Family physicians are ideally suited to provide health care in correctional settings; however, correctional medicine residency training is uncommon. In an elective jail health rotation at King County Correctional Facility, residents learn about health care in an urban county jail and gain insights into the patient experience. They see how jail health care is a link in the care continuum for medically underserved people. The roundtable will provide a framework for how this program could be replicated elsewhere and how correctional health experiential education may improve the quality of health care people receive post release.   

The COVID-19 pandemic has affected lives all over the world and wreaking havoc on medical, economic, social, political, and psychological infrastructure. Nevertheless, we have withstood the impact of this storm, mourned the loss of life, labored to protect our own health and rebuild our lives. Our psychological and emotional faculties are like muscles and can likewise be strengthened through specific “exercises” and techniques.

A study identified inability to sleep as the most common mental health sick call complaint in juvenile institutions in Puerto Rico over a 12-month period. This discussion will share findings, including potential correlations with any Axis 1 diagnoses. It also will summarize a literature review of pharmacological treatments and examine how the Puerto Rican patients’ pharmacological treatment “preferences” predict effectiveness.

While there is an abundance of evidence encouraging the effectiveness of Medicated Assisted Treatment or Medicated Assisted Recovery (MAT/MAR), starting such a program can be a huge undertaking especially for a correctional facility that may not have the full support or buy in to initiate such a program. Where do we start? How can we financially pay for this? Using and interactive round table discussion platform, learn the steps firsthand from correctional facilities in Illinois and California on how they began their journey along with the challenges they faced along the way.

This roundtable discussion will engage APRNs in a conversation about the legal and clinical responsibilities associated with on-call duty. We will discuss the importance of clear, structured communication during on-call encounters and appropriate documentation of the interaction. Participants will have an opportunity to share their experiences and concerns related to being on-call and discuss strategies that promote good clinical decision-making and improved patient outcomes.

Before wide availability of COVID-19 vaccines, The National Academies of Science, Engineering and Medicine developed an equitable framework to guide vaccine allocation. Data shows that despite elevated risk, many incarcerated populations were deprioritized in the allocation of the COVID-19 vaccine. This session will explore strategies to advocate and promote the equitable and timely receipt of future doses in incarcerated populations.

How many nurses are told to take a "hands off" approach to care? This is contrary to nursing education and illustrates one example of an ethical dilemma correctional nurses face daily. This roundtable will focus on evidence-based actions that nursing and correctional administrators can use to address ethical issues to increase moral resilience in staff. Using ethical principles and evidence-based practices, the audience will learn practical, interdisciplinary approaches to promote moral resilience.

This discussion will provide counsel and physician perspectives in best practices to defend lawsuits. We will cover charting and documentation issues, witness and testimony concerns, as well as case valuation from two different perspectives. Attendees will see how claims and lawsuits are viewed from the different perspectives and how claims can be resolved.

As state hospital waitlists continue to grow, there is a crisis of overpopulation of mental health patients confined in the jail system with nowhere to go. For patients deemed incompetent to stand trial, their case is at a standstill until they can be restored to competency. The introduction of a jail-based competency restoration program has been a viable solution in the Harris County Jail, one of the largest detention facilities in the state. This presentation will focus on the development and implementation of Harris County's JBCR and discuss the factors contributing to its over 90% success rate.

Withdrawal from fentanyl has been characterized as more rapid and severe than from other opioids, leading to a higher risk of precipitated withdrawal during buprenorphine initiation. Grounded in the harm-reduction model, microdosing initiation protocols were developed to improve treatment retention and stabilization of patients due to frequent complications arising during conventional initiation protocols. This discussion will review the microdosing initiation protocol along with patient considerations and special populations.

The mission at ECHO (Extension for Health Outcomes) is to democratize knowledge and get best practice care to the underserved, including the incarcerated. Corrections administrators are challenged with limited health care resources, high rates of infectious diseases including hepatitis C, and the epidemic of opioid addiction. ECHO is an ideal model to improve health care and provide education for medical staff and the incarcerated. The model allows for rapid learning and best-practice dissemination. 

This session will discuss a virtual Medication Assisted Treatment (MAT) program that is used in the several jailsand is integral for jail-to-community transition programs. Attendees will learn how the program was developed inclusive of sample assessment and treatment tools, MAT determination processes for long-acting injectables, tracking and reporting systems, on-site MAT injectable/oral medication procedures, on-site medical staff training, discharge tools for tracking, referral and jail-to-community processes and referral systems for continuity of care and medication consistency.

Presenters will discuss how they implemented a trauma-informed treatment program for incarcerated individuals that had the state’s best success rates. This program was highlighted in the Fall 2022 issue of CorrectCare.