Florida Department of Health: Corrections Programs Prison Pre-Release Planning and Jail Linkage Division of Disease Control and Health Protection

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

Introduction

• • • • • 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

cascade source: www.aids.gov

Division of Disease Control and Health Protection

Socioeconomic Factors and HIV

• • • • • • Poverty Discrimination, stigma HIV Prevalence Undiagnosed/untreated STDs Language barriers Incarceration

Division of Disease Control and Health Protection

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 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)

• 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)

• • • 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 Served CY 2012-13 (n=1,618 thru Oct 2013)

Division of Disease Control and Health Protection

PRP Map

Division of Disease Control and Health Protection

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 Served

CY 2012-13 (n=315 thru Oct 2013)

Division of Disease Control and Health Protection

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)

• • • • • • 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

Division of Disease Control and Health Protection

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

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 Tested

CY 2012-13 (n=47,762 thru Sept 2013)

0.5% Positive 0.8% Positive 0.6% Overall Positive Rate Division of Disease Control and Health Protection

CY 2012-13 (n=3,959 thru Sept 2013)

Division of Disease Control and Health Protection

JLP Annual Comparison

Testing, Linkages, Positives 2008-2013 (thru Sept 2013)

Division of Disease Control and Health Protection

Jail Linkage Program (JLP) Bureau of Communicable Diseases Florida Department of Health JLP in 16 Counties:

o

15 Counties funded by DOH

o

1 County unfunded (Monroe) Division of Disease Control and Health Protection

Corrections Infections Workgroup

HIV/AIDS Epidemiology Hepatitis Education STD and TB Substance Abuse/Mental Health Corrections Correctional Medical Authority Juvenile Justice

Division of Disease Control and Health Protection

Challenges: The Future

• • • • • Funding Sequestration Round 1 - 2013 Sequestration Round 2 - 2014 Program evaluations/reviews "High-impact" prevention

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How to Use Navigation

www.floridahealth.gov

Division of Disease Control and Health Protection

Cascade + Literacy Overall: HIV+ more common with < HS education Almost half FL HIV+ inmates < HS education

cascade source: www.aids.gov

Division of Disease Control and Health Protection

Cascade + Unemployed Overall: 45% are unemployed 88% FL HIV+ inmates with min-mod skills

cascade source: www.aids.gov

Division of Disease Control and Health Protection

Cascade + Depression Overall: 33% to 60% affected by depression

cascade source: www.aids.gov

Division of Disease Control and Health Protection

Alcohol and Other Drugs Overall: 53% alcohol use in past month Overall: 50% drug use in past year 33% FL HIV+ inmates poly drug users Overall: 15% considered heavy drinkers 15% FL HIV+ inmates IDU

cascade source: www.aids.gov

Division of Disease Control and Health Protection

Prevention Combination Prevention: Services Integration

cascade source: www.aids.gov

Division of Disease Control and Health Protection

VANCE BURNS CORRECTIONS SPECIALIST HIV/AIDS AND HEPATITIS SECTION BUREAU OF COMMUNICABLE DISEASES (850) 245-4424, EXT 2565 [email protected]

Division of Disease Control and Health Protection

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