, SAMH, ADAP, case mgmt, housing, transportation, etc
• Up to six-month follow up with inmate after release
Division of Disease Control and Health Protection
CLC Inmates ServedCY 2012-13
(n=315 thru Oct 2013)
CLC Inmates ServedCY 2012-13
(n=315 thru Oct 2013)
Division of Disease Control and Health Protection
Division of Disease Control and Health Protection
Peer Education Training Program (PET)
Peer Education Training Program (PET)
• DOC program located at Central Florida Reception Center (CFRC)
• Provide peer education train-the-trainer sessions
• Education and prevention information
• Trainer supervises inmate peer educators as they conduct sessions
Division of Disease Control and Health Protection
Peer Education Training Program (PET)
Peer Education Training Program (PET)
• 2012:
• 2 train-the trainer classes held
• 8 inmate peer educators trained
• 57 orientation sessions held
• 4,176 inmates attended sessions
• 2,977 (71.3%) requested HIV test after sessions
Differences: Prisons vs Jails
Differences: Prisons vs Jails
• Jails
• Funded/operated by local govt
• Length of stay between 23 - 46 days, not more than 1 year
• Appx 50% released within 48 hours
Division of Disease Control and Health Protection
Division of Disease Control and Health Protection
Jail Linkage Program (JLP)
Jail Linkage Program (JLP)
• Counties submitted proposals to provide services
• JLPs operate through CHD with no contracts
• Instead use MOAs
• JLP located in 16 jails
• Funding appx $1.2 million
Division of Disease Control and Health Protection
JLP Inmates TestedCY 2012-13
(n=47,762 thru Sept 2013)
JLP Inmates TestedCY 2012-13
(n=47,762 thru Sept 2013)
0.5% Positive
0.8% Positive
0.6% Overall Positive Rate
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Division of Disease Control and Health Protection
JLP LinkagesCY 2012-13
(n=3,959 thru Sept 2013)
JLP LinkagesCY 2012-13
(n=3,959 thru Sept 2013)
Division of Disease Control and Health Protection
JLP Annual ComparisonTesting, Linkages, Positives2008-2013 (thru Sept 2013)
JLP Annual ComparisonTesting, Linkages, Positives2008-2013 (thru Sept 2013)
Division of Disease Control and Health Protection
Jail Linkage Program (JLP)Bureau of Communicable DiseasesFlorida Department of Health JLP in 16 Counties:
o 15 Counties funded by DOHo 1 County unfunded (Monroe)
Division of Disease Control and Health Protection
Corrections Infections Workgroup
Corrections Infections Workgroup
HIV/AIDS EpidemiologyHepatitis
Corrections
Juvenile Justice
Correctional Medical Authority
Substance Abuse/Mental
Health
Education
STD and TB
Division of Disease Control and Health Protection
• Funding
• Sequestration Round 1 - 2013
• Sequestration Round 2 - 2014
• Program evaluations/reviews
• "High-impact" prevention
Challenges: The FutureChallenges: The Future
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Division of Disease Control and Health Protection
www.floridahealth.gov
How to Use Navigation
Division of Disease Control and Health Protection
HIV Care Continuum Cascade + Literacy
HIV Care Continuum Cascade + Literacy
cascade source: www.aids.gov
Overall: HIV+ more common with < HS
education
Almost half FL HIV+ inmates < HS
education
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Division of Disease Control and Health Protection
HIV Care Continuum Cascade + Unemployed
HIV Care Continuum Cascade + Unemployed
cascade source: www.aids.gov
88% FL HIV+ inmates with min-mod skills
Overall: 45% are unemployed
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Division of Disease Control and Health Protection
Overall: 33% to 60% affected by
depression
HIV Care Continuum Cascade + DepressionHIV Care Continuum
Cascade + Depression
cascade source: www.aids.gov
How to Use Navigation
Division of Disease Control and Health Protection
Overall: 53% alcohol use in
past month
HIV Care Continuum Cascade + Alcohol and Other Drugs
HIV Care Continuum Cascade + Alcohol and Other Drugs
cascade source: www.aids.gov
Overall: 50% drug use in past year Overall: 15%
considered heavy drinkers
15% FL HIV+ inmates IDU
33% FL HIV+ inmates poly-
drug users
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Division of Disease Control and Health Protection
HIV Care + Combination Prevention
HIV Care + Combination Prevention
cascade source: www.aids.gov
Combination Prevention:Services Integration
To protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts.
Division of Disease Control and Health Protection
VANCE BURNSCORRECTIONS SPECIALIST
HIV/AIDS AND HEPATITIS SECTIONBUREAU OF COMMUNICABLE DISEASES
(850) 245-4424, EXT 2565vance.burns@flhealth.gov