ATLAS Program: HIV testing and linkage in the Cuyahoga County Corrections center

1. ATLAS Program: HIV testing and linkage in the Cuyahoga County Corrections center Rachel Ciomcia, LISW-Project Coordinator Jenice Contreras, Director of Development

2. Care Alliance: Overview • Federally Qualified Health Center (FQHC) • Primary populations: • Homeless • Public Housing • HIV/AIDS • Uninsured/Underinsured • Services: • Primary Health Care for All Ages • Comprehensive Dental Care • Substance Abuse & Mental Health Counseling • Confidential HIV Testing, Treatment & Counseling  • 2007: 7,500 Patients through over 25,000 Encounters

3. SPNS Grant: From Application to Award • Current status of HIV Testing in the jail setting • Established relationship/collaborations • Increased testing opportunities

4. Cuyahoga County Corrections Center • CCCC holds about 1900 total inmates and is near capacity daily • About 80-100 bookings per day; Also release about 80-100 inmates per day • Holds all types of cases from misdemeanors to murder • Many waiting for trial or will be moved to state prison, some do serve out a sentence here • Male and female inmates (about 200-300 female inmates on average) • On any given day, there are 20-30 known HIV positive inmates in the general population (self-reported upon intake) • HIV care is referred out to the community; however jail medical staff does manage medication regimens and daily needs

5. ATLAS Program • Assess, Test, Link: Achieve Success • Program consists of HIV testing and linkage to care through case management • HIV Testing • HIV testing offered Monday thru Friday, 8:30am-12pm during the men’s health assessment and to all general intake pods • Rapid Test-10 minute processing time • Post test counseling occurs with each inmate, also-inmates will be approached to complete a survey of HIV knowledge and risky behaviors • Positive tests are referred to the Corrections medical staff for a blood draw to run a Western-blot for confirmation, also referred to linkage program • Goal is to test 200 inmates per month-meeting goal at this time • Currently completing about 10-15 tests per day, averaging about 10-20% acceptance rate from total population offered test per day • At this time, working on program for the female population-harder to access

6. ATLAS Program • Linkage to Care • Once an inmate is identified as HIV Positive, a referral to ATLAS Interventionist is made • Interventionist will meet with each inmate individually to discuss program-if inmate agrees to participate then an intake is completed, which includes baseline assessment. • Based on assessment during intake, a release plan is created. All referrals for medical care and needed community services are coordinated. Ongoing, regular contact occurs while inmate incarcerated to address all needs as they arise during stay. • Once inmate released, Interventionist will meet with inmate at regular follow up periods for one year post release for assessment of inmate’s retention and perception of care. • Will also incorporate multi-site evaluation

7. Special Considerations • Working in corrections environment raises special considerations • Confidentiality • Release planning with unknown release dates • Providing information/documentation to inmates • Work space • Medications • Effects of Corrections Officers on participation • Networking with the community