The Florida Department of Health (DOH), Bureau of HIV/AIDS, has made a concerted effort for many years to implement programs in prisons and jails to assist HIV-infected inmates prepare for the return to their local communities. More than 95% of incarcerated men and women will eventually return to their communities, so it’s important that we provide HIV-infected inmates with interventions that will help them reenter society with optimal health and a clear understanding of how to avoid passing the virus to others.
Estimates are that the rates of HIV/AIDS in correctional facilities are three to five times higher than in the general population and approximately 15 to 40 percent of inmates are hepatitis C infected. Therefore, many of these programs also have a counseling and testing component, not only for HIV, but for sexually transmitted diseases (syphilis, gonorrhea, and chlamydia) and hepatitis B and C.
II. Differences Between Prisons and Jails
There are common misconceptions about the nature of jails and prisons; often the terms are used interchangeably.
Funded and operated by the Department of Corrections (DC)
Have an average length of stay between three and five years
Are mandated to provide a level of care commensurate with community standards
Have a less transitional population than jails
Are mandated to test each inmate for HIV within 60 days of release
Are operated and funded by local county governments, often the local Sheriff’s Office
Have an average length of stay of 23 - 46 days
House inmates for not more than a year (if sentence is longer, the inmate is transferred to a DC prison)
Are not required to test inmates, unless they have been convicted of a sex-related crime
Approximately 50% of inmates are released within 48 hours
The Florida Legislature funds DC to house, feed and provide health care to its inmates, while jails rely solely on their local government for operating funds. The quality and amount of health care and support services vary from jail to jail. Some smaller, rural county governments are not able to provide more than the basic services, while the larger county jails may provide expanded services.
III. Florida DOH Corrections Programs
The following is a description of the various programs that the DOH is currently funding to provide support services to HIV-infected inmates:
Pre-Release Planning Program (PRPP)
The DOH currently contracts with the DC to provide pre-release planning services to HIV-infected inmates preparing to return to their communities. The PRPP includes all correctional facilities and some transitional programs, such as work camps. Funded through Ryan White Title II, the PRPP is responsible for offering pre-release services to all known HIV-infected prisoners in Florida Department of Corrections facilities. The DC employs five pre-release planners who are divided among four regions in the state to effectively reach and serve all inmates prior to release. The pre-release planners provide services directly to the inmate within six months of their end-of-sentence date to determine the community to which the inmate is returning and what type of services he/she will need. The pre-release planner will contact at least one to two social service agencies or medical providers to connect the client to the care system prior to their release. Upon an HIV-infected inmates’ release from a DC facility, they are given a copy of their medical records (if requested) and a 30-day supply of medication. Pre-release planners will follow up with the ex-offender and/or provider after one month to determine if the initial medical or social service appointment was kept. Beginning in November 2007 the PRPP added a community linkage coordinator to the program to assist inmates returning to the Miami-Dade and Broward area with transitional services. The Miami-Dade and Broward counties receive 33% of the HIV-infected inmates back to their community, highlighting the need for additional linkage services.
In 2006, approximately 66,780 inmates were tested for HIV in Department of Corrections facilities and 1,185 (1.77%) were found to be HIV infected. The PRPP served 1,151 inmates in 2006 and reported that 72% of the inmates receiving pre-release planning services kept their initial medical or social service appointment.
Jail Linkage Programs
The DOH currently funds 16 county health departments to implement transitional services in their local jails. The jail linkage programs are located in Alachua, Broward, Collier, Duval, Gadsden, Hillsborough, Lee, Manatee, Miami-Dade, Orange, Palm Beach, Pasco, Pinellas, Polk, St. Lucie, and Volusia counties, with an additional unfunded program Monroe County. These programs include: counseling and testing for HIV/AIDS, Tuberculosis, hepatitis, and STDs; prevention education; pre-release planning for inmates; and follow up services to ensure the releasees are still in care in their respective counties. Jail linkage staff often provides STD education sessions with inmates followed by voluntary HIV testing.
IV. Legislative Changes
Legislation passed in 2002 requires that all inmates are tested for HIV/AIDS prior to release from the DC prison system. It is unknown what impact this additional testing will have on support services in local communities. Of the estimated 90,000 inmates in Florida’s prison system, about 3,000 inmates are known to have HIV/AIDS. Some of the inmates enter prison with documented HIV/AIDS and others are tested while incarcerated. According to the Department of Corrections, about 100 HIV-positive inmates leave Florida’s prisons each month. The Pre-Release Planning Program provides five release planners to assist these men and women in preparing for release back to their communities by advocating services for them, including making appointments with county health departments for medical care and AIDS Drug Assistance Program services, and for case management services from local agencies.
If you are interested in additional information, call Kelly Browne at (850) 245-4444, extension 2611.