Correctional Healthcare in New Jersey AN OVERVIEW

1. Correctional Healthcare in New JerseyAN OVERVIEW

2. New Jersey Epidemiology • New Jersey has the third highest number of HIV/AIDS cases in correctional facilities in the Northeast (following NYS and Pennsylvania). • There are 612 inmates in state or federal prison reported to be positive for HIV/AIDS. Bureau of Justice Statistics, Sept. 2007

3. New Jersey Department of Corrections • 14 state-operated correctional facilities including: -Eight adult male correctional facilities -Three youth facilities -One facility for sex offenders -One women's correctional institution -One central reception/intake unit • There is also a Stabilization and Reintegration Program. • These facilities collectively house approximately 23,000 inmates in minimum, medium and maximum security levels.

4. New Jersey Department of Corrections (con’t) • Adult Diagnostic and Treatment Center • A. C. Wagner Youth Correctional Facility • Bayside State Prison • Central Reception and Assignment Facility • East Jersey State Prison • Edna Mahan Correctional Facility for Women • Garden State Youth Correctional Facility • Mid-State Correctional Facility • Mountainview Youth Correctional Facility • New Jersey State Prison • Northern State Prison • Riverfront State Prison • Southern State Correctional Facility • South Woods State Prison

5. New Jersey Department of Corrections (con’t) • Time of transition: Effective fall 2008, Correctional Medical Service’s contract ended with the New Jersey Department of Corrections (NJ DOCS). • University Correctional Health Care under University Behavioral Health Care (part of UMDNJ) was awarded the contract.

6. Health Care and Corrections • The following is a brief review of HIV-related services offered in the NJ DOCS. -Prevention Activities -Clinical Staff Education -HIV Testing -Medication Administration -HIV Care Delivery -Transitional Planning

7. Prevention Activities • General education regarding HIV prevention is provided to inmates in the NJ DOCS. • Condom distribution is not permitted as a prevention measure within the county jails or state facilities in New Jersey. • Condoms are considered contraband. In addition, sex within these facilities is prohibited.

8. Clinical Staff Education • Albany Medical College (AMC) is the HIV Correctional Regional Resource Center under the New York/New Jersey AIDS Education & Training Center (NY/NJ AETC).  • AMC collaborates with various AETC sites in New Jersey to deliver HIV clinical education and clinical mentoring for correctional providers in New Jersey (ID CARE, Garden State Infectious Disease Associates and UMDNJ).

9. HIV Testing Policies • The NJ DOCS has voluntary HIV testing. • Testing is performed by the NJ DOCS medical unit staff. • All inmates are offered an HIV test upon entry (“universal HIV testing”) but this is not mandatory. • No written informed consent.

10. HIV Testing Policies (con’t) • If an inmate declines an HIV test, he/she is asked to fill out a refusal form. • The inmate can request to be tested in the future. At that time, he/she must sign a consent form.

11. Medication Policies • In the NJ DOCS, HIV medications are administered using a combination of the Keep on Person (KOP) or Directly Observed Therapy (DOT) systems. • This is patient specific (e.g. degree of adherence). • This also varies by facility. • HIV medications that are liquid formulations or are injectable typically require the inmate to come to the medical unit.

12. HIV Care Delivery Like NYS, many correctional physicians in NJ have primary care backgrounds or specialty backgrounds with limited formal training in HIV medicine. NJ DOCS clinicians have the opportunity to consult with HIV specialists through the following sources: (1) NJDOCS Infectious Disease Physician (this provider covers facilities in Northern and Central NJ) (2) Cooper University (facilities in Southern NJ including Bayside, Riverfront, Southern State and Southwoods Correctional Facilities) (3) AIDS Education and Training Center

13. HIV Care Delivery • Inmates have access to all of the FDA-approved medications in the NJ DOCS. • As a result, there has been a rapid decrease in HIV-related deaths.

14. Transitional Planning • The NJ DOCS has an Office of Transitional Services. • Each facility has a discharge planner for all inmates exiting the system to ensure community linkages for aftercare and clinical services. This is for all inmates regardless of their HIV status. • Aftercare services include referrals, appointment scheduling, special housing arrangements or other identified needs specific to the inmate. • Inmates get a 14-day supply of all medications when they leave the NJ DOCS, including HIV treatment

15. New York and New Jersey AETC Correctional Education Contacts Center for Continuing and Outreach EducationUniversity of Medicine & Dentistry of New Jersey30 Bergen Street, ADMC 710P.O. Box 1709, Newark, NJ 07101Newark, NJ 07101http://ccoe.umdnj.edu/catalog/aids/index.htm Curtis Harris, MPADirector, Division of AIDS EducationPhone: 973-972-6325Fax: 973-972-3371harriscu@umdnj.edu Albany Medical College Division of HIV Medicine HIV Correctional Regional Resource Center 47 New Scotland Avenue, MC-158 Albany, NY 12208 http://www.amc.edu/Patient/services/HIV/Correctional.html Sarah J. Walker, MS Associate Director of HIV Correctional Education 518-262-4674 walkers@mail.amc.edu ID Care105 Raidar Boulevard, Suite 101Hillsborough, NJ 08844 Debbie M. Winters, APRN-BC, AACRNCoordinator 908-788-6045winter_dm@yahoo.com Garden State Infectious Disease Association709 Haddonfield-Berlin RoadVoorhees, NJ 08043 Kelly Rand, MACoordinator856-805-0002krand@gsida.org