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 5 th 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 Vernon C. Bain Center, Bronx Brooklyn Detentio n Center Manhattan Detention Center 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
CORRECTIONAL HEALTH SERVICES FaciliCes At A Glance 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* Length of Stay 60,000 / year mean=37 days; median~7d Return to Community ~78% *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
Air Bridge 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 http://en.wikipedia.org/wiki/file:pr_migration_1995-2000.jpg
TRANSNATIONAL CHECKLIST: PROGRAM 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
One Stop Career Center locacons Arecibo Neo Med HIV Center, Care Inc. Lucha Contra el SIDA, Inc. CDT Hormigueros PrevenCve Medicine Pry Med Medical Center, Inc. Puerto Rico Dept. of Health COSSMA, Inc. Inc. Associaconde Salude Primaria de Puerto Rico Corporacion Fondita de Jesus Corporacion SANOS Salud Integral de la Montana, Inc. Concilio de Salud Integral de Loiza,Inc IniciaCva Comunitaria de InvesCgacion, Inc. Caribbean Medical Hospital University of Puerto Rico Other FQACs
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) midlevel 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 ajordan@nychhc.org / 347-774-7170 Jackie Cruzado-Quinones, Project Manager jcruzado@nychhc.org / 917-715-6841 Janet Wiersema, Project Director jwiersema1@nychhc.org / 347-774-8259 Paul Teixeira, Evaluator pat2007@med.cornell.edu / 646-962-9439