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Program Wins Second National Award in Two Years
Washington, D.C. – Less than a decade ago, the health and mental health services program within the District’s Department of Corrections (DOC) was still under the control of a federal receiver. When initially appointing the receiver in 1995, United States District Judge William Bryant said that District officials “don’t give a damn” about inmates. In 2004, shortly before Councilmember David Catania (At-Large) became Chairman of the Committee on Health, the D.C. Jail was the subject of a scathing Government Accountability Office (GAO) report regarding the quality of health care offered to its inmates. But that was then.
Last Friday, the DOC learned that it has been awarded a second national award in two years for its health care program. The American Corrections Association (ACA), the nation’s premier corrections organization, selected the District’s HIV/AIDS testing and counseling program for its 2010 Exemplary Offender Program Award. The highly competitive award is bestowed annually on a correctional system that has exhibited excellence in the development and execution of an evidence-based program that fosters constructive growth of incarcerated populations.
“When I became Chairman of the Health Committee, the health services program at the D.C. Jail was an absolute joke. And that is putting it nicely,” said Catania. “Today, it is a national model. All of those involved in this transformation, especially Director Devon Brown of the Department of Corrections and Vincent Keane of Unity Healthcare, are to be congratulated for yet another prestigious award.”
Last year, the health services program at the D.C. Jail was named Program of the Year by the National Commission on Correctional Health Care (NCCHC). NCCHC recognizes programs of excellence among thousands of accredited jails, prisons, and juvenile facilities. In 2008, both the ACA and the NCCHC formally accredited the jail’s health services program for the first time in the city’s history. In addition, the D.C. Appleseed Center recently gave the program an “A” in its annual HIV/AIDS report card for the third consecutive year. And finally, the District’s health services program is widely considered to be the blueprint upon which the Centers for Disease Control and Prevention formulated its 2009 HIV Testing and Implementation Guidance for Correctional Settings.
Catania played an instrumental role in the development and design of the DOC’s current medical and HIV/AIDS testing programs. In response to the GAO report and growing community concerns regarding health services at the D.C. Jail, Catania and Councilmember Phil Mendelson held a joint oversight hearing on the subject in June 2005. At the hearing, 25 public witnesses testified, urging the government to identify an alternate model of care. Among the issues cited with regard to the previous system were irregular and potentially dangerous conditions of discharge, overwhelming bureaucratic barriers to care, difficulties with consistent medication administration, lack of coordination between the healthcare provider and District health agencies, and insufficient treatment for mentally ill inmates.
In the aftermath of the hearing, Catania was the driving force behind the adoption of a “community oriented” model of health care. Unity Healthcare, which operates the largest number of health care clinics in the city, was selected to provide medical services to inmates. Upon discharge, inmates can visit any of Unity’s 30 community health centers and even schedule appointments with the same doctor they saw while incarcerated. The model has resulted in substantially higher numbers of inmates keeping doctors’ appointments after their release.
“Previously, the health services program at the jail was completely walled-off from the city’s network of health clinics. There was no coordination or communication between the jail and community health care providers upon an inmate’s release,” noted Catania. “Moreover, the Department of Corrections was entirely too casual when it came to testing for HIV/AIDS. The jail was acting as an incubator of the disease, and there was little urgency among Department officials to address the issue.”
Due to Catania’s persistence, the D.C. Jail changed its HIV/AIDS testing policy from an “opt-in” policy to an “opt-out” policy in May 2006. The results have been dramatic. In the last 11 months, approximately 11 percent of females and 6 percent of males at the jail tested positive for HIV/AIDS upon entry. Both numbers are dramatically higher than the national average. Today, approximately 90 percent of all inmates are tested for HIV/AIDS upon intake (the remaining 10 percent have either opted out, were recently tested, or already know their positive status). In total, since instituting the new testing procedures, over 900 inmates with HIV/AIDS have been identified. These inmates can now receive medical and psychological treatment while incarcerated. In addition, aggressive efforts are made to continue this treatment in one of Unity’s many community health clinics upon their release.
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