Corrections_Today_Winter_2024-2025_Vol.86_No.4

HEALTH CARE

Three cohorts were considered for the pilot: pregnant women, non-pregnant women, and those with an un known pregnancy status (See Tables 1 & 2) . The Florida Department of Public Health generously provided the rapid syphilis testing kits free of charge for the program. The testing kits are considered a qualitative assay for detection of Syphilis antibodies and require two drops of blood using a finger stick. At the core of our Syphilis Opt-Out Testing Pilot is the compelling story of one patient, a 33-year-old single Caucasian woman known as ‘Jane Doe’. Her interaction with the criminal justice system unveiled a complex medical history, demonstrating the critical role of proac tive health care initiatives in correctional facilities. Meet Jane Doe A 33-year-old single Caucasian woman was arrested and booked into the Palm Beach County Sheriff’s Office. During the medical intake screening, Ms. Doe disclosed a recent emergency department admission for suspected chest pain. After the release of information was signed by the patient, the hospital records were provided to the jail. A review of the records indicated a blood test showing elevated D-dimer levels, hinting at a potential

pulmonary embolism or other dangerous blood clot. Despite that, the records indicated the patient signed out of the emergency department against medical advice. The hospital records also revealed that she had been given a pregnancy test that confirmed she was 11 weeks preg nant. Upon returning to the jail, Ms. Doe also reported recent alcohol, opiate, and cocaine use. Appropriate de tox protocols were initiated, and she was scheduled for medical appointments, prescribed prenatal vitamins, and given a pregnancy diet order. Ms. Doe was housed in an infirmary unit at the jail and seen by a medical provider before transfer to a general population housing unit. At this time, the Nurse Coordinator for the Syphilis Opt-Out Testing pilot administered the syphilis rapid test. The result was “reactive,” and confirmatory testing was ordered. All required documents were completed, and contact was made with the Palm Beach County De partment of Health Community Case Workers. Opt-out Testing Pilot implications Before administering the rapid test to any female admitted, the Nurse Coordinator completed a mandatory “Risk Assessment Form” to determine the clinical neces sity for the rapid test. This assessment ensures that

Table 1: Total Patients (Pregnant and Non-Pregnant)

History of Syphilis — Not Tested

Released Prior to Screening

Reactive Rapid Test

Not Offered Testing*

Age

Admitted

Opted-Out

Tested

under 18

4

3

1

0

0

0

0

18–24

215

164

24

21

0

0

6

25–29

222

163

30**

22

4

0

4

30–34

293

177

63

38

3

2

10

35–39

204

148

28

23

2

0

3

40+

479

350

70

41

4

1

13

Unknown (Age)

0

0

0

0

0

0

0

Total

1417

1005

216

145

13

3

36

% of Patients Booked

70.92%

15.24%

10.23%

0.92%

0.21%

2.54%

* Unavailable to Pilot Coordinator due to institutional reasons. ** One patient opted-out but decided to test soon after.

Corrections Today | Winter 2024-2025

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