ESTELITA M. QUIMOSING, M.D.DAETC – ARKANSAS

Associate Professor of Medicine, UAMSClinical Director, Jefferson Comprehensive Care System, Inc.

CLINICAL TRAINING FOR CORRECTIONS PERSONNEL

Objectives

To describe the clinical training for corrections personnel.

To understand the importance of linking the HIV+ inmate to the community once discharged from the prison.

TOPICS

Collaboration of ADC, JCCSI and DAETC

Tour of ADCLevels of

TrainingHIV-AIDS in the

Prison

HIV Screening in ADC

Privacy and Confidentiality

Linkage to ServicesDischarge PlanningSummary

Map of Arkansas The Arkansas Department of Correction (ADC), Jefferson

Comprehensive Care System, Inc. (JCCSI) and the DAETC

Arkansas local provider site are located in Jefferson county.

ADC - JCCSI - DAETC

The Arkansas Local Performance Site of the DAETC is in JCCSI. Training of ADC personnel by JCCSI/DAETC has been in progress for more than 10 years now.

“The Club”

How To Get There

In-patient and Out-patient

clinics

Gate Security

The Club’s Lovely Landscape

Dashboard view

The Triad

Watch Tower

Shackled Men in UniformBarbed-Wire Fence

The Facility

Diagnostic Unit: In-patient and Out-patient Clinics

Entry to the Clinic

JCCSI HIV Nurse and

Discharge Planner

ADC HIV Nurse and

Security Officers

Inmates in the Waiting Area

ADC Nurse Ann Teer triages the inmate with a Security Officer at a distance

Then the inmate goes to the waiting area until his name is called

Security and Confidentiality in the Clinic

HIPAA

Inmate’s chart is transported in a secured jacket

Ideally, the examination room should be closed, but I would not dare stay in a room alone

with the inmate behind a closed door.

Clinical Training for Correctional Personnel by DAETC

Action Steps Responsible

Needs Assessment Derrick

Levels 1 - 2 Clinical Faculty ***

Levels 3 - 4 Clinical Faculty

Technical Assistance Derrick, Hayley, Shari,

Chinetta, Darlene, Ann ***

Levels of Training

Level I: Lecture

Level 2: Skills building

Level 3: Case discussion

Level 4: Clinical Consultation

Trainer

Trainer Trainer

Active Learner

Active Learner

Patient

HIV-AIDS IN THE PRISON

Prevalence: 3-5x higher than in the general population

1.7% of total inmate population in USA

Bureau of Justice Statistics, 2007

0.7% of total inmate population in Arkansas

Arkansas Department of Correction, 2011

Total Inmate Population

HIV - AIDS

HIV Testing in the Prisons of USA

NOT A ROUTINE:

ON ADMISSION UPON RELEASE SYMPTOMS PRESENT UPON REQUEST INCIDENT HAPPENS HIGH RISK INMATE

Opt-out HIV Screening in Arkansas Department of Correction

Opt-out screening: HIV test is routine unless the inmate declines

HIV screening upon release started in 2010

HIV+ 2010 2011

On admission

17 5

Upon release

1 1

INMATE PRIVACY AND CONFIDENTIALITY

HIPAA (Health Insurance Portability and Accountability Act)

Discuss inmate’s care and services in private

Close examining room when possible

Secure medical records during transport

Linkage to Services

Services Responsible

HIV Prevention and Counseling ADC nurse

Medical evaluation and staging ADC Unit Physicians

HIV-AIDS and OI management HIV Specialist

Immunization ADC nurse

HIV in pregnancy UAMS Women’s Clinic

LINKAGE TO SERVICES UPON RELEASE FROM CUSTODY

Services Responsible

Discharge Planning Program ADC, JCCSI

List of HIV providers in Arkansas ADH, JCCSI, ARCare

Housing, Food, Employment Part C, Part B, Part D

Mental Health, Subs Abuse Tx Part C, Part B, Part D

LINKAGE TO SERVICES Discharge Planning in Arkansas

Referral to RWCA-funded HIV clinics

Provision of HAART x 30 days

2) Date of Release

3) Date of HIV+ test

Release Notification Form

4) Medication list

6) Release of Info

5) Parole Officer

1) Inmate’s Demographic

When going to first appointment

1. Picture ID 2. Release form for verification of residency and income 3. Verification of HIV Status 4. Copy of your most recent lab work5. List of current HIV medications 6. SIGN A RELEASE OF INFORMATION

Ann Teer ADC Disease Intervention Specialist, HIV Program

6814 Princeton Pike, P.O. Box 8707Pine Bluff, AR 71602

Office: 870-267-6789 or 870-247-4791 Ext. 6249Fax: 870-267-6243

Ann.teer@arkansas.gov

Instruction to Inmate

Summary

The training of Corrections Personnel by the JCCSI-DAETC staff has been a continuous process for more than 10 years now.

Discharge planning and linking to care in the community are integral parts in the care of HIV+ inmates.

THANK YOU!