12 P AT I E N T C A R E Expanding Our Ryan White Infectious Disease Services Prison Linkage: A Response to Evolving Patient Needs There are eight county jails within 60 minutes of The Wright Center. Through the prison linkage program, one of our newest components of case management, incarcerated and recently released individuals living with HIV/AIDS are provided with varying levels of support. Recognizing individuals with HIV can have specific challenges transitioning from incarceration, including accessing consistent medical care, transportation, securing housing, finding employment and establishing social supports, the United Way of Wyoming Valley funded a prison linkage program that began operations in late 2016. As the program gained momentum throughout 2017, 22 individuals were connected to supports. “We really need to examine the individual’s social history,” Erica Hubert, prison linkage case manager, said. “Unfortunately, most of them are going back to the same situations which got them into trouble in the first place. I want to do the best I can to make sure they are set up with the services they need and ensure they receive the necessary HIV care.” Hubert routinely attends judicial proceedings with many of her clients, often acting as the client’s primary support. As a testament to the program’s impact, several clients have voiced what a vital role Hubert plays in their everyday lives as she strives to earn their trust and manage their care. Since the development of the Prison Linkage Program, 100 percent of case management clients released from incarceration have been retained in medical care. We are poised to grow this program as funding becomes available. The Wright Center also provides comprehensive healthcare services, prevention education and support to individuals living with HIV/AIDS in a seven-county area within northeast Pennsylvania. Our Infectious Disease clinic is funded annually through a HRSA Ryan White Part C grant, and in 2017, we received approval of a three-year award, as well as eligibility for 340B supplemental funding. In 2017, the team was able to allocate all 340B funding to secure important resources for our patients, including dental care, and an Unmet Needs Assistance Program was established to help patients with services they may have otherwise been unable to access. Dr. Stephen Pancoast is an infectious disease specialist who has been treating patients in northeast Pennsylvania for 40 years: “The services we are able to provide and the growth of the clinic has been extremely gratifying to me,” Dr. Pancoast said. “We are not only able to provide for our HIV patients, but a full spectrum. We offer psychiatric services, dietary service, case management, general medicine and support services for patients with sexually transmitted diseases. The list is growing to be quite lengthy. It’s attractive to me as a physician to be able to work in a system like this. We have all of these modalities to help deliver good medical care to the patients. We have a support structure that makes sure patients are properly cared for. Those are the things that keep me interested.” Through proper treatment, HIV can become undetectable and the likelihood of transmission can be decreased. We strive to provide a full continuum of care and, ultimately, eliminate community viral load. The current undetectable rate at our clinic — 89.6 percent — exceeds the most recently reported average in Pennsylvania and also ranks us in top 25 percent of clinics country-wide. Along with HRSA, The Northeast Regional HIV Planning Coalition and United Way of Wyoming Valley invest resources into the clinic and its individuals served services annually. Our 2017 outcomes include: 622 1,796 89.6 % patient visits undetectable rate In 2017, we also connected 243 patients with eye care, audiology and dental services (audiology, 8; dental, 96; vision, 139) and also 12 patients co-infected with HIV and Hepatitis C were enrolled in a Hepatitis C treatment program. Ten achieved a Sustained Viral Response (cured), one dropped out because of drug-to-drug interaction and one is awaiting cure (test) results. Since the Hepatitis C treatment program started at The Wright Center in March 2016, a total of 33 co-infected individuals have entered this program.