Transcript VRLAC Project Summary – Page 2 - Tennessee Association of Drug

Methods
Results
Conclusions
 An algorithm was developed to guide the
implementation of an initiative to provide long-acting,
reversible contraceptives (LARC) to jail inmates.
The program was piloted in Cocke and Sevier Counties
from January 1 through June 30, 2014.
 The referral rate of 61.8% and interviews with
the inmates indicate both an interest in and
need for the program.
 A presentation was developed to educate local health
department staff on NAS and the importance of the
primary prevention initiative.
 An outreach plan with 2 educational pamphlets one on
NAS and the other on LARCs was developed to use
in securing the cooperation of jail officials in providing
a time/place to do an educational presentation and
providing transport for inmates wanting to receive a
LARC.
 Referral and tracking forms were developed.
 An educational presentation and pamphlet were
developed to inform inmates about the risk of NAS
associated with using narcotics during pregnancy and
how to minimize the risk of pregnancy through the use
of LARCs.
 Standardized
developed.
clinic
documentation
tools
were
 Initial Exam and LARC clinics were conducted in the
health department to provide services while
participants were still incarcerated.
 Collaborated with UT Family Physicians to provide
experience for residents to place LARCs.
 An access data base was developed for reporting.
 Selected two counties (Cocke and Sevier) having
25.8% of the total East Region NAS cases as pilot
sites and began implementation in January, 2014.
 Followed
the
PDCA
(PLAN-DO-CHECK-ACT)
continuous improvement cycle after each phase of the
implementation – from securing the “buy-in” from local
staff to data collection and reporting – evaluated the
processes and made revisions for continuous program
improvement and to ensure success as other counties
begin to replicate and implement the program.
Total Presentations
Total Participants
Total Referrals
Average Age of Referrals
Age Range of Referrals
Referrals Receiving Some Type of
Service
Patient History
Drug charge
History of drug use
Child born drug-dependent
Child ever in state custody
Taking anxiety meds
Taking pain meds
Drug use during pregnancy
Previous FP patient
Current BC Method
Condoms
Depovera
IUD
None
Unknown
Referrals Receiving
Contraceptive
Contraceptive Type Provided
(n=36)
Depo-Provera Injection
Mirena IUD
Nexplanon Implant
Paraguard IUD
Referrals Receiving LARC
Number Percent
5
110
68
61.8%
27
20-45
43
63.2%
19
34
9
6
1
1
9
12
44.2%
79.1%
20.9%
14.0%
2.3%
2.3%
20.9%
27.9%
3
1
1
34
4
7.0%
2.3%
2.3%
79.1%
9.3%
36
52.9%
9
6
19
2
27
25.0%
16.7%
52.8%
5.5%
39.7%
 Only 63.2% of the referrals received services
and 39.7% a LARC indicating that best
results are achieved when the presentation,
the initial exam, and the LARC placement can
occur within a 5 to 7 day period.
 The average cost for an infant born drug
dependent, diagnosed with NAS in 2011 was
$62,973. Providing a LARC to 27 women and
Depo-Provera to 9 women will greatly reduce
the risk of pregnancy. If only one pregnancy
is prevented for each participant, it would
represent a potential savings of $2,267,028.
Future Directions
 Three more counties in the East Region have
received training and are preparing to
implement the LARC initiative. The remaining
10 counties are to receive training in October,
2014.
 The Recovery Court Judge for four counties
will start making NAS/LARC education at the
health department a mandatory part of
sentencing for both men and women with
drug related charges in September, 2014.
 On December 4, 2014 the East Region
Medical Director and the Cocke/Sevier Health
Department Director will be conducting a
break-out session on the East Region’s
primary prevention initiatives at the
Tennessee Association of Drug Court
Professionals Annual Drug Court Conference
in an effort to expand the sentencing
requirement to other counties.
FOR ADDITIONAL INFORMATION CONTACT ERICA WILSON, EAST REGION HEALTH PROMOTIONS DIRECTOR
[email protected]