In today's economy we are all under a lot of stress to manage expenses, employment, health, and relationships. Imagine trying to do all those things as a black or Latino person, newly released from prison and with HIV/AIDS.
Fortunately, there are organizations that can help, and one such group is the New York-based Osborne Association (OA) whose HIV/AIDS Health Improvement for Re-Entering Ex-Offenders Initiative(HIRE) offers in-prison and community-based services to improve the health outcomes of inmates with HIV/AIDS who are reentering society.
The work is poignant but can make a social transition that much less difficult to make. "We are talking about individuals, some of whom have been in prison 10 or 15 years," said Gary Bartlett, deputy director of Treatment and Prevention Services at the Osborne Association. "Our staff goes into the Queensboro Correctional Facility in New York, and works with inmates that are soon to be released within 90 days of their state incarceration and we link these individuals up to services that are needed when they come home so that they are not caught up in the system."
Bartlett spoke at the Office of Minority Health's (OMH) conference on In-service Training, HIV/AIDS Health Improvement for Re-Entering Ex-Offenders Initiative (HIRE) during World AIDS Day, on December 1, 2011.
In 2009, the Association received a quarter of a million dollars from OMH to implement the HIRE program. From its beginning through 2011, nearly 42,000 individuals have participated in HIRE and more than 11,000 have been tested for HIV. Of those, more than 1,000 have tested positive.
To achieve the project's goal of successfully reintegrating formerly incarcerated individuals with HIV/AIDS, the Association provides referrals to high quality medical care and other services that address housing needs, entitlements, job training, behavioral and mental health treatment, and family support.
Bartlett said many people who are released from prison end up in shelters because they are disconnected from family and have no means of taking care of themselves. "Our goal is to bridge the gap so that those services are in place prior to release or on the day of release and that person has a place to stay, has a means of eating, has some kind of entitlements coming in, and most importantly, has a doctor to go to."
OA can secure a single room for a formerly incarcerated person to be available by the first day of discharge. The organization conducted transitional plans for 59 HIV/AIDS ex-inmates and connected 52 individuals to transitional housing in 2010.
"Once a person is housed and becomes stable, it opens up a lot of doors for them to follow a regimen that is beneficial, that creates healthy behaviors, so that they don't have to resort back to the things that they used to do," Bartlett said.
During the month prior to release, OA conducts health education workshops that promote awareness about HIV/STI and Hepatitis and that also focus on how to access healthcare.
The program is proving popular with inmates and demonstrates the need for such services. During the second year of the program, as many as 819 incarcerated individuals attended the workshops.
"We continuously do in-prison services," Bartlett said. "We service a large HIV-positive population coming out of Queensboro and, inside the facility, we do HIV testing [and] health education groups. We want them to heighten their awareness around HIV/AIDS, around Hepatitis C, and most importantly [to learn] what health resources are available to them once they are released."
The Project HIRE's testing campaign, called "Take Control of Your Life," has accounted for 292 HIV tests in prison during the project's second year. This campaign is in partnership with the New York State Department of Corrections and Community Supervision and the New York City Department of Health's Infectious Disease Testing Unit.
On the day of release, former inmates of Queesboro who have been trained by the Association to become Peer Navigators, serve as chaperons to the just-released prisoners. Because they can identify with the new ex-inmates, they provide immediate support to vulnerable individuals who might otherwise be tempted to use drugs or miss their initial parole visit, Bartlett said.
Once picked up, individuals are taken to the Bronx office and then to their transitional housing placement. Some ex-inmates are also escorted to their initial parole visit. During this time, HIRE staff reinforces the importance of following through with scheduled appointments and of contacting staff if they encounter difficulties. Statistically, individuals who use these transportation services remain in the HIRE program 58 percent longer than those who do not.
"At our office they are given a meal. We issue them a dignity kit- a bag full of cosmetics-and we schedule them for other activities in our Osborne program and then they are driven to their housing placement the same day," Bartlett said.
"We know [the first 90 days] is the most difficult time for individuals coming out of prison. And our peer navigators are the ones that take these individuals where they need to go; they are driven to a Health Resources and Services Administration office (HRSA), to the doctor, and to the program. A lot of them are mandated to a drug treatment program so they come in the building every day for drug treatment and through that program we are able to work with them on a day-to-day basis."
In 2009, in order to address the health needs of former inmates and to decrease the health care disparities among minorities from undeserved communities in the Bronx, OA entered into partnership with the Montefiore Medical Center and developed the Montefiore Open Access Transitions Clinic.
"This federally qualified health clinic was developed exclusively for re-entry individuals," Bartlett said. "Our peer navigators work at the clinic, greeting individuals, assisting them with paperwork."
To address language issues, a number of OA navigators are also bilingual in Spanish. Bartlett says this is another way that navigators establish good rapport with former inmates. "There's a trust factor with individuals coming out of prison. They don't want to give up a lot of information to systems and so our navigators are there."
The Clinic, which was developed with the assistance of a grant from HRSA, serves a significant role in the reintegration process by teaching inmates to effectively manage their disease. "The clinic teaches them about nutritional benefits. It does demonstrations, showing them what they should eat with their medications. They receive coupons so they can go to food markets and stop eating at fast food restaurants, and it makes sure that they have a regular supply of medication when needed."
Finally, Bartlett said one of the most important aspects of the HIRE project is that it allows OA to reconnect ex-inmates with their families.
"I can't speak enough about that," he said. "We are talking about people who are disconnected from everyone and have been for a number of years. People that are scared, [who] don't know what is going to happen in their lives, [who] might have done something that they are not proud of."
The mission of the OA was borne out of strong personal belief in human redemption.
The organization was established in 1931 to continue the work of Thomas Mont Osborne, an industrialist and former mayor of Auburn, New York who spent a week in Auburn prison as a prisoner in 1912. He lived like the other prisoners and the experience left him inspired and dedicated to the goal of turning America's prisons from what he said were "human scrap heaps into human repair shops."
Convinced that a criminal justice system that "restores to society the largest number of intelligent, forceful, honest citizens," could be possible, Osborne went on to become a progressive warden at Sing Sing, where the majority of his prisoners did not return to prison after release. He also established the Mutual Welfare League and the National Society of Penal Information, and later became known as the "pioneer and prophet of prison reform."
Bartlett has worked for OA for the past 13 years, and will receive his Master's in Public Administration in June 2012. He is a Certified New York State HIV Pre/Post Test Counselor, responsible for all In-Prison and Community HIV services for OA.
"This country has a high incarceration rate, the highest in the world, and when you look at the minorities in this country, black and Latinos make up 64 percent of the incarcerated [population]," Bartlett said, yet "black and Latinos account for only 30 percent of the population. There is a desperate need for services for the minority population in terms of public health and public safety. We can make some drastic changes in how this country deals with incarceration."
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