When HIV-positive offenders are released from prison in Florida, they are sent on their way with 30 days worth of medication - enough, the state Department of Corrections hopes, to get them through that initial transition period until they begin receiving care in the community.

But, these offenders have more than medication in their possession when they leave prison life behind; they are also armed with knowledge about their disease and a plan for how to stay healthy and succeed in the community after incarceration.

The Florida DOC's Pre-Release Planning Program targets HIV-positive offenders who are nearing the ends of their sentences.  It connects these people to a planner who works with them both in prison and in the community to ensure that they will have all of their needs met once they are released.

"If there is an HIV-positive person in [one of ] our prison[s] and they are being released, we follow-up [with] them," said Graham Smith, Medical and Health Education Director for the Florida DOC. 

About four to six months prior to an individual's release, one of the department's four pre-release planners meets with the inmate to introduce him or her to the program. 

Informing Offenders

"Our initial contact is intended to make them aware of what we're trying to do, to help them and to inform them that there's also a support system out there," Smith said.  "We attempt to deal with prevention issues, [like] safer sex and, often, we talk about HIV morphology and pathology and how the disease progresses."

The planners aim to conduct two more interviews with HIV-positive inmates prior to their release.  According to Smith, offenders typically have questions about the program after they first meet with a planner.  The second interview is an opportunity for the offenders to make inquiries and to plan for what services they will need in the community.

"The second interview is more or less recapturing with them what we think their needs are and [we] talk about a plan of care," Smith said.  "[We talk about] the things that they feel they need in connection with how we can support them once they get out."

Once an inmate's needs have been identified, the planner and the offender together design a plan of care for the HIV-positive individual, which includes what services he or she will need in the community.  With those needs identified, the planner can then begin to make connections in the community for the inmate prior to his or her release. 

According to Smith, one of the key ties the planner develops for the inmate is to a case manager in the community.

"Case managers are crucial in the care process," Smith said.

Preparing for Life After Incarceration

During the last pre-release interview with an inmate, the planner makes sure that all of the offender's paperwork is squared away.  Inmates are given copies of their medical records and referrals to care providers in the community.  Smith said the planners also make sure that the offenders have filed the appropriate documents if they are eligible for any assistance from state or federal agencies.

"[We] make sure that they have a copy of their own medical records along with a referral to where they are going for care," Smith said.  "Then [we] also provide the person on the outside who is a care provider a copy if the same record."

Additionally during this final meeting with the planner, inmates sign paperwork authorizing the DOC to monitor the care they are receiving in the community so the planners can ensure that all of the offenders' needs are being met on the outside, Smith said.

"They have given us the authority to monitor their care," Smith said.  "We attempt to be in contact with them to make sure that they make a connection with their provider, that they are actually getting care and that they are satisfied with the care they are getting."

According to Smith, once the HIV-positive individual has been released from prison and referred to a case manager in the community, the Pre-Release Program planners remain involved with them, but take on more of a secondary role.

Community Care

"We allow the community organization to take the lead," Smith said.  "Our job is to be sure that they are getting what they need," he added.  "We advocate; we educate; we facilitate."

If an ex-offender's needs are not being met in the community or the individual needs additional services, the DOC's planners are still there to support them for six months to a year after they are released from incarceration, Smith said.

"Anything that is of concern to them is our job," Smith said. 

And with the support of the DOC's pre-release planners and an external case manager, Smith believes that these HIV-positive ex-offenders have a greater chance of succeeding in the community, staying healthy and remaining crime free. 

"[They are] less apt to fall back into prison because there is a support system, which includes some of the basic living needs a person has," Smith said. 

Smith estimates that, thanks to the department's Pre-Release Planning Program, recidivism rates of HIV-positive offenders have been lowered considerably, from nearly 60 percent to 20.

"The belief when we first entered into this program was that with the appropriate social support system on the outside that it would reduce people returning [to prison], which - by the way - it has [done]," he said.

Resources:

Smith (850) 487-0921