to protect, promote and improve the health of all people in florida through integrated state,...
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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
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Division of Disease Control and Health Protection
IntroductionIntroduction
• HIV Care Continuum
• Prisons vs Jails
• Counseling and Testing
• Prevention and Linkage
• Collaboration and Challenges
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Division of Disease Control and Health Protection
HIV Care Continuum Cascade
HIV Care Continuum Cascade
cascade source: www.aids.gov
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Division of Disease Control and Health Protection
Socioeconomic Factorsand HIV
Socioeconomic Factorsand HIV
• Poverty
• Discrimination, stigma
• HIV Prevalence
• Undiagnosed/untreated STDs
• Language barriers
• Incarceration
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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
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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
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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
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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
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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)
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Division of Disease Control and Health Protection
PRP Map
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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
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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
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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
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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
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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
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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
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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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How to Use Navigation
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)
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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)
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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)
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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
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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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How to Use Navigation
Division of Disease Control and Health Protection
www.floridahealth.gov
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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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How to Use Navigation
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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How to Use Navigation
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
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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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How to Use Navigation
Division of Disease Control and Health Protection
HIV Care + Combination Prevention
HIV Care + Combination Prevention
cascade source: www.aids.gov
Combination Prevention:Services Integration
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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 [email protected]