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Asilomar Corrections Update

Asilomar Corrections Update. Tulsky, Teague and Cast of Dozens. Obstruction of justice sentence spawned prison cell housekeeping. “We’re fascinated by her because she only spent 3 weeks in jail which none of us have managed to do” …Man on the street in Washington, DC.

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Asilomar Corrections Update

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  1. Asilomar Corrections Update Tulsky, Teague and Cast of Dozens

  2. Obstruction of justice sentence spawned prison cell housekeeping

  3. “We’re fascinated by her because she only spent 3 weeks in jail which none of us have managed to do” …Man on the street in Washington, DC

  4. Prisons and Jails in the US :The Other Developing World • Rise in incarcerated population 2.25M 6/06 • HIV infected – 20K plus known w/ estimates of another 25% not reporting or unknown • Mandatory HIV testing on entry – 19 states (3 on exit, including Nevada), but set to change soon • Hot topics are HIV prevention, testing, specialist vs generalist care, addiction RX

  5. Corrections 101: Roadmap • Jails – County and City facilities • State Prisons – One or many usually in state that supports them • Federal Prisons - Distinct and around the country

  6. Corrections 101: Roadmap • Immigration C E (ICE)- Federally run throughout the country • Juvenile facilities (by age w/ some exceptions) – Separate county (juvy hall) and state facilities

  7. Whose in Charge of the Road? • California Department of Corrections and Rehabilitation (CDCR) – After losing multiple court cases around health care, lost control of health care completely 12/05 • Federal Receiver – Robert Sillen’s company Correctional P R . Exclusive control of all health related contracts and personnel • University of California – San Diego and San Francisco with large subcontracts for evaluation of clinicians (SD) and evaluation and support of inmate care (SF)

  8. Whose in Charge of the Road? • Other States • Is your health care run by for profit, not for profit or government programs ? • What outside partners are going in? – • Local health departments always involved around syphilis, active TB and infectious diseases • What community partners are going in? – • Some prisons and jails with “community partnership” programs for health and inmates

  9. Roadmap Leading Out • Parole – Criminal justice monitoring after prison release, usually added on to total time. Requires release to county of conviction, not necessarily home base • Probation – Monitoring on release from local jail, shorter periods and may count as part of punishment

  10. Roadmap Leading Out • Transitional Case Management Program (TCMP) – HIV medical discharge planning and community support often contracted out by the Dept of Corrections to local health agencies

  11. TCMP-HIV LPS Centerforce – Bay area counties Northern CA Kern County Department of Public Health Riverside County Health Services Agency Mental Health Outreach Program and Association with Drew University .

  12. TCMP-HIV LPS University of California, San Diego San Joaquin County Public Health Services San Luis Obispo County Public Health Dept Sierra Foothill AIDS Foundation .

  13. Corrections 101: Access Tips Accessing Staff for Educational Efforts • Pharma Leads the Way • Dinner meetings • CME for educational sessions • Network in those venues • Ask Corrections Staff to be Educators • Would they talk to community clinics where inmates receive care after release? • Teach medical and nursing student about correctional health ?

  14. Corrections 101: Access Tips • Find the Nurses! • Nurses and NP/PAs often key care givers (Ex: calls to the HIV warmline) • Nurses have large variety of jobs in correctional setting and are in general the most amenable in professional development, CMEs and networking

  15. Corrections 101: • Be patient, empathetic, persistent • Getting inside (or getting them outside) is all about building relationships • Pass on the work to AETC partners (ex USC, Oregon, Nevada) • They may not know they need you, but they need you

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