Florida jail opens community link to aid drug abusers, HIV-positive

The Broward County Sheriff's Department has forged an alliance with the County Health Department to help substance abusers and HIVpositive offenders and reduce costs.

The Florida program provides a continuum of care for offenders who had been shuffling in-and-out of the corrections system for

The Jail Release Linkage Project increases the likelihood that an offender will continue to receive health care outside the jail system, which keeps them from sliding back into old habits and reduces the prospect that they will commit a new crime.

The project enrolls offenders in a drug treatment program soon after release and provides job training.

For every success story, there are thousands of cases where this type of program is not available.

And in many places, the needed linkages between jails and outside communities simply do not exist.

Medical and substance abuse treatment in jails, like prisons, varies from institution to institution, ranging from very good to abysmal.

"There are about 3,300 jails in this country and each one is autonomous," says John Miles, Special Projects Manager for Corrections at the Centers for Disease Control and Prevention (CDC).

"You are not dealing with one system."

Jails, though, present their own unique barriers and challenges because inmates are held for short periods of time.

Jails hold about 650,000 offenders at any one time and as many as 22 million people cycle in and out of jails on a yearly basis, according to some estimates.

"The biggest problem for jails is continuity," Miles says. "A jail could do all the right thing&Ai&'_ three days later the person is gone and there is no mechanism established to follow that individual. Certainly, it is not the jail's responsibility.

Jails also represent "an inevitable break in therapy for many people with HIV," one analyst points out. "Many people spend a few days to a week in jail-just long enough for patients with HIV to develop resistance to their medications if they are unable to take their medications or if they are not given their therapies on time. They are then released back into the community with viral resistance - it is a huge problem."

The high prevalence rate of HIV/AIDS and other co-morbid conditions among offenders has pushed correctional health care to the forefront of the public health system, forcing institutions to serve as de facto_ hospitals and mental health institutions for poor, disadvantaged populations. It is a role that prisons-and particularly jails-are ill equipped to fulfill.

The Jail Release Linkage Project in Ft. Lauderdale is a collaborative effort between the Broward County Sheriff's Office, the Broward County Health Department and Emergency Medical Service Associates (EMSA), the health providar for the jail, which was recently purchased by Prison Health Services (PHS), another correctional health care provider.

When the project began in 1997, the three entities signed a collaborative agreement, spelling out the responsibilities of each organiution in providing continuity of care for HIV-infected offenders both inside and outside of the Broward County Jail system.

Since its inception, the project has connected more than 600 offenders to services on the outside, providing a bridge between the jail and services in the community.

More than 80 percent of HIV positive inmates are now linked to care and treatment as a result of the Jail Release Linkage Project, says Lisa Agate, Director of the AIDS Program at the Broward County Health Department.-James Arvantes.

James Arvantes is editor of Positive Populations in Prisons. For more details on the program call 202-662-7035.