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OPERATIONALIZING THE TRANSNATIONAL FRAMEWORK: PARTICIPANTS, PROGRAMS & SYSTEMS
NYC Correctional Health Services
Alison O. Jordan LCSW Jacqueline Cruzado-‐Quinones Janet Wiersema, MPH Paul Teixeira, DrPH
Bronx Health & Housing Consortium 5th Annual Convening December 8, 2015
NYC CHS: INTEGRATING TRANSNATIONALISM
• Assessing transnationalism ▫ Participants, Programs and System
• Integrating transnationalism ▫ Participants, Programs and System
• Points of intervention ▫ Jail-based patients, Jail Health Providers, Community
network
• Fidelity documentation ▫ Participants and Training
RIKERS ISLAND
Manhattan Detention
Center
Brooklyn Detention Center
Vernon C. Bain Center, Bronx
Transitional Health Care Coordination
Twin Epidemics: Mass Incarceration & HIV
Correc&onal Health is Public Health
Over 70% of people released to the
community after incarceration return
to the areas of greatest
socioeconomic and health disparities
At A Glance
FaciliCes 12 jails: 9 on Rikers Island (1 female facility, 1 adolescent facility), 3 borough houses, public hospital inpaCent unit
Average Daily PopulaCon ~10,800 (2014)
Annual Admissions 60,000 (2014)
Community Releases* 60,000 / year
Length of Stay mean=37 days; median~7d
Return to Community ~78%
CORRECTIONAL HEALTH SERVICES
*Annual releases from NYC DOC Report of Discharges by zip code for CFY’14
JAIL DEMOGRAPHICS
We estimate that Puerto Ricans are 1/3 of Hispanic population.
TRANSNATIONALISM: PARTICIPANTS, PROGRAMS & SYSTEMS
• Transnational Checklist • Added specific ethnicity to RW assessment • EHR report reviewed weekly for recruitment • Air Bridge program integration • Curriculum Development / Partner training
TRANSNATIONAL CHECKLIST Key indicators: ▫ Ethnic identifier (e.g., Nuyorican, Boriqua, Puerto
Rican) ▫ Place of birth / childhood; Parent birth place ▫ Length of time in states? PR? ▫ Location of family / friends ▫ Air Bridge? ▫ Access to health care / services –states? PR? ▫ Finances - send /receive money from PR? ▫ Overall impact on healthcare / HIV care?
• Interested in PR-based services?
PROGRAM INTEGRATION
EHR RW Assessment includes specific ethnicity: • Informs study recruitment / enrollment • Discharge planning • QA / Integrity of Recruitment • Fidelity to service model / known denominator
http://en.wikipedia.org/wiki/File:PR_Migration_1995-2000.jpg
Deren et al. 2007 found:
HIV-infected Puerto Ricans seek care in NYC
62% of NY-based Puerto Ricans lived in PR
42% of PR-based lived in NYC
“Air Bridge”
If seeking return to PR: • Refer to One Stop Career Center of PR • Over 60 MOUs with other agencies to provide
health care and other support services Limited time? • Refer to Harlem United for enrollment and services
TRANSNATIONAL CHECKLIST: PROGRAM
Arecibo HIV Care
CDT Hormigueros PrevenCve Medicine Inc.
Corporacion Fondita de Jesus
COSSMA, Inc.
Corporacion SANOS
IniciaCva Comunitaria de InvesCgacion, Inc.
Lucha Contra el SIDA, Inc.
Neo Med Center, Inc.
Pry Med Medical Center, Inc.
Puerto Rico Dept. of Health
Salud Integral de la Montana, Inc.
Associaconde Salude Primaria de Puerto Rico Caribbean Medical
Concilio de Salud Integral de Loiza ,Inc
Hospital University of Puerto Rico
Other FQACs
One Stop Career Center locaCons
SYSTEM INTEGRATION OF TRANSNATIONALISM:
• Worked with NYU Center for Latino Adolescent and Family Health (CLAFH) to develop curriculum using: ▫ HRSA / ETAC materials ▫ Transnationalism checklist ▫ ETAC / UPR webinars
• Curriculum includes transnationalism concepts administered in two setting and in three formats: ▫ Jail- and community- based training ▫ 3 training formats: 1) doctors and clinical staff, 2) mid-
level staff, 3) support staff
TRAINING ATTENDANCE (to date) Training Location
Grand Rounds
Mid-Level (Half day)
Case Mgt (Full Day)
Total
Rikers 73 42 105 220 Bronx TBD 19 47 66 Citywide Coming Soon! Total (to date) 73 61 152 286
Selected Slides from Provider Training:
Thank you!
Alison O. Jordan, Principal Investigator [email protected] / 347-774-7170
Jackie Cruzado-Quinones, Project Manager [email protected] / 917-715-6841
Janet Wiersema, Project Director [email protected] / 347-774-8259
Paul Teixeira, Evaluator [email protected] / 646-962-9439