Baystate Medical Center Hampden County Correctional Centers Springfield, MA PI: Tom Lincoln PD: pend

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Baystate Medical Center/ Hampden County
Correctional CentersSpringfield, MAPI Tom
LincolnPD pending as of 10/18LE Dominique
Simon Levine

• Enhancing Linkages to HIV Primary Care
• in Jail Settings
• Grantee Meeting
• 10/25/2007 10/26/2007
• Rockville, MD

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Project Description

• Expand existing Hampden County model to better
  address behavioral health needs
• 2 (to start) dually-based mental health
  clinicians in jail and community health centers
• Unilateral family intervention training (CRAFT)
• Office Based Opiate Addiction Therapy nurses at
  health centers. As appropriate, initiate in jail.
• HIV Self Management Education (Stanfords
  Positive Self-Management Program (PSMP))

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Project Goals and Objectives

• Enhanced linkage to and use of mental health
  services
• Better coordination of mental health and primary
  medical care
• Improved retention in primary care
• Improved family cohesion
• Improved use of substance abuse treatment

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Enhancements to Existing Services Available for
HIV Inmates

• Proposed intervention enhances existing services
• Increases volume of voluntary rapid HIV
  counseling and testing from approx 2k to 3k (yr 1
  supplement)
• Adds the continuity of care to existent jail
  mental health treatment (dual diagnosis). Same
  clinician from jail to health center.
• Increases coordination of mental health with
  medical service
• MH will need to supplement case management as DPH
  case management program diminished
• New service
• Family intervention/training for loved ones of
  addicted patient

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Project Team and Collaborative Partners

• Grantee Baystate Medical Center
• PI Tom Lincoln ? PD pending
• LE Dr. Dominique Simon Levine/Allies in
  Recovery experience evaluating 16 SAMHSA-funded
  service grants (including 2 re-entry projects)
• Hampden County Correctional Centers mens,
  womens, prelease, residential addiction
  treatment, day reporting
• Behavioral Health Network- currently provides
  mental health services in the jail, courts,
  community crisis centers, traditional ambulatory
  MH services
• Allies in Recovery- Community Reinforcement and
  Family Training (CRAFT) organization
• Community health centers

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Target Population

• 130 HIV released from jail initiate with 2 of
  4 health centers
• 90 men, Puerto Ricangt AA gt White
• Hampden Co- primarily from Springfield Metro
  area- 500,000
• 5 intake prevalence HIV infected yrs prior blind
  surveillance, presumably less at present. Of
  general population, slightly over half have used
  drugs in past 3 months, and slightly under half
  have CAGE score 2-4

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Local Evaluation Strategy

• Process evaluation design (qualitative)
• Participant Observation at staff and clinical
  meetings, and staff trainings
• Formal and informal interviews with project staff
  and collaborators
• System evaluation design (mixed
  qualitative/quantitative)
• Dose and referral logs, ditto process evaluation
  design
• Outcome evaluation design (quantitative)
• Client Crosssite tool, GPRA-lite, BSI, Coping
  Inventory Family members Becks, Happiness
  scale, Family Environment Scale

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Local Data Collection

• Individual Level Client demographics, mental
  health symptoms, substance use, income, housing,
  belief in coping strategies for sobriety, project
  dose, referrals to medical/MH/SUD/housing etc.
  Family members depression, accessing tx, family
  cohesion, expressiveness, and conflict.
• Program Level Dose, referral utilization,
  implementation barriers and solutions for
  addressing them
• System Level Referral network utilization,
  collaborator involvement, system-wide
  implementation barriers and solutions for
  addressing them
• Data Collection instruments, participant
  observation, interviews
• Data Collectors evaluation team will collect
  qualitative data case workers will collect
  quantitative data

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Outcomes

• MH/SUD Clinicians dose, referrals, demographics,
  mental health symptoms, SUD coping skills, dose,
  referrals to care/treatment
• Case Workers dose, referrals to care/treatment
• CRAFT Groups clients accessing and staying in
  treatment reduction in harmful substance use
  improved quality of life for family and
  relationship cohesiveness.

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Expected Challenges Possible Solutions

• IRB approval, hiring and keeping good
  bicultural/bilingual staff difficulty with
  follow-up.
• IRB work hard to finalize data collection tools
  and start review process ASAP
• Staffing build in evaluation training
  redundancy, support well
• Follow-up incentivize, build buy-in for project,
  train on reaching hard to find clients support
  staff well. Revised plan to include
  outreach/locator.

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Contact Information
Dr. Tom Lincoln Hampden County Correctional
Ctr 627 Randall Rd. Ludlow, MA 01056 Page 413
794-0000 p49456 413 794-4458 thomas.lincoln_at_bhs.or
g

• Dr. Dominique Simon Levine
• Allies in Recovery
• 16 Armory St, Ste 7-9
• Northampton, MA 01060
• 413 210-3724
• dominiquesimon_at_comcast.net