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CLINICAL TRAINING FOR CORRECTIONS PERSONNEL. ESTELITA M. QUIMOSING, M.D. DAETC – ARKANSAS Associate Professor of Medicine, UAMS Clinical Director, Jefferson Comprehensive Care System, Inc. Objectives. To describe the clinical training for corrections personnel.
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CLINICAL TRAINING FOR CORRECTIONS PERSONNEL ESTELITA M. QUIMOSING, M.D. DAETC – ARKANSAS Associate Professor of Medicine, UAMS Clinical Director, Jefferson Comprehensive Care System, Inc.
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 ADC Levels of Training HIV-AIDS in the Prison HIV Screening in ADC Privacy and Confidentiality Linkage to Services Discharge Planning Summary
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.
In-patient and Out-patient clinics How To Get There
The Club’s Lovely Landscape Dashboard view
The Triad Watch Tower Shackled Men in Uniform Barbed-Wire Fence
Diagnostic Unit: In-patient and Out-patient Clinics
JCCSI HIV Nurse and Discharge Planner
Security and Confidentiality in the Clinic • 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 ADC HIV Nurse and Security Officers Inmates in the Waiting Area
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.
Levels of Training • Level I: Lecture • Level 2: Skills building • Level 3: Case discussion • Level 4: Clinical Consultation Active Learner Trainer Trainer Patient Trainer Active Learner
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 HIV - AIDS Total Inmate Population
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
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 Discharge Planning in Arkansas • Referral to RWCA-funded HIV clinics • Provision of HAART x 30 days
Release Notification Form 1) Inmate’s Demographic 2) Date of Release 3) Date of HIV+ test 4) Medication list 5) Parole Officer 6) Release of Info
Instruction to Inmate When going to first appointment Picture ID Release form for verification of residency and income Verification of HIV Status Copy of your most recent lab work List of current HIV medications SIGN A RELEASE OF INFORMATION Ann Teer ADC Disease Intervention Specialist, HIV Program 6814 Princeton Pike, P.O. Box 8707 Pine Bluff, AR 71602 Office: 870-267-6789 or 870-247-4791 Ext. 6249 Fax: 870-267-6243 Ann.teer@arkansas.gov
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.
Oh Freedom!
