Title Subtitle 1 1 Health Commission Director of Health - - PowerPoint PPT Presentation

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Title Subtitle 1 1 Health Commission Director of Health - - PowerPoint PPT Presentation

Oct 20, 2023 211 likes •389 views

Jail Health Services Lisa A. Pratt, MD, MPH Director / Medical Director Jail Health Services Title Subtitle 1 1 Health Commission Director of Health Information Coordination of Compliance & Finance Policy & Planning Human

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Subtitle

Title

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Jail Health Services

Lisa A. Pratt, MD, MPH Director / Medical Director Jail Health Services

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Director of Health

Finance Policy & Planning

Zuckerberg San Francisco General Laguna Honda Hospital Transitions Managed Care & Patient Finance Ambulatory Care Primary Care Behavioral Health Jail Health Maternal, Child & Adolescent Health

Human Resources Information Technology Coordination of Division Initiatives

Environmental Health Community Health Equity & Promotion Disease Prevention & Control

Public Health Emergency Preparedness & Response

Emergency Medical Services Office of Equity & Quality Office of Ops, Finance & Grants Mgmt. Center for Learning & Innovation

Applied Research, Community Health Epidemiology & Surveillance

Center for Public Health Research Bridge HIV

Security Communications Compliance & Privacy Affairs

Health Commission

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JHS Organizational Structure

Jail Health Services Medical Behavioral Health Re-Entry & HIVIS Dental Pharmacy

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JHS Budget

FY 2014-2015 Operating Budget Salaries & Benefits 23,967,272 Professional & Specialized Services 3,641,078

  • Includes BHS, X-RAY, Podiatry, UCSF OBGYN

Pharmaceuticals 2,478,792 Material & Supplies 624,680 Other Expenses 297,102 $ 31,008,924

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JHS Staffing

163 FTE

Nurse Managers 3.0 Psychologist 1.0 RNs 61.6 Therapists 20.0 LVNs 25.0 Counselors 4.0 MD/NPs 12.6 Pharmacists 3.0 Administration 4.0 Pharm Technicians 5.0 Support Staff 14.0 Dentist 1.4

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Who is in the SF Jail?

Total unique patients in 2015: 15,000

Current average daily census: 1,250

  • 86% of people in SF Jail have not been sentenced
  • 14% are serving a sentence
  • 7-14% Seriously mentally ill

Average length of stay

  • 65% less than 7 days
  • 18% 7-30 days
  • 16% 30 days or more

Sex and Gender Identity

  • 86% are men; 14% are women (SFSD)
  • 78% men, 13% women, 10% declined to answer (JHS)
  • Trans Women 61, Trans Men 17

Source: Jail Information Management System

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SF Jail Entry 2009-2016

28,776 25,037 24,233 23,741 23,695 21,029 20,032 21,033 17,912 16,402 16,566 17,249 15,005 14,441 5000 10000 15000 20000 25000 30000 35000 Triage Intake

FY 09-10 FY 10-11 FY 11-12 FY 12-13 FY 13-14 FY14-15 FY15-16

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Race/Ethnicity 2015

African American 36% White 34% Latino 16% Asian/Pacific Islander 8% Unknown 3% Native American 1% Other 2%

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Care in the Jail

Triage →

  • Acute: ZSFG ED/PES

Intake →

  • Subacute: BHS evaluation, psychiatry referral,

substance use detox, primary care -> specialized housing

  • Chronic care: primary care, psychiatry and mental

health services, dental services

Referral →

  • RN assessment
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2015 JHS Encounters

Medical Services

Triage 20,333

  • ED Referrals

613

Intake screening 14,417 Nursing visits 31,144 Clinician visits 25,187 Dental visits 2,016 Pharmacy fills 194,000

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Behavioral Health Services

  • Evaluation
  • Evidence-based individual and group therapy
  • Medication management
  • Assessment and referrals to community treatment
  • Substance abuse assessment and treatment
  • Reentry Services
  • Crisis Intervention
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Behavioral Health Services

Stabilization and Reentry:

  • Comprehensive mental health evaluation

6,567

  • Psychiatry visits

4,258

  • Group therapy visits

27,397

  • Individual therapy visits

18,810

  • Reentry planning visits

6,894

Crisis Intervention:

  • 5150 hold at the jail

465

  • Admission to 7L

330

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HIV & Integrated Services

Screening and Prevention 2015

  • 8,900 tests done
  • PrEP and PEP overdose education
  • Condom and naloxone distribution

Center of Excellence 2015

  • HIV Medical Care – 339 patients
  • Medical Case Management – 127 patients
  • Psychosocial assessment
  • Medication adherence support
  • Discharge planning
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JHS Innovative Programs

Substance Use Treatment

  • Methadone and Buprenorphine

Prenatal, Intrapartum and Post-Partum Support

  • UCSF OB/GYNs
  • Birth Justice Project

Clinical Pharmacist-Managed Clinics Hepatitis C treatment with direct-acting antivirals Reentry Programming

  • Misdemeanor Behavioral Health Court
  • Mentoring and peer support program (MAPS)
  • Transitional Age Youth services
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Opportunities - BHS

Medication Management

  • Continuity of medication
  • Increased number of prescribers

Stratification Tools

  • Screening instrument to determine level of care
  • Validated suicide assessment tool

Psychiatric Sheltered Living Units

  • Strengthen stabilization and community transition

programs

  • Develop individual treatment plans for group therapy
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Opportunities

  • Expand public health surveillance and treatment
  • Initiate and coordinate medication-based relapse

prevention therapies

  • Expand HIVIS model to medically complex patients
  • Medical case management and supported continuity
  • Integrate HIVIS and BHS re-entry programs
  • Sharing resources and best practices
  • Formalize linkage opportunities across healthcare

and social service entities