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

Division of Disease Control and Health Protection Introduction HIV Care Continuum Prisons vs Jails Counseling and Testing Prevention and Linkage Collaboration and Challenges

Division of Disease Control and Health Protection HIV Care Continuum Cascade cascade source:

Division of Disease Control and Health Protection Socioeconomic Factors and HIV Socioeconomic Factors and HIV Poverty Discrimination, stigma HIV Prevalence Undiagnosed/untreated STDs Language barriers Incarceration

Division of Disease Control and Health Protection Differences: Prisons vs Jails Differences: Prisons vs Jails Prisons Funded/operated by state Length of stay between years Level of care similar to community standards

Division of Disease Control and Health Protection HIV-infected Inmates HIV/AIDS rates in corrections settings are 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

Division of Disease Control and Health Protection 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

Division of Disease Control and Health Protection 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

Division of Disease Control and Health Protection PRPP Inmates Served CY (n=1,618 thru Oct 2013) PRPP Inmates Served CY (n=1,618 thru Oct 2013)

Division of Disease Control and Health Protection PRP Map

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

CLC Inmates Served CY (n=315 thru Oct 2013) CLC Inmates Served CY (n=315 thru Oct 2013) Division of Disease Control and Health Protection

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

Division of Disease Control and Health Protection 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

Differences: Prisons vs Jails Differences: Prisons vs Jails Jails Funded/operated by local govt Length of stay between days, not more than 1 year Appx 50% released within 48 hours Division of Disease Control and Health Protection

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

Division of Disease Control and Health Protection JLP Inmates Tested CY (n=47,762 thru Sept 2013) JLP Inmates Tested CY (n=47,762 thru Sept 2013) 0.5% Positive 0.8% Positive 0.6% Overall Positive Rate

How to Use Navigation Division of Disease Control and Health Protection JLP Linkages CY (n=3,959 thru Sept 2013) JLP Linkages CY (n=3,959 thru Sept 2013)

Division of Disease Control and Health Protection JLP Annual Comparison Testing, Linkages, Positives (thru Sept 2013) JLP Annual Comparison Testing, Linkages, Positives (thru Sept 2013)

Division of Disease Control and Health Protection Jail Linkage Program (JLP) Bureau of Communicable Diseases Florida Department of Health JLP in 16 Counties: o 15 Counties funded by DOH o 1 County unfunded (Monroe)

Division of Disease Control and Health Protection Corrections Infections Workgroup HIV/AIDSEpidemiology Hepatitis Corrections Juvenile Justice Correctional Medical Authority Substance Abuse/Mental Health Education STD and TB

Division of Disease Control and Health Protection Funding Sequestration Round Sequestration Round Program evaluations/reviews "High-impact" prevention Challenges: The Future

How to Use Navigation Division of Disease Control and Health Protection

How to Use Navigation Division of Disease Control and Health Protection HIV Care Continuum Cascade + Literacy cascade source: Overall: HIV+ more common with < HS education Almost half FL HIV+ inmates < HS education

How to Use Navigation Division of Disease Control and Health Protection HIV Care Continuum Cascade + Unemployed cascade source: 88% FL HIV+ inmates with min-mod skills Overall: 45% are unemployed

How to Use Navigation Division of Disease Control and Health Protection Overall: 33% to 60% affected by depression HIV Care Continuum Cascade + Depression cascade source:

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 cascade source: Overall: 50% drug use in past year Overall: 15% considered heavy drinkers 15% FL HIV+ inmates IDU 33% FL HIV+ inmates poly- drug users

How to Use Navigation Division of Disease Control and Health Protection HIV Care + Combination Prevention cascade source: Combination Prevention: Services Integration

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 BURNS CORRECTIONS SPECIALIST HIV/AIDS AND HEPATITIS SECTION BUREAU OF COMMUNICABLE DISEASES (850) , EXT 2565