Strategic Partnerships in Time of Economic Turmoil

Background: STD services in correctional facilities are often fragmented, treatment-based services focused on the management of acute infections at intake and chronic infections subsequently. The opportunity to diagnose and treat populous STD bacterial infections is often lost although research indicates prevalence in these high risk populations is significantly higher when compared to general population.  Preliminary data analyses of inmates in select correctional institutions indicates 12% of inmates have a prior history of STD (chlamydia, gonorrhea, syphilis) infection in the previous two years. Nearly 25% of those with a history had repeat infections. Data suggests offering comprehensive intake screening in institutions is a necessity and an ideal “public health opportunity.”  

Objectives: Provide STD Specialty Care to inmates that results in cost savings, and to increase the quality of STD services offered in select correctional institutions.  

Methods: In December 2008, The Florida Departments of Health (DOH) and of Corrections (DOC) initiated a pilot to supply quality STD Specialty Care in five correctional institutions. DOC agreed to implement population-based STD screening of arrivals. DOH personnel agreed to deliver STD Specialty services for HIV, chlamydia, syphilis, gonorrhea, herpes and genital warts. DOH central pharmacy dispensed reduced 340b priced treatment drugs. Demographic inmate data (DOC), clinical data  (DOH) contract laboratories data (Spectra/ClinLab/Labcorp), and  STD surveillance data were linked.  

Results: The collaboration between agencies has optimized cost savings, improved quality of care, and increased routine STD services available to inmates. To date, the cost savings equates to $1.5-million. Projected cost savings expected to exceed $3-million for the 2-year pilot.  

Conclusions: Provision of STD screening to historically high-risk populations is feasible, cost-effective, and effective to interrupt the transmission of STDs.  

Implications for Programs, Policy, and/or Research: Interagency collaboration significantly cut cost and improves care.