1. Integrating CT Screening as standard of care in juvenile detention facilities
Sharon Jaques, RN, BSN,PHN CCHP
San Bernardino County Probation Department

2. Objectives
Describe elements of transition from health department based program to a probation model.
Provide data demonstrating program improvement.

3. Background State regulations – Title 15 County Probation structure
Custody
Medical services
# and types of staff
hours of coverage

4. Juvenile Justice Facilities
Three JDAC’s in San Bernardino County
Central Juvenile Detention & Assessment Center
Annual bookings – 288 female & 1,730 male
West Valley Juvenile Detention & Assessment Center
Annual bookings – 210 female & 1,126 male
High Desert Juvenile Detention & Assessment Center
Annual bookings – 235 female & 1,434 male

5. Partnerships Health Department/Juvenile Justice collaborations:
Get Tested (2001) CT screening in one hall
ClaSP (2003) CT screening in one hall
Reproductive health

6. Methods Health Department Model
Public Health staff conducted screening
one location
3 hrs/3 days week
Not at booking

7. Performance Level Screening coverage Proportion screened
28% countywide
60% at Central JDAC only ( )
Coverage dropped late 2006
Reason for decreased screening coverage
Decreased number of hours and days staff at hall
Limited selection of persons screened

8. Development of New Plan
Problem: Not screening enough youth; contract requires at least 60% of females
Barriers
One site with limited hours of coverage
Remedy
Expand number of sites
Increase hours of coverage
Plan
Collaborate with Probation
Provide training and TA

9. Probation Model
April Probation Medical Staff began specimen collection
Transition was progressive
Model:
three locations
24/7
At booking

10. Elements of Transition
Contracts
Processing
Staff bookkeeping - TLR
Medical Standard of Care Protocols
CT test at booking
Forms
Electronic systems
Training
Staff – all levels

11. Transition cont’d Data Laboratory testing
Establishing system
Migrating unique identifiers to ensure consistency in individual reporting
Combining data systems for project duration
Laboratory testing
CT tests to hospital instead of PHL
Follow up of released positives
New referral systems

12. Continuous Challenges with New Model
Addressing IT issues
Transfer of minors between facilities
Identifying where the minor originated
Follow up with minors released prior to treatment

13. Results

14. Proportion Screened
N=42
N=165
N=178
N=167

15. Proportion Screened Trend (2003-2007)

16. Conclusions
Working directly with the probation departments in health jurisdictions is an effective model for maximizing CT screening coverage in juvenile detention facilities.
Implementing protocols to include CT screening at booking as standard of care in juvenile detention facilities can significantly enhance the number of young females screened and cases identified.

17. Education Improvement Goals
Incorporated STD and HIV education into facility Health Fairs.
Expand current education model
Tip Top Program

18. Question & Answers
Contact info:
(909)