Name of OMH Grant Program: HIV/AIDS Health Improvement for Re-entering Ex-offenders Initiative (HIRE)
Initial Year of Funding: 2009
Project Period (Number of Years): 3
- Grantee Organization Name: Housing Works, Inc.
- Organization Address (Street, City, State, Zip): 57 Willoughby Street, Brooklyn, NY 11201
- Organization Website URL (if any): www.housingworks.org
- Brief Description of the Organization: Housing Works has extensive experience providing and coordinating health and social services for persons with histories of incarceration. They currently serve 2,000 individuals living with HIV/AIDS and their families annually.
GRANT PROJECT INFORMATION
- Title of Grant Project: The HIRE Program
- Amount of OMH Award: $250,000
- Name of Project Director: Radames Rios
BRIEF DESCRIPTION OF GRANT PROJECT
Upon release from prison, ex-offenders in NYC face challenging circumstances and instability, which can also increase their HIV risk or exacerbate their existing HIV-related conditions. This project targeted re-entering minorities (primarily African-Americans and Hispanics/Latinos) who were HIV-positive or at high risk of HIV infection, including men who have sex with men, individuals with substance use and/or mental health disorders, and women of color. The purpose of this project was to provide access to prevention and treatment services to re-entering minorities who are HIV-positive or at high risk of HIV infection by coordinating a seamless, comprehensive continuum of health, social, and support services for incarcerated individuals in pre-release and/or recently-released status, and by ensuring continuity and retention and successful resource linkage through extensive care coordination and follow-up services.
Housing Works and its partners provided discharge planning, case management, HIV testing, counseling and treatment adherence; referrals to substance abuse and mental health treatment; referrals to comprehensive healthcare services; referrals to job placement assistance programs; and referrals to housing assistance agencies. Program participants received immediate testing upon intake in the Housing Works comprehensive continuum of care.
It was anticipated that linkage to the continuum of care would increase access to available HIV-related services, provide participants with the appropriate resources and educational materials, and increase adherence to treatment. Performance measures included the number of clients who were connected to care or services, the number of clients who took their medications as prescribed, and the number of clients who had a source of ongoing care. In addition, the program hoped to have HIV-related services available to 100 percent of program participants at specified time intervals.
To evaluate the program, Housing Works conducted an evaluation incorporating quantitative and qualitative data collected from pre-discharge planning information on inmates; from pre-release medical reports of formerly incarcerated individuals, and from formerly incarcerated individuals who received intake services at Housing Works upon release Data was collected through surveys, case records, and clients’ self-reports. The evaluation content included both subjective and objective measures.
Key program findings reported throughout the grant period:
- HIV testing and counseling provided within one week post-release. All of the new program participants (669 people) received HIV testing at one of Housing Works’ primary care clinics within one week post-release.
- Linkage to appropriate care. All of the newly enrolled individuals were connected to the continuum of health, social, and support services provided (a total of 1,414 services).
- Increased utilization of services. After 6 months, 86.7 percent of the participants remained in care.
- Increased employment or stable housing. About 69 percent of program participants either obtained gainful employment or permanent housing.
RELATED 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.
- Leadership: Strengthen and broaden leadership for addressing health disparities at all levels.
- Health System and Life Experience: Improve health and healthcare outcomes for racial and ethnic minorities and for underserved populations and communities.
- Cultural and Linguistic Competency: Improve cultural and linguistic competency and the diversity of the health-related workforce.
- Data, Research, and Evaluation: Improve data availability and coordination, utilization, and diffusion of research and evaluation outcomes.
RELATED HEALTHY PEOPLE 2020 OBJECTIVES & SUBOBJECTIVES
- AHS-1.1 Increase the proportion of persons with medical insurance
- AHS-3 Increase the proportion of persons with a usual primary care provider
- AHS-5.3 Increase the proportion of adults aged 18 to 64 years who have a specific source of ongoing care
- AHS-5.4 Increase the proportion of adults aged 65 years and older who have a specific source of ongoing care
- AHS-6.1 Reduce the proportion of persons who are unable to obtain or delay in obtaining necessary medical care, dental care, or prescription medicines
- AHS-6.2 Reduce the proportion of persons who are unable to obtain or delay in obtaining necessary medical care
- AHS-6.3 Reduce the proportion of persons who are unable to obtain or delay in obtaining necessary dental care
- AHS-6.4 Reduce the proportion of persons who are unable to obtain or delay in obtaining necessary prescription medicines
- 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-8.2 Reduce new cases of perinatally acquired AIDS
- 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
- HIV-14.1 Increase the proportion of adolescents and adults who have been tested for HIV in the past 12 months
- HIV-14.3 Increase the proportion of pregnant women who have been tested for HIV in the past 12 months
- HIV-14.4 Increase the proportion of adolescents and young adults who have been tested for HIV in the past 12 months
- HIV-16 Increase the proportion of substance abuse treatment facilities that offer HIV/AIDS education, counseling, and support
- HIV-17.1 Increase the proportion of sexually active unmarried females aged 15 to 44 years who use condoms
- HIV-17.2 Increase the proportion of sexually active unmarried males aged 15 to 44 years who use condoms
- MHMD-4.2 Reduce the proportion of adults aged 18 years and older who experience major depressive episodes (MDEs)
- MHMD-5 Increase the proportion of primary care facilities that provide mental health treatment onsite or by paid referral
- MHMD-8 Increase the proportion of persons with serious mental illness (SMI) who are employed
- MHMD-9.1 Increase the proportion of adults aged 18 years and older with serious mental illness (SMI) who receive treatment
- MHMD-9.2 Increase the proportion of adults aged 18 years and older with major depressive episodes (MDEs) who receive treatment
- MHMD-10 Increase the proportion of persons with co-occurring substance abuse and mental disorders who receive treatment for both disorders
- MHMD-11.1 Increase the proportion of primary care physician office visits that screen adults aged 19 years and older for depression
- MHMD-12 Increase the proportion of homeless adults with mental health problems who receive mental health services