AIDS Care Group Chester, PA Howell I' Strauss, DMDP'I'

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AIDS Care GroupChester, PAHowell I. Strauss,
DMD-P.I.

• 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

• Services will target five Pennsylvania county
  jails to reach prisoners before release to
  effectively plan for and carry out comprehensive
  discharge and reintegration services. ACG will
  utilize psychiatric assessment, deployed case
  management, transportation, food, shelter and
  phone cards during the reintegration process to
  help insure adherence to HIV medical care and
  reduce recidivism.

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Project Goals and Objectives

• Goal Address all current barriers to clinical
  and social services for incarcerated and newly
  discharged HIV positive adults to help insure
  seamless reintegration into the community,
  adherence to HIV medical care, commitment to risk
  and harm reduction behaviors.
• Objectives Jail based education to inmates to
  remove disease stigma and early identification of
  HIV inmates.
• Partner with jail administrative and treatment
  staff for buy in of discharge coordination with
  ACG.
• Create coordinated care plan which includes
  deployed case management, psychiatric gate keeper
  evaluations and linkages to all uniquely required
  services for each released prisoners.

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Enhancements to Existing Services Available for
HIV Inmates

• Describe how the proposed intervention enhances
  existing services such as
• Provide jail based testing to 1200 incarcerated
  adults in first year.
• Provide jail based education to administrative
  and treatment staff with new coordination in
  systems leading to improved discharged process.
• Upon discharge provide immediate linkage to
  deployed case manager with first goal being a
  psychiatric assessment of the released inmate.
• Utilize transportation, food, clothing and phone
  cards to insure success with reintegration
  activities.

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Project Team and Collaborative Partners

• Grantee AIDS Care Group
• Howell Strauss, DMD P.I.
• Irshad Shaikh, MD, PhD Evaluator
• Ann Ferguson, MSN, RN - Coordinator
• Jails 5 Pennsylvania suburban county jails
• Collaborative partners
• State and County political leadership
• Case management and supportive service agencies
  in each county
• Substance abuse treatment centers
• Community Correctional facilities
• Medical providers for inpatient and outpatient
  care
• Consumer and provider collaborations

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Target Population

• 20,000 new commitments among five Pennsylvania
  suburban county jails
• Counties have 14.6 of Penna. county jail inmate
  total and 13.2 of the States reported AIDS
  cases. Over 50 are incarcerated secondary to a
  substance abuse offense.
• 92 male, 8 female 65 AA 15 Latino(a) 20
  Caucasian
• The group is adult living below poverty levels
  and dependent on RW CARE Act and other publicly
  funded agencies to address medical care and other
  social service needs

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Local Evaluation Strategy

• Process evaluation design
• Number of inmates receiving HIV counseling and
  testing
• Number of inmates linked into projects deployed
  case management discharge program
• Number of inmates discharged who received
  psychiatric gatekeeper services and linkages to
  medical care and social service providers
• Outcome evaluation design
• Among discharge inmates linked into reintegration
  program how many receive case management,
  psychiatry, medical care and substance abuse
  services
• Number that remain free from recidivism
• Number retained in medical care measuring CD4,
  viral load and Axis I diagnoses over 6, 12 and 18
  months.

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Local Data Collection

• Data
• On the individual level race, gender,
  transmission, age, number of incarcerations and
  time in jail, HIV medical staging and psychiatric
  acuity
• On the program level number of interventions and
  linked agencies involved in the coordinated
  comprehensive care program
• On the systems level availability of housing,
  jobs, medical care and social services.
• Describe method of data collection confidential
  one on one interviews by assigned project staff
  chart abstractions, and supportive documentation
  from collaborating agencies.
• Describe who will collect data assigned project
  staff.

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Outcomes

• From point of discharge
• Number linked to deployed case management
• Number evaluated by psychiatric gatekeeper
• Number linked to medical care with follow up and
  retention visits at 6, 12 and 18 months
• Number of linkages to supportive services
• Number of inmates who returned to jail
• Number lost to care

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Expected Challenges Possible Solutions

• Describe the major challenges
• Jails cultures and subcultures
• Disease stigma
• Poverty, discrimination, addiction and surviving
  the streets in the communities in which inmates
  return
• Propose possible solutions to these challenges
• Identifying barriers unique to each client
• Use of multiple service providers capable of
  addressing barriers
• Linking care through deployed case management to
  help insure continuity and success with the
  reintegration process

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Howell I. Strauss, DMD P.I.2304 Edgmont
AvenueChester, PA 19013610-389-2301fax
610-667-2380Strausshi_at_aol.comaidscaregroup.org