Photo: whatknot CDC Demonstration Project:

Dallas County Jail Re-entry Project

From the Frontline: Public Health Institutes Complementing the Public Health System Session

National Network of Public Health Institutes Annual Conference New Orleans, May 15, 2008 Klaus Kroyer Madsen Vice President, Programs

Dallas County Jail (DCJ)

• • • • • 7th largest detention facility in the nation Receives over 100,000 admissions per year 57% of which are released within three days 68% released within seven days At 95% capacity, DCJ holds approx. 7,000 inmates Photo: WD502

Photo: WD502

Jail Health Services at DCJ

• • Managed by the Dallas County safety net hospital (Parkland Health and Hospital System) Serves about half of the inmates • Large infrastructure projects including HIT to connect JH with Parkland Hospital and Community Oriented Primary Care Clinics

Health Status of DCJ Jail Health Patients

• 35% have mental health disorders Top Medical diagnoses: 1. Hypertension 2. Asthma / Chronic obstructive pulmonary disease 3. Diabetes (Insulin and non-Insulin dependent) 4. Chronic pain 5. Heroine / Opiate

Towards a Holistic View of Jail Health

• • • Visits with Jail Health administrator to identify “wicked problems” to address On top of Wish List: improve jail health by

eliminating recidivism!

Conversations with County Commissioners, County and City staff to map stakeholders for community engagement process

THI Project Approach

Activity #1: Implement an intervention with community leadership group to Activities Outputs Outcomes

Inputs

funding Concerned THI staff leaders expertise) THI Staff leadership group Community Development lore Community development lore

Activity

intervention with community leadership group to address the Convene leadership group Activity #2: Document processes and strategies Identify sponsor organization feasibility in community collaboration and effectiveness

Outputs

Health Institute’s process for community Working coalition that is engaged and energized and able to affect change Production of a model and tools for community Increased interest use about the issue among the processes that were and were not effective Define Issue Activity #4: Create community development/coalition building tools Collect and share supporting data with community leaders Identification of key processes for community collaboration use in order to create change and improve Community plan to issues in the Dallas community Collaboration of stakeholders that initiates implementation of the community plan

Community Meetings

• First Community Meeting – 75 community members (service providers, non profits and some former inmates) indentified 10 community priorities

Community Meetings

• Second Community Meeting – 30 former inmates and family members validated and narrowed community priorities

Community Meetings

• Third Meeting – 45 community members (providers and inmate organizations) developed task force structure to

address the objective of reducing recidivism

• Employment • Housing • Continuity of Care • Mental Health / Substance Abuse – Created steering committee for implementation and sustainability

Leadership Represented on SC

• • • • • • • Parkland Health and Hospital System Dallas County – Commissioners Court – Public Health – Sheriff’s Department Dallas Independent School District Dallas Leadership Foundation Dallas Police Department Operation Oasis Vision Regeneration

Outcomes

• • • • THI helped Parkland Jail Health connect with governmental and non-governmental partners Established strong connections between consumer and family organizations and the provider system Created powerful action-oriented steering committee and task force structure for implementation and sustainability Continued strong support of the project sponsor

Project Impact to Date

• • • • • • • Access to DCJ for HIV/AIDS advocacy NGO Social worker hired to provide HIV/AIDS counseling Voluntary HIV screenings by Public Health Dept. at the Jail Health intake Social worker hired to support pregnant inmates and their families Parkland Health Plan card to inmates upon release to provide medical home and access to Rx Release of homeless inmates to new public-private partnership homeless center Referral of inmates from drug rehabilitation center to Community Oriented Primary Care Clinics

Next Steps

• • • Task forces to present implementation recommendations to Steering Committee Establishment of new identity for the initiative Presentation of project ideas to public sector and philanthropic funding partners Photo: whatknot

Our Mission:

To provide leadership to improve the health of Texans and their communities through education, research, and health policy development.

Contact Us: www.texashealthinstiute.org / 512-279-3910 8501 N. MoPac Expressway, Suite 420 / Austin, Texas 78759 Klaus Krøyer Madsen THI Vice President, Programs [email protected]

512-279-3905