Jail Health Services Correctional health is an integral part of the - - PowerPoint PPT Presentation

Jail Health Services

Correctional health is an integral part of the public health sector.

Inmates and ex-inmates are part of the

communities that we live in. What happens to them is vital to the health of the community and to public health.

David Satcher,

former US Surgeon General

Constitutional Right to Health Care

[The] principles [behind the guarantee against cruel and unusual punishment] establish the government’s obligation to provide medical care for those whom it is punishing by incarceration. An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met.

Estelle v. Gamble, US Supreme Court (1976)

Innovative Programs/ Policy Issues/ Research

 Integrated Delivery System  Women’s health program  Diabetes program  Chronic offender program  COVER Project  Impact of Affordable Care Act  Transgender groups  Condom distribution  Flu vaccination program  Crisis Intervention Team trainings  Transition of complex medical/ mental health patients  Integrated testing program  BANPH  Jail-based Hep B Free Campaign  Research  Navigator study  Geriatric study  Teaching

Complex Patients/ Difficult Transitions

 BH - 68 year-old-man, morbidly obese. Requires bariatric

bed and assistance with bathing. Mild cognitive impairment and mental health problems.

 TL – 91 year-old-man with cognitive impairments. In jail x

3 years. Currently at SFGH. Needs assistance with ADLs.

 LP – 60 year-old homeless man with severe cognitive

• impairment. In prison for past 12 years. HIV+ , insulin-

dependent diabetes, pulmonary hypertension, suicidal,

• alcoholic. Unable to understand and communicate medical
• status. Has never taken medications on his own, has

never managed his diabetes for himself. Housing options limited by registered sex offender status. Needs assistance with basic life skills, e.g., grocery shopping.

Integrated Testing

 LHEAP Team (Linkages to Health

Education and Prevention) offers screening, testing and disclosure for HIV, STD and hepatitis.

 Integrates previously “siloed” staff

and intervention efforts.

 Collaborative effort between JHS

and STD division.

FAP Bay Area Network for Positive Health (BANPH)

 Part-time Engagement and Linkage Specialist

(funding ended in June 2012)

 Referrals from Jail Medical Staff and

Supervised Pretrial Release

 Serves HIV+ prisoners incarcerated less than

72 hours and not engaged in HIV care

 Project evaluation data to inform national

grant efforts

 Goal: To engage out of care clients in to

care.

BANPH (continued)

 80 prisoners identified  Participants were found to have had an HIV

diagnosis for approximately 10 years.

 Lengthy engagement process: 17 contacts

• ver months (in some cases, over a two year

period)

 Many reported not being in care because

they didn’t feel sick.

 Effort is expensive and labor intensive, but

when someone actually engages in care, extremely effective.

Jail-Based Hep B Free Campaign

 FAP leads the Jail Health Services

implementation effort

 HBV testing, vaccination, and

treatment efforts target API and MSM populations in the jails

Navigator Project (FAP & UCSF)

 Study to test the effectiveness of an enhanced

case management intervention including peer navigation services available to HIV+ inmates leaving SF Jails.

 360 participants over four years  Length of participation: one year after initial

release from jail

 Enhanced intervention includes:

 In-jail HIV prevention counseling  One year of post-release intensive case management

built upon peer navigation services.

Geriatric Research Project

Needs Assessment:

 Patients  JHS staff  Custody staff  Legal professionals  Police officers

Teaching

 Ob-Gyn Residents  HIV rotation  3rd year medical students  Nurse practitioner students