Overview and Inventory of HHS Efforts to Assist Incarcerated and Reentering Individuals and their Families . Special Projects of National Significance (SPNS) Program Grants: Enhancing Linkages to Primary Care and Services in Jail Settings Demonstration Models (FY 2007 — FY 2010)


Funding Mechanism: Grant (Demonstration Sites); Cooperative Agreement (Evaluation and Support Center)

Total Available Funding: $4.55 million

Number of Awards: 11

Average Award Amount per Year: $400,000 (10 Demonstration Sites); $550,000 (1 Evaluation and Support Center)

Length of Project Period: 4years; September 1, 2007 — August 31, 2011

Federal Partners: None

Summary: The SPNS Enhancing Linkages to HIV Primary Care and Services in Jail Settings Initiative is a multi-site demonstration and evaluation of HIV service delivery interventions coordinated by Emory University, the evaluation and support center selected for this initiative.

This initiative funds 10 demonstration sites to design, implement and evaluate innovative methods for linking persons living with HIV/AIDS who are in jail settings or have been recently released from local jail facilities to primary medical care and ancillary services. Interventions include flexible and suitable case management strategies that promote durable linkages and follow up as the person moves between jail and the community. The study design assesses the effectiveness of the selected model(s) in identifying HIV positive persons in jail settings and providing linkages to HIV primary care services upon release and integrating services for releases within the community's HIV continuum of care.

Background: Correctional systems have an opportunity to provide coordinated prevention and treatment interventions for infectious diseases in concert with local public health officials. Individuals who are disproportionately affected by high rates of infectious diseases and adverse social conditions often cycle through jail and prison systems for various offenses, including drug related and sex offenses. Both behaviors place individuals at risk for contracting HIV disease. It is estimated that over one-quarter of all HIV-infected individuals in the U.S. pass through the correctional system each year. Many people released from jails have serious, unmanaged infectious diseases and mental illnesses. Public health and safety could be improved through greater collaboration among correctional facilities, public health agencies, and community-based organizations. Ideally, the interventions are initiated with inmates and coordinated upon their release to the community.

Grantees: AID Atlanta, Inc. (Atlanta, GA), Care Alliance Health Center (Cleveland, OH), AIDS Care Group (Chester, PA), Yale University AIDS Program (Hartford, CT), University of Chicago School of Public Health (IL), Baystate Medical Center, Inc. (Springfield, MA), University of South Carolina Research Foundation (Charleston, SC), Philadelphia FIGHT (PA) New York City Department of Health and Mental Hygiene (New York, NY), Miriam Hospital (Providence, RI) and Emory University Evaluation and Support Center (Atlanta, GA)

Evaluation Activities: A multi-site evaluation is coordinated by Emory University, Rollins School of Public Health, under cooperative agreement awarded by the HIV/AIDS Bureau. The evaluation will assess the effectiveness of the selected models in providing appropriate health services to the target population, in integrating those services within the community’s HIV continuum of care, and in maximizing reimbursement for health care services, when available.

Future Prospects: A manual titled “Jail: Time for Testing” will be released August 2010. The purpose of this guide is to provide point-of-reference guidance for persons working within agencies involved with the criminal justice system, public health departments, or AIDS service organizations to assist them in implementation of an opt-out HIV testing program in a jail setting. This guide will discuss the benefits and challenges of instituting an expanded HIV testing program. For persons working in correctional settings, it will discuss the merits of collaborating with outside agencies. For outside personnel, it will focus on the essentials for getting your foot in the door to effectively partner with the criminal justice system.


Adan Cajina
Chief, Demonstration and Evaluation Branch 
Phone: 301-443-3180
E-mail: ACajina@hrsa.gov

Additional information can be found at www.enhancelink.org.

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