1. Offender Care (AKA Prison Care) LouAnn Gerard RN, Director Of Patient Relations Lores Roeder RPh, MBA Brenda F. Daigle-Murry APRN, MSN, Ed, ANP-C, CCRN

2. Background Purpose for PI Activities Decrease the number of visits for Offender Care Decrease the cost of Offender Care

3. Offender Care at WOM Objectives: Streamline healthcare delivery Decrease the cost of delivery of Healthcare for Offender

4. Changing the way we deliver Offender Health Care Created a team Review the cost of the delivery system Changed how Offender Care is delivered Implement drug formulary for medication management

5. Visits for Offender Care Number of offenders seen by the NP at Calcasieu Jail for Calendar Year 2007 4374 offendersAverage census in Calcasieu Parish 2008 3852 offenders Jail is approx. 1200-1500 2009 4815 offenders

6. Decreased the cost of medication for offender care Formulary management –Drug efficacy, safety and cost –Drug choices –Formulation choices 340 B pricing for qualifying offenders Management of diseases

7. Economic Impact for FY 2010 Reduction of Calcasieu Parish Police Jury Expenditure for Hospital bills $110,306 Savings from 340B pricing for HIV medications: Calcasieu$137,700 Savings from 340B pricing for HIV medications: Phelps$243,840 Total $491,846

8. Visits Attended

9. No Show Clinic Appointments

10. Charges For Prisoner Care

11. Inmates No Longer at Prison

12. Return PRN

13. Lessons Learned All Offender care cannot be controlled Develop criteria for Offender emergency room visit Always be politically correct in providing Offender care Trust is developed by consistency