Ryan White 2012 Grantee Meeting

New York City (NYC) jails are at the epicenter of an epidemic that overwhelmingly affects black and Hispanic men and offers a significant opportunity for public health intervention. The NYC Department of Health and Mental Hygiene, the Health Authority in the NYC jail system, instituted a program to identify the HIV-infected, initiate transitional care coordination services within 48 hours of jail admission, and facilitate linkages to primary care in the community. Trained health professionals provide transitional care coordination services using a caring and supportive, 'warm transitions' approach. Post-release, access to care is facilitated with an aftercare letter, discharge kit including condoms and medication, and accompaniment and transportation as needed. Linkages to primary care may be the right first step to facilitate continuity of care for people with HIV returning home from jail and the public health of the community to which they return. Program outcomes will be highlighted

Learning Objectives:

• Participants will be able to identify five strategies to facilitating access to care for hard-to-serve populations.
• Participants will be able to implement a 'warm transitions' approach to working with hard-to-serve populations including criminal justice involved, and housing insecure persons with substance use disorders.
• The process of integrating care coordination with primary care services to improve medication adherence and continuity of care will be discussed.