Issues: In 2002 over two million people were incarcerated in American correctional facilities; 600,000 are released each year (http://www.ojp.usdoj.gov/bjs/pub/pdf/pjim02.pdf).  Rates of HIV/AIDS are up to five times higher in correctional facilities than in the total population (Hammett et al, 2002: AJPH).  Targeted case management services help HIV-infected inmates successfully reenter society.  

Description: CDC and HRSA sponsored the 7 state Corrections Demonstration Project (CDP) from 1999-2004.  Emory University and Abt Associates conducted a longitudinal client-level evaluation.  While each grantee developed a unique program, the general model included a CBO case manager providing pre-release discharge planning (appointments and referrals to medical and social services) and post-release case management.  

Lessons Learned: The CDP served over 6,300 HIV-infected inmates; about 20% participated in the evaluation.  Many received post-release services.

	Jail	Prison
Total Clients Served	4,009	2,342
Client-Level Evaluation	704	517
Released	373	406
Service Utilization 30 Days Post-Release
Case Management	63%	62%
HIV Care*	58%	80%
HIV Medications**	45%	70%
Mental Health Care	42%	36%
Substance Abuse Treatment	31%	36%
*% HIV+ releasees **% releasees with mental health diagnosis

Jail releasees who received discharge planning were significantly more likely to participate in case management (p<0.1) and HIV care (p<0.05) than those who did not.  Prison releasees with an appointment for substance abuse treatment were significantly more likely to participate than those with no appointment (p>0.001).  Future analyses will model the effect of discharge planning on service utilization in more depth.  

Recommendations:

Facilities/CBOs provide discharge planning, especially appointments.

CBOs provide targeted case management for releasees.