How To Gain Access To County Jails For Delivery Of HIV/AIDS Services
- What should I know before contacting a county jail in order to gain access to deliver HIV-related services?
- How do I begin to establish relationships with county jail leaders?
- How do I convince the county jail staff that my program will provide them with a needed service?
- What do I need to do to implement HIV-related services in the context of general health promotion?
- How do I customize my HIV-related services to best meet the needs of the county jail?
- What are the rules and regulations that I need to know to provide HIV-related services within the county jail?
- How do I foster good working relations with county jail staff based on mutual sensitivity and respect?
- How do I identify staff who understand jail dynamics and are comfortable delivering programs in this setting?
- How do I sustain my program in the county jail setting?
- Where can I find resources to enhance and sustain program services within the county jail?
Effective delivery of HIV prevention and intervention services in criminal justice settings often relies on a partnership among public health, corrections and community based organizations. The importance of such partnerships has gained increasing recognition. While some successful examples of collaborations have been highlighted, little, if any, guidance has been provided to community-based organizations (CBOs) seeking to offer services in local jails.
To meet this need, the Criminal Justice Committee of the New York State (NYS) HIV Prevention Planning Group (PPG), in collaboration with AIDS Institute staff, developed a guide for CBOs interested in offering HIV-related services within local correctional facilities. Development of this guide involved a review of literature and roundtable discussions to increase to Committee's and AIDS Institute's understanding of county jail systems. Discussions focused on factors that contribute to facilitating CBOs' access to county jails to provide HIV-related services.
A draft of the guide was developed and finalized by Committee members and AIDS Institute staff. A final draft was circulated for review and comment to attendees of the roundtable discussions and other contributors. Specifically, we would like to thank the following persons for their input: Jim Laurence and Peggy Loffredo, NYS Commission of Corrections; Pat Coury-Doniger, University of Rochester Center for Health and Behavioral Training; Pam Wright, Family Services, Inc.; and Alice Haskins, Ontario County Jail.
In order to understand how the guide is used and if it may be made more useful, your comments are welcome. Please address any questions or comments to: Director, Bureau of Community Based Services, AIDS Institute, Corning Tower, Room 342, Albany, NY 12237.
The AIDS Institute greatly appreciates the work, dedication and partnership of the PPG and its Criminal Justice Committee. We hope that this document plays an important role in your efforts to offer HIV-related services within local county correctional facilities.
Susan J. Klein, M.S.
Director, Division of HIV Prevention
Community based organizations (CBOs) provide a valuable service to incarcerated individuals, releasees and their families. Working with, and for, this population requires both dedication and commitment. The complexity and the challenges of providing criminal justice services can be daunting. The challenge becomes even greater when providing for the needs of HIV-infected and affected individuals.
Overall, there has been greater acceptance of public health interventions within correctional settings. New, modern jails may provide opportunities as welcoming places to work. There are many individuals working in corrections who are actively seeking to work with community-based organizations (CBOs) and who recognize the important role that CBOs can play within the facility.
The intent of following information is to lend assistance to CBOs preparing to enter a county jail to provide HIV/AIDS-related services.
What should I know before contacting a county jail in order to gain access to deliver HIV-related services?
- Understand the culture, language and perspective of security. Corrections staff are trained to protect the safety of inmates and facility staff. CBOs' priority is the health and welfare of inmates. There may be a conflict in these priorities. Understanding and accepting these differences is key to working effectively with corrections staff.
- Never let CBO staff actions jeopardize program presence within the facility.
- Be able to clearly articulate what your program can and cannot do.
- Assess whether there is a specific need in the jail that your HIV program could meet and use that in your overall strategy to approach the jail.
- Know the process and protocol for approaching county jail staff. Executive staff must speak to executive staff. An introductory letter from the CBO's executive administrator to the jail administrator is an important first step. CBOs can explore opportunities to gain support from other state and/or local agencies (e.g., letters of support, memoranda of understanding). The clearance structure for entrance to the facility must be known and followed.
- Know the landscape. It is important to be aware of issues that the local county government is experiencing that may have a direct effect on if, how, and when you will be able to provide services within the jail. A local controversy can negatively impact your efforts. The landscape also pertains to the internal "politics" and relationships within the facility. There may be alliances that can strengthen your ability to deliver program services as well as disable or place barriers to implementation.
- Understand that medical staff may be private contractors. Develop good work relationships with both medical and corrections staff.
- Establish relationships with county jail leaders.
How do I begin to establish relationships with county jail leaders?
- Identify the appropriate contact person. The CBO must identify persons in authority in the jail setting. It is not always apparent by title or function who is in charge. The authority or "power" to enable the CBO to provide services may lie with the medical director or with jail administration. Key personnel may include the sheriff or undersheriff, deputy superintendent, or the nurse administrator. The appropriate contact person will vary from jail to jail. Most jails will have a community coordinating services contact who is responsible for community entreé into the jail. If there is not a community coordinating services contact, the jail administrator will designate with whom to coordinate services. The CBO must ask the question of the jail administration, "Who do I need to speak with?"
- Understand the interdependence between assessing jail needs and establishing good relationships with county jail leaders.
- Know the necessary components for establishing good relationships with jail personnel. These include: medical director, jail administrator, sheriff, undersheriff, nurse, corrections officers, and civilian personnel. Be prepared. Be willing to compromise. Be calmly persistent. Communicate with all disciplines.
- Develop a written agreement outlining roles and responsibilities of corrections, medical and CBO staff. The directors of each agency/facility should sign this agreement.
- Have realistic expectations.
- Understand that rules change or are enforced differently by different staff. Rule enforcement may also be effected by lock-down or national emergency.
- Cite that the source(s) for your educational program are reputable (i.e., the Centers for Disease Control and Prevention (CDC), the National Institutes for Health (NIH), the New York State Department of Health (NYSDOH) and/or the National Institute of Justice (NIJ)).
- Build relationships at multiple levels.
- "Market" and "sell" your program as a needed service to all jail staff with whom you may interact (e.g., security, medical, mental health, education).
How do I convince the county jail staff that my program will provide them with a needed service?
- Present what your program can offer so that the jail will perceive your program as helpful (e.g., jail staff training/staff development, productively occupy inmate's time, public health benefits).
- Present yourself as reducing rather than adding to workload. Ask jail personnel these questions: "How can we complement what you do?" and "How can we fill the gaps?"
- Present yourself to the jail administration as a positive reflection of their ability to administer successful programs within the jail.
- Emphasize that the benefit to security is that the CBO services decrease violence within the population by productively occupying the inmates' time.
- Offer to provide jail personnel with in-service presentations.
- Provide HIV-related services in the context of general health promotion. Seek opportunities to integrate other related topics for staff and inmates (e.g., hepatitis C (HCV), hepatitis B (HBV), sexually transmitted diseases (STDs) and tuberculosis (TB)).
What do I need to do to implement HIV-related services in the context of general health promotion?
- Have an understanding of all the available health and human service resources that exist within the jail.
- Assess how your program will fit into the provider network and ensure that your services are integrated into that existing network.
- Help jail personnel to understand the need for HIV continuum of service: education, counseling and testing, supportive services, and transitional planning.
- Foster sensitivity about HIV in the context of public health awareness and the impact of HIV on the community.
- Customize services to meet the county jail needs.
How do I customize my HIV-related services to best meet the needs of the county jail?
- Be prepared to provide in-service training and information on HIV prevention and intervention services to jail staff. Be aware of the limited time available for training. Seek opportunities to incorporate your information into required training.
- Offer to present HIV-related information and services to jail visitors as a means of further educating inmates and their families.
- Be flexible in scheduling.
- Provide your program service within the guidelines, rules and regulations issued by the facility.
What are the rules and regulations that I need to know to provide HIV-related services within the county jail?
- Inquire whether the jail has an orientation program for CBO staff providing inmate services. Ensure that your staff attend this program.
- Follow established procedures to obtain clearance.
- Know what is defined as contraband.
- Know the language of corrections. For instance, terminology makes a difference. Consider what words to use and ask if you aren't sure. Some common words include correctional officer or "CO", inmate, client, parole and probation.
- Control what is brought in and out of the facility.
- Know what clothing and accessories are appropriate to wear.
- Know the approval process for materials distribution and course content (e.g., curriculum) prior to use in the facility.
- Know that communicating messages, transporting materials and correspondence from an inmate to someone in the community is prohibited.
- Know that it is inappropriate to ask an inmate to disclose information related to his/her criminal charges unless specifically related to service delivery.
- Limit the amount of personal information that is shared with inmates that is not related to service delivery. The relationship between the inmate and CBO staff is focused on working together to meet the concrete needs of the inmate. For example, it is appropriate for an ex-offender or someone in recovery to discuss his/her personal experience related to successful return to his or her community or substance use treatment. It is not appropriate to discuss personal relationships, including details regarding partners or family.
- Be aware that CBO staff must never provide inmates with their home address or home phone number.
- Be knowledgeable about established protocol, Occupational Safety and Health Administration (OSHA) regulations and union issues.
- Foster good working relationships by operating within the set protocols and guidelines of the facility.
How do I foster good working relations with county jail staff based on mutual sensitivity and respect?
- Make requests for program assistance in a non-demanding manner.
- Treat correctional officers with respect and professionalism.
- Do not react personally to situations.
- Be aware that jail facility staff may resent that intensive services are offered to HIV-infected inmates and not to other inmates with chronic health issues.
- Be aware that a variety of issues may affect who can enter the facility and what services can be provided. Recognize that issues of racism, as well as stigma and discrimination against the incarcerated, can affect a CBO's ability to gain access and/or provide service to inmates.
- Choose CBO staff that understand jail dynamics and are comfortable delivering programs in this setting.
How do I identify staff that understand jail dynamics and are comfortable delivering programs in this setting?
- Choose CBO staff that understand and have the ability to deal with dynamics associated with racial and ethnic diversity. These dynamics may be with staff and/or with inmates.
- Prepare staff to work within the jail setting. Staff must know the process to enter the facility as well as how to sustain their services within a correctional setting.
- Explore with the staff person assigned to the correctional facility their motivation for working within this setting.
- Assess the readiness of staff to work within a correctional facility. Determine if there is staff commitment to work within corrections. As one jail administrator observed, "If jail isn't a pleasant place to be, why would it be a pleasant place to work?"
- Understand that not everyone is suited to work in this setting. Dedication and the personality of CBO staff are key ingredients in successful jail programs. Staff must have the ability to relate to both the inmates and the correctional staff.
- Be prepared to provide continual support and staff professional development in order to sustain the program.
How do I sustain my program in the county jail setting?
- Provide consistent services.
- Communicate to jail officials in advance about all changes in staff, schedules or program content.
- Routinize your program into the jail's activities.
- Coordinate and collaborate with facility security staff and other CBOs that work within the facility.
- Identify if there is a jail volunteer coordinator and/or an existing CBO coordinating body to organize the CBOs to efficiently deliver services within the facility. If there is not an existing volunteer coordinator, work towards establishing a coordinating body to meet on a routine basis with other volunteer CBOs and security to ensure optimal coordination of services.
- Establish a "landlord-tenant" relationship with jail administration. Recognize that you are a "guest " in their facility.
- Give routine updates to jail administration and seek opportunities for jail administration to have input into your program services.
- Share local HIV data with jail staff.
- Notify jail staff immediately if there are issues of potential conflict that should be discussed, evaluated and/or resolved.
- Do not get involved in the internal politics of the jail.
- Forge alliances with other agencies to provide requested services that your agency is unable to provide.
- Identify resources to enhance and sustain program services within the county jail.
Where can I find resources to enhance and sustain program services within the county jail?
- Utilize the internet as a resource:
- National HIV, STD and Corrections Websites:
- American Bar Association Juvenile Justice Center
- American Correctional Association
- American Correctional Health Services Association
- American Jail Association
- Centers for Disease Control and Prevention (CDC)
- CDC National Center of HIV, STD and TB Prevention, Divisions of HIV/AIDS Prevention
- CDC/Health Resources and Services Administration (HRSA) Criminal Justice Demonstration Project
- Corrections Connection
- Council of Juvenile Correctional Administrators
- Health Resources and Services Administration (HRSA), HIV/AIDS Bureau
- National Commission on Correctional Health Care
- National Juvenile Detention Association
- National Minority AIDS Council
- Office of Minority Health, HIV/AIDS Initiative
- U.S. Food and Drug Administration
- U.S. National Institute of Corrections
- U.S. Occupational Safety and Health Administration