Patient wellbeing and medical ethics require safe, effective opioid withdrawal therapy for newly incarcerated people dependent on opioids before admission. Many correctional facilities may be hesitant to use opiates such as methadone or buprenorphine. Research shows that off-label gabapentin and clonidine can be used to effectively control acute opioid withdrawal. This presentation describes the successful treatment regimen and diversion concerns.

Educational objectives

Describe a novel nonopioid treatment for opiate withdrawal in a correctional facility

Compare a nonopioid protocol vs. opioid withdrawal treatment

Review how to transition people who have been withdrawn from opioids from corrections safely back to the community

Level: Intermediate

As advances in technology continue to influence the medical field, the role the nurse is evolving. One of the nurse's primary responsibilities is to focus on the care and safety of the patient. Theory and practice are the foundations of the nursing process. An integral component of this process is critical thinking. This presentation will look at the importance of the nursing process, evidence-based practices, and the value of critical thinking in promoting patient safety and favorable outcomes.

Educational objectives

Describe the nursing process

Define the concepts of critical thinking

Discuss nursing interventions and the goals of patient care

Level: Basic

The Prison Rape Elimination Act and the related standards were developed to prevent, detect, and respond to sexual abuse in corrections. However, neither PREA nor the Standards provide specific guidance regarding evaluating a patient and documenting the evaluation. This presentation explores through case examples what constitutes forensic evidence and the ethical challenges facing both medical and behavioral health professionals in conducting and documenting PREA evaluations.

Educational objectives

Discuss guidelines for appropriate documentation related to forensic examinations and behavioral health evaluations conducted pursuant to PREA

Explain the legal and ethical implications of considering forensic evidence when conducting PREA forensic examinations and behavioral health evaluations

Describe the challenges in conducting and documenting PREA evaluations

Level: Intermediate

Engaging at-risk youth in juvenile justice settings can be challenging for even the most seasoned professionals. This session will review a successful initiative at one juvenile justice facility supported by the behavioral health, restorative justice, and "credible messenger" teams. The new approach increased youth engagement with cofacilitated group sessions and wellness activities, daily reflection of restorative justice principles, and a revised level system.

Educational objectives

Restate the traditional roles and responsibilities of behavioral health, restorative justice, and credible messenger teams

Describe the barriers to traditional approaches to engaging youth in cognitive behavior treatment

Discuss the challenges and successes of combining behavioral health with restorative justice and credible justice programs

Level: Intermediate

Using Louisiana State Penitentiary as a case study, this session will describe an analysis of correctional staff members' views on delivering end-of-life care. This presentation covers the meaningful experiences of staff members participating in a hospice-based peer-inmate program, as well as future research considerations to attain a better understanding of the needs of the dying and their essential providers.

Educational objectives

Discuss the experiences of correctional staff who deliver essential care for dying, incarcerated individuals

Examine the role correctional staff members play within correctional hospice-based programs

Summarize the needs of the dying and their providers

Level: Basic

With the stresses inherent in the correctional environment, as well as the additional stressors from the COVID-19 pandemic, correctional nurses are susceptible to compassion fatigue. The presenter will discuss compassion satisfaction, compassion fatigue, and burnout. In an exercise, attendees will take Stamm's Professional Quality of Life (ProQOL) scale to measure how they rate. Get informed about risk factors, signs, symptoms, and prevention strategies for compassion fatigue.

Educational objectives

Define compassion fatigue

Distinguish levels of compassion fatigue using the ProQOL scale

State risk factors and self-care strategies for compassion fatigue

Level: Intermediate

Insomnia is a common complaint in corrections and a core symptom of many psychiatric disorders. It puts patients at increased risk for developing anxiety, depression, psychosis, violence, and even suicide. This session will describe the classic sleep model, the most common sleep disorders, the unique challenges in treating insomnia in corrections, and the risks of not treating acute and chronic insomnia. Attendees will gain a tool box of treatment options for our unique environment.

Educational objectives

Identify two reasons why it is important to treat sleep disturbances

Name five unique challenges with treating sleep disturbances in the correctional setting

Discuss three behavioral and two pharmacologic options for treating insomnia in a jail or prison

Level: Basic

An effective sick call system is a key component to a patient's access to care. Depending on the facility type and resources available, responses to patient care requests can be accomplished in various ways. This presentation will provide administrators, nurses, and providers with knowledge of national standards related to responding to nonemergency health care requests from patients, including discussion of common pitfalls with sick call systems.

Educational objectives

Review national standards related to nonemergency health care requests and services

Describe various systems for conducting sick call

List common pitfalls with sick call systems

Level: Basic

During the COVID-19 outbreak, California Correctional Healthcare Service and California Hospital Association collaborated to redirect doses of monoclonal antibody to correctional facilities to treat high-risk patients who had contracted COVID-19. Providers found a decrease in severity of disease, hospitalization, and death. Learn when treatment with monoclonal antibody is indicated for COVID-19, and how to identify appropriate patients, obtain informed consent, safely infuse, and monitor this high-risk population.

Educational objectives

Identify eligible high-risk patients with COVID-19 who would benefit from IV monoclonal antibodies

Demonstrate understanding of the consent, treatment, and monitoring requirements for the use of monoclonal antibodies

Analyze the essential interdisciplinary processes needed to support the use of IV monoclonal antibody treatment in corrections

Level: Intermediate

This session will describe a major initiative to implement trauma-informed, evidence-based treatment in a correctional setting. Evidence-based treatment criteria included SAMHSA guidelines, positive psychology, chemical dependency counseling, trauma groups, and individual counseling. The program's success was measured in the best rates of recidivism seen in the state. Attendees will discuss best practices for implementation and the benefits of this type of treatment to the patient and staff. Educational objectives Identify physiological signs of trauma Differentiate between behaviors related to trauma and behaviors related to criminal thinking Analyze how to integrate current policies with a trauma-informed approach Level: Basic

The Middlesex Sheriff's Office medical model evolved tremendously during the COVID-19 pandemic. By establishing transparent, targeted communications, MSO minimized secondary crises that would have diverted resources from the COVID-19 response. Attendees will find that using a targeted communications plan for each stakeholder group builds meaningful engagement and trust that sustains an agency through a crisis.

Educational objectives

Explain the difference between crisis management and emergency management

List the secondary constituencies and other stakeholders who may be affected by a correctional crisis

Create concrete action steps to avert the secondary impacts of a crisis

Level: Intermediate

Engaging with individuals who act violently or have experienced trauma can cause secondary and vicarious trauma. Such trauma can be insidious, affecting us psychologically and physically, and may result from a one-time encounter or from cumulative exposure to incarcerated individuals' traumas. Clinicians have an ethical responsibility to recognize the signs of trauma in themselves and their colleagues. This session will describe secondary and vicarious trauma, how to recognize their effects, and how to reduce their impact on ourselves and our patients.

Educational objectives

Identify secondary and vicarious trauma

Describe the effects of secondary and vicarious trauma

State how to cope with the effects of trauma on correctional health care work

Level: Intermediate

Despite the critical role of correctional mental health professionals, there is limited academic research on their experiences. This session will discuss a research study that included in-depth interviews with 22 master's and doctoral-level correctional mental health professionals. It will explore the roles of clinical supervision versus "management" with a focus on enhancing clinical supervision resources for mental health staff. It concludes with brainstorming and analyzing a problem-solving model for correctional supervision.

Educational objectives

Identify key theoretical explanations related to the experience of correctional mental health professionals

Explain a proposed model of correctional clinical supervision for mental health professionals

Analyze the study's findings related to clinical supervision for correctional mental health professionals

Level: Intermediate

Correctional medicine is rarely taught in nursing schools and is relatively unknown as a career path, making it very difficult to recruit and retain nurses. How can a medical unit in corrections overcome these obstacles? Learn the tips and tricks that can help staff your nursing department. More importantly, learn what can be done to retain nurses long-term.

Educational objectives

Review the challenges of recruiting in correctional settings

Name the tools needed for an employer to successfully recruit nurses

Compare ways to retain correctional nurses

Level: Basic

The World Health Organization defines social determinants of health as "conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." Attendees will learn about SDOH and how to assess for them in the incarcerated population. This information can support successful reentry by identifying services individuals might need to mitigate the impact of SDOH after discharge.

Educational objectives

Define social determinants of health

Identify trends in assessment of SDOH in various health care settings

Name three ways that SDOH data can be used to create value-based health care outcomes

Level: Basic

This presentation focuses on a new federally funded demonstration project implemented by the South Carolina Department of Health and Environmental Control, the South Carolina Department of Corrections, and the University of South Carolina School of Medicine. The project's aim is a sustainable program supporting continuity of HIV medical care for people released from state prisons into the community, emphasizing postrelease care engagement, adherence to treatment, and viral suppression.

Educational objectives

Describe the benefits of public health and corrections partnerships to improve outcomes across the HIV care continuum

Analyze South Carolina's approach to engage priority populations, partners, and stakeholders to implement a pre- and postrelease discharge planning program for incarcerated persons with HIV

Identify early lessons learned for successful community reentry for incarcerated persons with HIV to maintain care and treatment outcomes

Level: Intermediate

Health care in corrections can be challenging since security concerns often take precedence over health care goals. Concerns can arise over capacity and competency, informed consent and informed refusal, confidentiality and privacy, and dual loyalty. Using case studies, this session will provide guidance in ethical principles and concepts to assist in decision making and ultimately, build confidence in your practice. Educational objectives Define important bioethical principles and concepts Identify ethical issues that arise in correctional health care Apply important bioethical principles and concepts in decision in correctional health care Level: Intermediate

Research indicates treatment adaptations are necessary for clients with neurocognitive and developmental delays to be successful in sex offense treatment. This presentation will outline common challenges that warrant adaptive treatment and common adaptations made for treatment. Practical applications will be discussed through comparing traditional treatment assignments to adapted assignments and providing case examples. Treatment approaches are based on cognitive behavioral therapy, dialectical behavioral therapy, and acceptance and commitment therapy.

Educational objectives

Recognize different neurodevelopmental and neurocognitive disorders that require adapted treatment approaches

Differentiate between traditional treatment approaches and adapted treatment approaches

Describe application of adapted treatment approaches

Level: Basic

The National Clinician Consultation Center provides free, on-demand access to HIV, hepatitis, and substance use clinical expertise through a unique teleconsultation model. Consultants offer evidence-based guidance while acknowledging differing resources and community landscapes. Presenters will share how correctional health providers used teleconsultation to help achieve desired outcomes, such as decisions regarding pharmacotherapy for HIV/HCV/SUD. Correctional systems can also leverage services and content expertise for internal quality improvement and capacity building.

Educational objectives

Describe the types of clinical questions and scenarios that are available through NCCC

Recognize how the NCCC can support equitable, high-quality HIV, HCV, and/or substance use disorder care delivery

Discuss how correctional health providers can use the NCCC to help with reentry transitions and continuity of care

Level: Advanced

The leading cause of death in jails is suicide. To avoid these deaths, prevention must be a priority. The core components of a suicide prevention program will be identified and discussed in this presentation. The presenter will share proper assessment and documentation strategies, and describe how to increase the quality of care and reduce legal liability.

Educational objectives

Identify the core components of a suicide prevention program

Explain requirements for assessment and documentation

Discuss the standards courts use when evaluating a claim arising from the suicide of an incarcerated person

Level: Intermediate

Research indicates that correctional settings are key points of intervention for addressing substance use disorders and preventing the possibility of fatal overdose after release. This presentation will present the current state legislative landscape and provide examples of successful evidence-based MAT programs in state prisons. In addition, presenters will discuss the MAT Act, a proposed state-level legislative solution to issues prevalent in implementing and administering MAT programs in correctional settings. Educational objectives Review existing legislation that enables access to MAT in correctional settings Discuss best practices and lessons learned from jurisdictions that have implemented MAT programs in corrections Summarize the MAT Act, a model law and detailed legislative template Level: Basic

While trauma programs have much to offer the incarcerated, the prison setting itself is inherently triggering and retraumatizing. For the past decade, the Northeast Reintegration Center has overcome many of these issues with the Mosaic program, a comprehensive trauma treatment intervention. Presenters will identify critical issues for designing, planning, executing, and sustaining this program as well as strategies to build and maintain support for trauma treatment among prison staff and leadership.

Educational objectives

Identify the key elements of effective trauma recovery programs for incarcerated women

Describe the therapeutic framework for selecting interventions and implementing treatment

Define strategies to build support among prison staff and leadership to ensure success

Level: Intermediate

In 2020, the California prison system revolutionized the way it provides substance use treatment. The new approach requires close communication with state parole and county probation partners to help patients safely transition to the community after release, facilitated through a real-time information-sharing portal. This presentation describes the new portal, how data is used, and plans to expand the exchange of data with county and state agencies. Data sharing also may help track patient outcomes in the future.

Educational objectives

Describe the technologies used to create the information-sharing portal between the CDCR and California's 58 counties

Identify four types of data shared through the CDCR's prerelease registries

Analyze data-sharing opportunities at the state level that could be used to improve future services

Level: Basic

Prisons and jails must provide access to medically necessary specialty services that are beyond the scope of on-site providers. Managing all aspects of off-site service procurement and payment is challenging and many correctional facilities use outmoded or inefficient tools and strategies. This session will explore the elements of a modernized system of managing off-site provider and facility services including options for establishing a favorable provider network and reasonable reimbursement rates; efficient claims adjudication, payment and monitoring; and mining claims data to manage population health and on-site provider performance.

Educational objectives

Identify at least two options for establishing networks for off-site specialty and facility care

State three risks of using in-house personnel to manage claims payment

List at least three reports from off-site claims that can inform your facility's population health management and/or on-site provider performance

Level: Intermediate

Research is beginning to reveal the emotional toll on mental health from the pandemic. One of the hardest hit groups are those working in health care. Reports of nurse and physician suicides shine a spotlight on the fear, devastation, and social isolation experienced by so many. This presentation will highlight recent studies regarding the impact on mental health, the increase in suicide and mental suffering, and strategies to provide support for health care staff.

Educational objectives

Describe the impacts of the pandemic on the mental health of health care providers and frontline workers

Discuss the risk for suicide for health care professionals and frontline workers

Identify strategies to recognize signs of emotional distress related to the pandemic

Level: Intermediate

Health care professionals often provide sworn testimony in civil and criminal matters. Learn how your testimony could be used and how poor testimony can lead to litigation problems. The presentation will help prepare clinicians for providing testimony and how to avoid pitfalls. Common denominators in accurate sworn testimony involve confidence, respect, and preparation.

Educational objectives

State different ways that sworn testimony can be used

Discuss how to properly prepare to provide sworn testimony

List common problems that lead to poor litigation outcomes

Level: Intermediate