CT Department of Correction Colleen Gallagher, MA, CCHP

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1 CT Department of Correction Colleen Gallagher, MA, CCHP Correctional Managed Healthcare/ UCONN Health Center Cindy Letavec, RN,BSN, CCHP Candace Pettigrew, RN,BSN

2 Program Value, Revitalization and Workforce Development

3 In Memory of Wanda White - Lewis CTDOC Health Services Program Director Founder of the Connecticut Inmate Certified Nurse Assistant Program

4 The Department of Correction provides comprehensive health care to the offender population that meets a community standard of care, and includes medical, mental health, dental, addiction and ancillary services, in compliance with applicable state and federal laws and consent decrees. This spectrum of health care is carried out through a partnership the Department has established with the services of the University of Connecticut, Correctional Managed Health Care

5 Correctional Managed Health Care Vision Correctional Managed Health Care will become a national leader in correctional health care in collaboration with the Connecticut Department of Correction and UConn Health. Mission Correctional Managed Health Care shall provide compassionate and clinically appropriate health care to inmates within the CDOC correctional facilities and halfway houses. Our services shall be resource-sensitive and promote a safe, secure and healthy environment that supports successful re-integration into the community. Values Clinical and organizational excellence Respectful and supportive work environment Professionalism, compassion, innovation and diversity Integrity, teamwork and trust Education, research and continuous improvement of services

6 Workforce Development Sustaining a Certified Nursing Assistant (CNA) Inmate Worker Program allows for cost effective resources to supplement and improve the inmate patient experience while providing viable job skills.

7 CNA Program History First class October 2006 A vocational job within the institution The program, oversight and the Instructional facilities have to be approved by the CT Department of Public Health. To date 5 facilities have been approved. York, Bridgeport, MacDougall, Osborn and Corrigan CNA s are supervised by staff nurses in the infirmary at all times. CNA s are able to provide bedside care and ADL assistance Each CNA must sign a confidentiality statement A coordinator oversees the applications, interviews and communication

8 CNA Program History All inmates must apply to be in the program, strict criteria, interviews The program consists of 70 hours of classroom training and 120 hours of clinical training Every inmate has a nurse preceptor when they are performing their clinical training This is a program that is very popular. We receive many applications from inmates to become part of the program Two major areas are addressed with this program. A good job while in prison and assistance in finding a job after discharge Students are very enthusiastic, very eager to learn A range of short and long term inmates

9 THE PROGRAM Valued Program Collaborative Effort Program Revitalization

10 Program Value Supplemental care resource Aging population and complex care Additional resource for nursing Measuring effectiveness Inmate workforce development Popular inmate worker program Viable job skills for discharge Nursing workforce development Stakeholders in program/candidate success Professional development

11 Program Value As health care demands continue to rise, it is essential to continually evaluate the effectiveness of health care provided while delivering cost effective care which is safe and results in quality outcomes. The Inmate Worker CNA Training Program affords the medical units additional support with hands on care. This added workforce resource is of value with the ever growing population of elderly inmates and those with complex medical issues. The program presents the opportunity to enhance the inmate patient care experience and provides staff assistance with hands on care. CMHC medical units constantly strive to improve the delivery of healthcare to our patient s.

12 Nursing Workforce Development The Program provides: Nurses as stakeholders in this supplemental resource for care provision to be involved in the training and development of CNA s. Opportunities for continued professional development as an Educator in the classroom and/or at the bedside. Program improvements included focusing on nursing workforce development with respect to their roles as Coordinators, Instructors and Preceptors.

13 Collaborative Effort The Collaborative: CT DOC and CMHC and CT DPH In 2014 the opportunity presented itself for CMHC to take on a greater responsibility with the program. All stakeholders recognized the need for review, revisions and updates and were engaged. Program review, revisions and updates were warranted with all facets of the program. Structured program improvement plan with tasks identified and designated.

14 A Collaborative Review Reviewed/Revised: Candidate Eligibility Criteria Recruiting Process Custody Post Orders CT Department of Public Health requirements Training Site Certification, Host Facilities, Support and Availability Training Program-curriculum and clinical skills practicum Training Program-development and enhancements Roles/Responsibilities - Nursing Supervisor, CNA Coordinator, Classroom Instructors and Clinical Preceptors Communication

15 Outcomes of the review New Criteria and Custody Review Custody Post Orders Reviewed/Revised Consolidated class Revised Manual and Forms New Manuals / Handbooks Technology Standardized Instruction Clinical and Classroom Inmate Oversight and Supervision Coordinator Custody Requirements Meetings

16 Processing the Applicants Identify statewide need Post recruitment flyers Inmates fill out application Initial screening /selection of applicants (criteria)

17 Processing the Applicants CRITERIA Overall risk score of 4 or below Security risk group factor: 2 Escape Profile Factor: 3 or below High School/GED diploma Disciplinary Report free: Class A: 3 year Class B: 2 years Class C: 6 months Substance Abuse Treatment Needs Score: <4 (Or case by case basis as recommended) No assault 10 years No assault on age 65 or over per State Law Mental Health score of 3 or below Submit to a random drug screening Must have a minimum of 2 year sentence Sex offenders score of 2 or below (Or case by case basis as recommended) The final candidate s chosen are decided by the Nursing Supervisor, Facility Administration, CNA Coordinator and Program Director, and cannot be challenged.

18 Processing the Applicants Candidate Interviews / Selection Candidate Training Offered Classroom Instruction Clinical Component Final Exam State Registration Placed in position

19 Raising the Bar Expanding the accountability for staff, custody, inmates Education Nursing Custody Inmates Training Program for Inmate Population Technology Power points Schedule Evaluation

20 Coordinators Role Significant Role Oversees the CNA Program within the institution Liaison between custody and medical staff Reports and manages infractions of program Attends statewide quarterly workshop Prepares schedules Organizes in-services for inmate CNA s Completes performance evaluations Address any issues or concerns of the CNA verbally or in writing

21 Statistics Class # had 16 graduates 9 classes to date Over 65 Inmates have been trained to date 5 facilities have hosted training 3 released inmates have secured jobs Cross over from Hospice volunteer to CNA certified

22 Roadblocks / Barriers Custody Control Issues Getting a Job Competing programs Space for teaching Resources Boundaries Unions

23 NCCHC Standards Non Compliance P-C-06 Inmate Workers Trained inmate workers have job duties in designated infirmaries, certified through a state-approved nursing assistant program. Inmates should not make treatment decisions or provide patient care and they should not be substitutes for regular program staff. Inmates may assist other inmate in activities of daily living in regular housing units only, not in an infirmary setting.

24 Boundaries / Teams Caregivers Nursing Team Nursing boundaries Perception Custody

25 Inside / Outside Community Standards Do s and Don'ts inside Difference for instructors Application process Difference for supervisors Clinical Custody

26 Discharge Community Planning Job Development Still in progress Career Centers Letters Personal Care Attendance Community connections Inmate success

27 NURSING HOME SURVEY Regarding hiring of ex-offenders 35 agencies surveyed: 11 would not hire ex-offenders 14 no response 12 would hire ex-offenders 6 only misdemeanors, no felonies 2 yes for hiring felons 4 case by case basis

28 Sustaining Identified places Updating criteria Input from the field Routine Funding Resources Community DPH Registration Certification Support

29 Around the Country What s happening by you?

30 UCONN HEALTH TEAM AWARD