- Grantee Organization Name: Metropolitan Charities, Inc.
- Organization Address (Street, City, State, Zip):3170 3rd Ave. North, St. Petersburg, FL, 33713
- Organization website URL (if any): www.metrotampabay.org
- Brief Description of the Organization: Metropolitan Charities, Inc. was formed in 1984 to provide a variety of needed services to the HIV/AIDS community of Tampa Bay. The organization is one of the largest providers of HIV/AIDS services in West Central Florida, as well as in the state, serving approximately 3,000 clients at any one time.
Grant Project Information
- Title of Grant Project: Community Re-entry Health Improvement Program
- Amount of OMH Award: $250,000
- Name of Project Director: Priya Rajkumar
Brief Description of the Grant Project
The purpose of the Community Re-entry Health Improvement Program was to:
- Link and coordinate re-entrants with community HIV and re-entry services,
- Through case management, monitor referrals made to health services, mental health, substance abuse, and a number of community support services for African American and Hispanic/Latino re-entrants in West Central Florida (Hillsborough, Hernando, Pasco and Pinellas Counties), and
- Refer ex-offenders to emergency services such as shelter/transitional or permanent housing, food stamps, General Educational Develop (GED) preparation and testing, and job training.
The intended outcomes of this project were: 1) 80 percent of project participants that are HIV-positive (non-AIDS) will experience a decrease in viral load and an increase in CD4 counts; 2) 60 percent of project participants with AIDS will be alive at the end of the grant period; and 3) 90 percent of HIV-positive project participants will report satisfaction with health care linkage services.
The project provided HIV-positive and high-risk ex-offenders with links to a continuum of health and support services including: medical care, medication treatment, long-term case management, substance abuse treatment, mental health counseling, transportation, housing, and employment services. This was accomplished through a one-on-one intake interview, conducted by a trained linkage case manager using a standardized needs assessment tool (Comprehensive Needs Assessment Instrument) developed as part of the project. The linkage case manager served as a central point of coordination once the client was released. Once assessed, staff engaged clients in the development of a care plan, which included key actions to be followed, such as needed appointments for clinical care coordination, primary care, prescription assistance, HIV testing, mental health and/or substance abuse counseling, and other medical services. Another major element of the grantee's intervention was the provision of HIV/AIDS awareness training workshops. The training session focused on educating participants about risk behaviors that can lead to HIV infection, as well as how to take preventive measures to avoid infection.
An external, mixed-method evaluation focused on measuring change in clients' health outcomes, measured by lab results taken at multiple points in time. The evaluation also focused on tracking change in clients' knowledge and awareness of HIV/AIDS and avoidance of risky behaviors. The goal of all strategies funded under the OMH grant, including coordination, referral to, and monitoring of health services for the re-entering ex-offenders, was to support re-entrants in successfully transitioning back into the community and maintaining and improving their health status. As such, the project's primary measure of intervention effectiveness was adherence to treatment and continuity of care post-release as demonstrated by participants' decreasing viral loads, and avoidance of a progression from HIV to AIDS.
Key program findings reported throughout the grant period indicated:
- HIV/AIDS prevention education workshops improved clients' knowledge of HIV/AIDS transmission and risk behavior, and led to testing and knowledge of their serostatus. Analysis of pre/post scores of the HIRE Knowledge/Risk Behavior Survey showed that 89 percent of those who participated in the project's HIV/AIDS awareness education workshops increased their knowledge of HIV/AIDS transmission and risky behavior. In addition, over 1,007 clients received rapid HIV tests and results after completing the HIV/AIDS knowledge training, which exceeded the target set at the onset of the project.
- Linkage to primary care, support services, and access to medication within 30 days post-release enabled participants to continue HIV/AIDS care without interruption, or to start care if not previously diagnosed. Without immediate linkage to care, individuals can easily become lost to care, which leads to increased viral loads and poor health outcomes. Of the 326 HIV-positive ex-offenders who participated in the project, 81.1 percent produced lab results that show decreased or sustained undetectable viral loads. Additionally, a total of 326 participants were linked to care, and a total of 5,232 linkages/referrals to healthcare services were made over the life of the grant which exceeded the goal set at the start of the project. Ninety percent of HIV-positive ex-offenders who participated in the project were satisfied with health care linkage services.1 Finally, there were no cases of HIV-positive participants who did not adhere to treatment or whose HIV status progressed to AIDS.
- The AIDS Awareness Training Workshop developed under the grant has been adopted at the state level. The Florida Department of Corrections (FDOC) has incorporated the HIV prevention training delivered to participants prior to release into the existing 100-hour transition program mandated by the Florida Transitional Assistance Act of 1987. Also, the project is now included as a resource in a discharge planners' resource directory both for the FDOC and at the Federal Bureau of Prisons (FBOP). With this new referral resource, discharge planners now have a means for systematically coordinating the release of HIV-positive ex-offenders with primary care and other support services as re-entrants transition back into their communities.
Identified Best Practice
- Building effective partnerships. Key partnerships and ongoing communication with correctional facilities and government entities influenced additional adoption of the HIRE model at the community level. As mentioned previously, by actively engaging in relationships with the FDOC, Metropolitan Charities Inc., encouraged the FDOC to incorporate the HIRE HIV prevention training curricula into the existing 100-hour transition program mandated by the Florida Transitional Assistance Act of 1987. Furthermore, the HIRE project was included as a reference in the FDOC's Reentry Resource Guide, an important tool for FDOC discharge planners to consult when coordinating the release of ex-offenders. These accomplishments expanded the reach of the HIRE program.
National Partnership for Action to End Health Disparities Goals
- Awareness: Increase awareness of the significance of health disparities, their impact on the nation, and the actions necessary to improve health outcomes for racial, ethnic, and other disparities populations.
- Health System and Life Experience: Improve health and healthcare outcomes for racial and ethnic minorities and for underserved populations and communities.
Related Healthy People 2020 Objectives & Subobjectives
- HIV-3 Reduce the rate of HIV transmission among adolescents and adults
- HIV-4 Reduce new AIDS cases among adolescents and adults
- HIV-5 Reduce new AIDS cases among adolescent and adult heterosexuals
- HIV-6 Reduce new AIDS cases among adolescent and adult men who have sex with men
- HIV-7 Reduce new AIDS cases among adolescents and adults who inject drugs
- HIV-11 Increase the proportion of persons surviving more than 3 years after a diagnosis with AIDS
- HIV-12 Reduce deaths from HIV infection
- HIV-13 Increase the proportion of people living with HIV who know their serostatus
1. From September 2009 to August 2012, 133 clients completed the client satisfaction survey.