Prison to Community Transition Project

State: IL Type: Model Practice Year: 2011

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The Prison to Community Transition Project (PCTP) is a program designed to reach the recently released from prison population with HIV testing, prevention and care linkage referral information. According to 2006 Illinois Department of Corrections (IDOC) data, less than half of those released from an Illinois State Prison facility have received an HIV test. In July 2007, the Illinois Department of Public Health (IDPH) provided $25,000 for the development of a pilot project to reach those recently released from state prison facilities with HIV services.

Jackson County Health Department (JCHD) developed and piloted the PCTP in April 2008 and fully implemented the program in 2009. Through the implementation of the PCTP, 78% of the targeted men and women recently released from prison have received an HIV test. JCHD is in its third year of funding for the PCTP and we are currently receiving $60,000 from IDPH for this initiative.

The primary goal of the PCTP is to improve health outcomes of those recently released from prison, with a special emphasis on HIV/AIDS. There are four public health related objectives that are accomplished through implementation of the PCTP:

• To increase the number of those recently released who know their HIV status.

• To increase the linkage to care and coordination of care prior to release for those inmates who are HIV.

• To improve social determinants of health, such as job status, income, and education.

• To increase access to primary care, substance abuse treatment, and dental care.

The implementation of this program has enhanced our existing HIV Prevention efforts and our HIV care programming. Through this program we have provided an HIV test to 394 parolees and provided 13 HIV inmates with linkages to care. The primary factor that continues to lead to the ongoing success of the PCTP are the strong community partnerships have been built and maintained. The unprecedented coalition of public health, corrections, substance abuse treatment facilities, life skills training agencies and faith based organizations has allowed this program to thrive and be replicated throughout Illinois.

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Jackson County Health Department
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Prison to Community Transition Project
The Prison to Community Transition Project (PCTP) is a program designed to reach the recently released from prison population with HIV testing, prevention and care linkage referral information. According to 2006 Illinois Department of Corrections (IDOC) data, less than half of those released from an Illinois State Prison facility have received an HIV test. In July 2007, the Illinois Department of Public Health (IDPH) provided $25,000 for the development of a pilot project to reach those recently released from state prison facilities with HIV services. Jackson County Health Department (JCHD) developed and piloted the PCTP in April 2008 and fully implemented the program in 2009. Through the implementation of the PCTP, 78% of the targeted men and women recently released from prison have received an HIV test. JCHD is in its third year of funding for the PCTP and we are currently receiving $60,000 from IDPH for this initiative. The primary goal of the PCTP is to improve health outcomes of those recently released from prison, with a special emphasis on HIV/AIDS. There are four public health related objectives that are accomplished through implementation of the PCTP: • To increase the number of those recently released who know their HIV status. • To increase the linkage to care and coordination of care prior to release for those inmates who are HIV. • To improve social determinants of health, such as job status, income, and education. • To increase access to primary care, substance abuse treatment, and dental care. The implementation of this program has enhanced our existing HIV Prevention efforts and our HIV care programming. Through this program we have provided an HIV test to 394 parolees and provided 13 HIV inmates with linkages to care. The primary factor that continues to lead to the ongoing success of the PCTP are the strong community partnerships have been built and maintained. The unprecedented coalition of public health, corrections, substance abuse treatment facilities, life skills training agencies and faith based organizations has allowed this program to thrive and be replicated throughout Illinois.
JCHD is located in the southern part of Illinois and provides care and treatment services for those HIV in the lower 19 counties, (www.hivcareconnect.com). For this project we teamed up with the Region 5 parole district, which covers the lower 24 counties of the state, and is home to nine state prison facilities. IDOC data reveals that the rate of HIV infection among inmates is nearing 6%, yet less than 50% choose to be tested while incarcerated. Inmates of known HIV status need better coordinated HIV care linkage prior to release. This project addresses better coordination of care just prior to release and immediately after release for those who are HIV and also increases the number of a very high risk group who know their HIV status.
Agency Community RolesJackson County Health Department (JCHD) is the primary funded agency of the PCTP, and provides leadership and coordination for the overall program. As previously mentioned, JCHD has a long history of delivering successful HIV prevention and care programming and is viewed as a leader in our state. JCHD was initially funded for a pilot project to develop a program designed to increase HIV testing and linkage to care in those recently released from prison. During the pilot, JCHD sought information about the prison and parole system and what was currently being provided. Through this community discovery process we identified a core group of stakeholders and planned the first pilot events. JCHD continues to serve in a leadership role in the coordination of the Summit of Hope events and in the training for partners. This collaboration has led to JCHD’s membership on the local re-entry task force. Costs and ExpendituresThe Prison to Community Transition Project (PCTP) is a program designed to reach the recently released from prison population with HIV testing, prevention and care linkage referral information. According to 2006 Illinois Department of Corrections (IDOC) data, less than half of those released from an Illinois State Prison facility have received an HIV test. In July 2007, the Illinois Department of Public Health (IDPH) provided $25,000 for the development of a pilot project to reach those recently released from state prison facilities with HIV services. Jackson County Health Department (JCHD) developed and piloted the PCTP in April 2008 and fully implemented the program in 2009. Through the implementation of the PCTP, 78% of the targeted men and women recently released from prison have received an HIV test. The primary goal of the PCTP is to improve health outcomes of those recently released from prison, with a special emphasis on HIV/AIDS. There are four public health related objectives that are accomplished through implementation of the PCTP: • To increase the number of those recently released who know their HIV status. • To increase the linkage to care and coordination of care prior to release for those inmates who are HIV. • To improve social determinants of health, such as job status, income, and education. • To increase access to primary care, substance abuse treatment, and dental care. The implementation of this program has enhanced our existing HIV Prevention efforts and our HIV care programming. Through this program we have provided an HIV test to 394 parolees and provided 13 HIV inmates with linkages to care. The primary factor that continues to lead to the ongoing success of the PCTP are the strong community partnerships have been built and maintained. The unprecedented coalition of public health, corrections, substance abuse treatment facilities, life skills training agencies and faith based organizations has allowed this program to thrive and be replicated throughout Illinois. ImplementationThe goals and objectives for this practice were accomplished by providing the Summit of Hope (SOH) events, participating in Re-entry summits and by building the capacity of the stakeholders concerning HIV issues. Our objectives are: • To increase the number of those recently released who know their HIV status. • To increase the linkage to care and coordination of care prior to release for those inmates who are HIV+. • To improve social determinants of health such as job status, income, and education. • To increase access to primary care, substance abuse treatment, and dental care. As we developed this model practice we accomplished the following tasks: 1.) Assess the organization of the current parole system and identify key stakeholders. 2.) Determine what is currently being included in the parole system to facilitate parolee access to HIV programming and other needed resources. 3.) Meet with and build relationships with key stakeholders. 4.) Form executive planning group and identify other key players. 5.) Request the annual dates for state prison re-entry events, receive clearance for attendance, and provide referral services at each event. 6.) Provide HIV education for executive planning group. 7.) Within the executive planning group, SOH event tasks are assigned to the following key agencies: Parole The local parole office plays an invaluable role in this programming.Local parole agents take the lead to invite parolees from their current case load. This happens through a letter sent from the agent to the parolee. Parole also initiates the assistance of correctional counselors from local correctional facilities at the SOH event. The correctional counselors serve as a “buddy” or daily guide for the parolee. Upon arrival at the SOH event, the correctional counselor meets with the parolee and completes a service questionnaire. This questionnaire determines the various needs of the parolee and serves as a guide to seek specific service vendors throughout the event. This is key to successful service delivery. Not only do the parolees get to take advantage of the many services, but the parole agents also get to meet with many of the parolees that are on their caseload, all in one day. This is an added time management advantage for the agent.  Public health initiates the registration of vendors from various agencies and ensures that HIV testing and care referrals are available at the event. Within this program, public health also coordinates the logistics such as securing the location and other needed resources and organizing the set up. Vocational Ed Agencies that offer vocational training take the lead on organizing fee-for-service vendors, and covering the costs of services such as transportation to the event, drivers’ license and identification fees, GED registration, and vocational training/registrations. Faith-based Faith-based agencies provide the core of our volunteers which provide snacks and transportation, act as event buddies, practice employment interviews and offer support groups. 8.) Meet regularly to ensure planning is progressing. 9.) Hold first SOH pilot event. Invite media and community leaders. 10.) Have parolees and providers evaluate the SOH event. 11.) Make changes to future SOH events based on evaluations. 12.) Hold upcoming annual planning meetings. The timeline for these tasks: Year 1 Tasks 1-7 take place the majority of year 1, with the pilot being held near the end of the year (tasks 8-9). Year 2 Tasks 10-12 were completed at the beginning of year 2. The annual SOH planning meeting begins with a debriefing of the pilot event. Both parolee and provider surveys are completed at the end of each SOH event and reviewed to make the needed changes. The upcoming calendar year is reviewed, 6 annual SOH dates/locations are chosen. The executive planning groups also schedules meetings 1 month prior to each SOH event to ensure all tasks are completed.
To increase the number of those recently released who know their HIV status and are being linked to care. Performance measures used to evaluate the practice: The program tracked the number of HIV individuals who were linked to care and number and risk level of individuals tested for HIV. The percentage of program participants who received HIV testing was also measured. The impact for the training for project partners is measured by changes in knowledge and attitudes. Data collection: Linkages to care were documented through confirmed enrollment at one of the eight HIV Care Connect Lead Agencies throughout the state. The number of HIV tests provided and risk assessments were documented through the submission of each test in the statewide database system, Provide. Participants in the training were given a pre-post test of knowledge and attitudes. Evaluation results: 394 HIV tests (78% of summit participants) 13 Linkages to HIV care Prior to this programming most partners were unaware of local HIV care services and did not understand HIV disease as a whole. Most were unable to comfortably discuss risk reduction measures. Since the training, our partners have a much greater understanding of HIV transmission, treatment options, risk reduction counseling and local service availability. Feedback: Partners reveal a greater understanding and comfort regarding HIV knowledge, HIV risk reduction and understanding options for linkage to HIV testing and care. To increase access to medical, dental, substance abuse treatment and other social services. Performance measures used to evaluate the practice: The program tracked program satisfaction and suggested improvements among parolees and community agencies. The program tracked the number of individuals who were provided referrals and services at each Summit of Hope. Data collection: Each parolee was given a satisfaction survey. Community agencies were asked to track services provided as well as respond to a satisfaction survey. Evaluation results: The following are comments from Parolee surveys: • “Truly appreciated, how polite, kind, and friendly everyone was.” • “We were not treated differently.” • “The heartfelt and non-judgmental attitudes, everyone helping one another.” • “The mock interviews really helped me brush up on things I had forgotten for an interview.” • “This gives hope to those that have lost all hope.” • “Although I received a lot of valuable information, I didn’t know that I would be at the event for 3 hours, and was almost late for work.” During the first year of the program, 515 parolees attended a Summit of Hope event and were provided health related services which included: 363 primary care/dental referrals, 227 substance abuse treatment service referrals, and 93 H1N1 vaccinations. In addition, parolees were provided assistance in getting a state-issued ID (183), connected to employment services (194), given training in job interviewing (63), provided life-skills training (233), enrolled in educational training (86), and registered with Child Support Services (75). Many other referrals such as for transportation services and faith-based referrals were also provided. The outcome of this project will be recognized through improved health and well-being of parolees. One measure of this is the recidivism rate of parolees. While it is too soon to determine all outcomes of this project, preliminary recidivism data reveal nearly a 40% reduction in return to prison by those parolees who have attended a Summit event. Feedback: These survey results are shared and discussed with the stakeholders, resulting in improvements such as sharing with the parolees (on their invitation letter) what to expect for the event, the length of the day, the services to be offered, and the types of documentation they may need to bring. We also made improvements such as staggering the invitation time slot for better crowd
This program has the commitment of key stakeholders such as corrections, parole, vocational training and faith based organizations, and the list just keeps growing. The primary partners of public health and department of correction have an extremely collaborative relationship that benefits both entities and largely meets each agency’s goals. The program has received a great deal of positive attention in Illinois from the media and the administration of state agencies. The program recently was invited to provide a presentation to the Lieutenant Governor and Secretary of State. Dozens of other social services agencies such as substance abuse treatment, employment, education, primary health care, dental care, child support, faith-based, affordable housing options, Secretary of State Drivers’ Services, numerous support/self help groups are active participants. These agencies recognize the Summit of Hope as an opportunity to reach a very high risk target audience. Each stakeholder brings their specific resource to the table and everyone, providers and parolees alike, benefit from the interaction. As this program continues to grow, we have an increased commitment and a growing interest of community partners. One community agency shared, “It’s all about public safety, if you can provide someone the tools to live on the right side of the law, you’ve increased the chance to reduce crime in your community while assisting the parolee to begin a successful life.” The needs of the “whole-person” are being met by eliminating the barriers that could keep the parolee from accessing services and making poor choices. In addition, time is set aside at each event for the participating agencies to network with each other in addition to providing services. This interaction has added significantly to how the agencies benefit from participation. The Summits have reduced the previously held stereotypes that all ex-offenders are bad people. The parolee surveys reveal the appreciation of being treated fairly and with respect at the events. Grant funding from the Illinois Department of Public Health has been available to this program for the past 3 years. Some of this funding was focused on developing the model and putting together a how-to manual. This work has already paid off, since this program has been replicated in 5 other locations throughout the state. Not all the replication sites have received funding, yet they have been able to have successful events. This has largely been due to a well-developed model and finding many community agencies that wish to become involved and are willing to bring their resources to the table. This replication success is a very good indicator of sustainability. The key ingredient to sustainability is that the Summit of Hope events help the participating community agencies to meet their mission and serve a very high risk population in a cost-efficient and effective manner. Agencies are not expending added time or staff; they are merely moving their services for one day, out to the target population at a different location. “It’s an absolute win-win event”, one provider reveals. “I enrolled 22 new clients today. That’s more that I see in an entire month.”
 
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