Culturally Competent Care Alison O Jordan, PI/Executive Director Jacqueline Cruzado-Quiñones, Program Manager Paul A. Teixeira, Program Evaluator Janet Wiersema, Project Director New York City Department of Health and Mental Hygiene Primary Care & Prevention / Correctional Health Services Panel Presentation: Community Engagement and Stigma-Reduction Interventions

Intervention Overview Intervention Levels: Individual: Clinicians and Puerto Rican care coordinators will work one-on-one with clients Group: Clinical, professional, and support staff will be trained to provide culturally competent care Community: Trained providers in the jails and at community providers will provide culturally competent care to persons of Puerto Rican origin.

Why this intervention? NYC hold the largest concentration of Puerto Ricans in US Of all HIV patients in NYC : – 5% were born in PR – 27.5% named Spanish as primary language NYC jail population is disproportionately Latino: – About 1,670 incarcerations each month – 653 Latino HIV patients admitted to NYC jails in 2011 Puerto Rico - New York Air Bridge reports: – 62% of NYC-based participants had lived in PR – 42% of Puerto-Rico-based participants had lived in NY – Half of the NYC-based participants left Puerto Rico to be with family, find employment, or end drug use. NYC SPNS Jail Linkages Initiative – Outcomes for Latinos / Puerto Ricans were below average

Core Components: Community Engagement & Stigma Reduction Train community-based providers at all levels: – Clinical staff (doctors, nurse practitioners, medical assistants) – Non-medical Professional staff (care coordinators, care navigators, health educators, social workers) – Support staff (administrative staff including reception) Various training approaches – Discipline-based Grand Rounds / general training – Half day and Full day sessions – “Booster” trainings at months Webinars for sustainability

Community Partners Acacia Network (formerly Promesa) ▪ AIDS Service Center NYC ▪ Alternatives to Violence Project ▪ APICHA ▪ Argus Community, Inc. ▪ Bailey House Inc ▪ Bellevue Hospital Center: Virology Clinic ▪ Betances Health Care ▪ Beth Israel Medical Center ▪ Bridge Back to Life Center Inc. ▪ Bronx Parent Housing Network Inc ▪ Brookdale University Hospital & Medical Center ▪ Brownsville CDC ▪ Callen Lorde Community Health Center ▪ Community Health Action of Staten Island ▪ Community Healthcare Network – Bronx ▪ Community Healthcare Network – Manhattan ▪ Community Service, The Lesbian, Gay, Bisexual and Transgender Community Center ▪ Comprehensive Health Care Center (CHCC) ▪ Damian Family Care Center dba PSHS) ▪ Daytop Village ▪ Dr. Martin Luther King, Jr Health Center ▪ Exponents Inc ▪ F.A.C.E.S. ▪ The Fortune Society ▪ Harlem Hospital Center (HHC) ▪ Harlem United ▪ Harlem United Community AIDS Center ▪ HELP/PSI, Inc. ▪ Housing Works, Inc. ▪ Institute for Family Health ▪ Interfaith Medical Center ▪ Jacobi Medical Center ▪ Kings County Hospital Adult OPD ▪ Long Island Assoc. for AIDS Care, Inc. ▪ Lutheran FHC ▪ MMC Albert Einstein College of Medicine Division of Substance Abuse ▪ Montefiore Medical Center - Family Health ▪ Mount Sinai Hospital of Queens ▪ Mount Sinai Medical Center Jack Martin Clinic ▪ New York Presbyterian Hospital, Harkness ▪ North Central Bronx ▪ Palladia, Inc/Centralized Admissions ▪ Positive Health Project, Inc. ▪ Project Samaritan Health Services ▪ Queens Counseling for Change ▪ Queens Hospital Syringe Exchange Program ▪ Services for the Underserved ▪ St. Barnabus Hospital - Pathways Center ▪ St. Luke’s Roosevelt Center ▪ Sunset Park Family Health Center ▪ SUNY Downstate / LICH Psychiatric Associates ▪ Trinity Multi-Service Center ▪ Unique People Services, Inc. ▪ Village Center for Care of New York ▪ Women In Need, Inc. (WIN) ▪ Women's Prison Association ▪ Woodhull Medical and Mental Health Center ▪ Wyckoff Heights Medical Center

Intervention Sites Health Centers Health Homes Supportive Housing Substance Use Treatment Programs Re-entry Services AIDS Service Organizations Consumer Advisory Groups

Linkage and Retention Training is intended to improve service delivery Providers that demonstrate successful engagement in care rates will be placed on a priority referral list Ongoing retention in care will also be a factor in considering referral resources and measured through re incarceration rates

What a Team!

Thank you! Questions?