To protect, promote and improve the health of all people in Florida through integrated state,...

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


IntroductionIntroduction

• HIV Care Continuum

• Prisons vs Jails

• Counseling and Testing

• Prevention and Linkage

• Collaboration and Challenges


HIV Care Continuum Cascade

HIV Care Continuum Cascade

cascade source: www.aids.gov


Socioeconomic Factorsand HIV

Socioeconomic Factorsand HIV

• Poverty

• Discrimination, stigma

• HIV Prevalence

• Undiagnosed/untreated STDs

• Language barriers

• Incarceration


Differences: Prisons vs Jails


• Prisons

• Funded/operated by state

• Length of stay between 3 - 5 years

• Level of care similar to community standards


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


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




• 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


PRPP Inmates ServedCY 2012-13

(n=1,618 thru Oct 2013)

PRPP Inmates ServedCY 2012-13

(n=1,618 thru Oct 2013)


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


CLC Inmates ServedCY 2012-13

(n=315 thru Oct 2013)

CLC Inmates ServedCY 2012-13

(n=315 thru Oct 2013)



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




• 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



• Jails

• Funded/operated by local govt

• Length of stay between 23 - 46 days, not more than 1 year

• Appx 50% released within 48 hours



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


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

How to Use Navigation


JLP LinkagesCY 2012-13

(n=3,959 thru Sept 2013)

JLP LinkagesCY 2012-13

(n=3,959 thru Sept 2013)


JLP Annual ComparisonTesting, Linkages, Positives2008-2013 (thru Sept 2013)

JLP Annual ComparisonTesting, Linkages, Positives2008-2013 (thru Sept 2013)


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)


Corrections Infections Workgroup

Corrections Infections Workgroup

HIV/AIDS EpidemiologyHepatitis

Corrections

Juvenile Justice

Correctional Medical Authority

Substance Abuse/Mental

Health

Education

STD and TB


• Funding

• Sequestration Round 1 - 2013

• Sequestration Round 2 - 2014

• Program evaluations/reviews

• "High-impact" prevention

Challenges: The FutureChallenges: The Future



www.floridahealth.gov



HIV Care Continuum Cascade + Literacy

HIV Care Continuum Cascade + Literacy


Overall: HIV+ more common with < HS

education

Almost half FL HIV+ inmates < HS

education



HIV Care Continuum Cascade + Unemployed

HIV Care Continuum Cascade + Unemployed


88% FL HIV+ inmates with min-mod skills

Overall: 45% are unemployed



Overall: 33% to 60% affected by

depression

HIV Care Continuum Cascade + DepressionHIV Care Continuum

Cascade + Depression




Overall: 53% alcohol use in

past month

HIV Care Continuum Cascade + Alcohol and Other Drugs

HIV Care Continuum Cascade + Alcohol and Other Drugs


Overall: 50% drug use in past year Overall: 15%

considered heavy drinkers

15% FL HIV+ inmates IDU

33% FL HIV+ inmates poly-

drug users



HIV Care + Combination Prevention

HIV Care + Combination Prevention


Combination Prevention:Services Integration

To protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts.


VANCE BURNSCORRECTIONS SPECIALIST

HIV/AIDS AND HEPATITIS SECTIONBUREAU OF COMMUNICABLE DISEASES

(850) 245-4424, EXT [email protected]

To protect, promote and improve the health of all people in Florida through integrated state,...

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