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    Custody
Ready For Work at the Jails
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          Dr. Kerndt
Custody    Senior Rep   Field Services
Twin Towers
               Twin Towers
              Twin Towers Correctional Facility

   The Twin Towers Correctional Facility, also referred to in
         the media as Twin Towers Jail, is a complex
      erected in Los Angeles, California to house inmates
               of the Los Angeles County Courts.

              It is the world’s largest jail

  The facility is located at 450 Bauchet Street, in Los Angeles,
and is operated by the Los Angeles County Sheriff's Department.

The facility consists of two towers, a medical services building,
     and the Los Angeles County Medical Center Jail Ward

The 1.5 million square foot (140,000 m²) complex was opened
                            in 1997
  The Inmate Reception Center is the primary intake and release facility
 of male inmates for the Los Angeles County Sheriff's Department Jail System
            which currently houses approximately 18,000 inmates.

IRC is responsible for the maintenance and storage of all male inmate records
                         , clothing, property, and funds.
                                 IRC is the transfer
   and pickup point for inter facility transfers and for custody transfers
              and custody releases to the state prison system,
                    INS, and other governmental agencies.

      IRC conducts initial medical and mental screening of inmates.
     IRC is also responsible for the classification of all male inmates
                and population management of the jail system.
                    We are currently the largest facility in the
           Sheriff's Department with approximately 800 employees,
                    of which about 450 are professional staff.

            IRC IS A TEMPORARY HOLDING LOCATION ONLY!
                       VISITING IS NOT ALLOWED!
Men’s Central Jail
Century Regional Detention Facility
In March 2006, CRDF officially re-opened to be utilized as an
all female jail facility.

The two rehabilitation programs that were being held at CRDF
have been relocated to North Pitches Detention Center.

CRDF will continue to provide a booking center for Century
Station, Compton Sheriff's Station and for all female prisoners
           The Custody staff
•   Vince Lewis
•   Margarita Melgoza
•   Sandra Chacon
•   Sarah Verdugo
•   Natalie Kelley
•   Maria Arevalo
•   Special thanks to Anissa Brown, Jolene
    Yoneoka, and Gabriel Montano
Drop a Little Jail and Prison
        Knowledge
        Los Angeles County Jail
            Demographics
• 88% Males
• 12% Females

•   44% Hispanic
•   35% Black
•   16% White
•   03% Other
                    Jails
• Jails are locally-operated correctional
  facilities that confine persons before or
  after adjudication. Inmates sentenced to
  jail usually have a sentence of a year or
  less, but jails also incarcerate persons in a
  wide variety of other categories.
Why Would We test For STD’s in
     Jails and Prisons?
    Sexual Violence in Youths
• Approximately 1 in 5 of reported allegations of
  juvenile sexual violence were substantiated.
• Youth-on-youth incidents were more likely to
  occur in the victim’s room (37%) or in a common
  area (32%), compared to staff-on-youth
  incidents (7% and 13%, respectively).
• Victims received physical injuries in 12% of
  substantiated incidents of youth-on-youth sexual
  violence; about half received some form of
  medical follow-up.
     Sexual Violence in adults
• Correctional authorities substantiated 885
  incidents of sexual violence in 2005, 15% of
  completed investigations.
• 38% of allegations involved staff sexual
  misconduct;
• 35% inmate-on-inmate nonconsensual sexual
  acts;
• 17%, staff sexual harassment; and 10% inmate-
  on-inmate abusive sexual contact.
• Half of inmate-on-inmate sexual violence
  involved physical force or threat of force.
Most Inmates Have No Clue of
        Their Status
Nearly a quarter of both State prisoners and jail inmates
           who had a mental health problem,

    Compared to a fifth of those without, had served
           3 or more prior incarcerations.

       Female inmates had higher rates of mental
          health problems than male inmates

     (State prisons: 73% of females and 55% of males;
    Federal prisons: 61% of females and 44% of males;
       local jails: 75% of females and 63% of males).

   Only 1 in 3 State prisoners, 1 in 4 Federal prisoners,
  and 1 in 6 Jail inmates who had a mental health problem
        had received treatment since admission.
Inmates Classified By Colors
                 K6G

               Trustees

          General Population

          Sick and Dr. Care

           Child Molesters

             Kitchen Staff

             Mentally ILL

           Court/ transport
        Breakdown of Institutions

                         Custody Unit


Twin Towers 1          MCJ               CRDF       Wayside


Twin Towers 2   K6G                IRC           Various Prisons


                      Gen Pop            POD’s
   Public Health Opportunities
• Prevention of Transmission
• Reach a massive group of people who
  need various types of health care
• Opportunity to identify health problems
  and disease
• Opportunity to Directly administer and
  observe treatments
• Time for teaching and understanding
Why Care? They are Just inmates,
    prisoners, scum, mental,
    degenerates, bums, etc
• 25% of HIV- Infected Americans
• 33% of Americans infected with Hep C
• 40% of Americans with Active TB
• 50% may have some type of mental
  disorder
• 75% may have alcohol or substance
  abuse issues
Neighbors, Friends, Family
                PHI



Deputies                 Jail I.D. Nurses

           partnership


    K6G Staff   Medical and treatment
    Collaboration and Negotiation
                  Law Enforcement




Inmate needs/wants and rights   Public Health
K6G (K-11 Unit)
         What is K6G-Formally K11
Angels for gay inmates: thanks to two straight deputies,gay inmates in the L.A. County jail have a
     chance to get
an education and learn how to stay out of prison.
A gay man who was arrested and taken to the Los AngelesCounty jail in decades past would have
     probably been thrown
 in with other gay prisoners in what was known as the "queens' tank."
There were widespread reports in the 1970s of gay men being beaten, raped, and locked away in
     dingy isolation in "thehole" as well as countless complaints of prison guards soliciting sex
 Some guards routinely threatened the safety of prisoners.
For gay felons the jail became a notorious cycle--after release most of them would return within a few
     months to
 suffer the same trauma again.
Inmates in Los Angeles County's K-11 ward can enroll in the Social Mentoring Academic and
     Rehabilitative Training program,
an educational service to gay, lesbian, bisexual, and transgendered prisoners. And they can get
     support from straight sheriff's deputies Randy Bell and Bart Lanni, who envisioned SMART when
     they realized that gay inmates were returning to prison at a higher-than-average rate. In the five
     years since SMART's inception the recidivism rate among participants has plummeted from 94%
     to 30%, while the rate for straight prisoners remains approximately 65%.
SMART offers gay prisoners classes ranging from anger management to preparatory instruction for
     the General Educational
Development tests, a series of exams adults may take to earn high school--equivalency diplomas. The
     program also includes drug rehabilitation services and testing for sexually transmitted diseases
45,000

40,000

35,000

30,000

25,000                 Chlam
                       Gonor
20,000                 P/S Syph
                       EL Syph
15,000

10,000

 5,000

    0
         2006   2007
       Testing of Men and Woman
•   HIV            •   Rapid HIV
•   Syphilis
•   Gonorrhea      •   Syphilis
•   Chlamydia      •   GC
                   •   CT (urine only)
• GC
•   Throat
•   Rectal
•   Urine

• CT
•   Rectal
•   Urine
How Are Positive Results Reported

               Patients go to a Medical Provider

                  Dual Reporting System
                     Providers and Lab
                 Must report positive results

            CMR sent to the County of Los Angeles
                         (Data Entry)

  Positive Results researched and then sent to specific QUES
     In the Casewatch system to be assigned for follow up
Who Gets Partner Services

                         Custody


             Reactors         Contacts   Request


 Outside testing              Clusters   Symptoms

           Inside Screening
  So Where do the PHI’s come
             in?
• Custody PHI’s cover Approximately 5 or more
  facilities
• The bulk of their interviews are done at the
  Men’s Central Jail (MCJ)
• The vast majority of the positive Syphilis and
  HIV Are from the K6G unit
• PHI’s are responsible for the Interviewing and
  Treatment and Diagnosis of each positive
  patient assigned to them.
• If a patient submits sexual partners or clusters
  the PHI is responsible for initiating each
  respective paper and generating it to the field or
  ICCR
        Average time in Jail
• Average Length of stay is 44.2 Days
• Average Weekly Releases overall = 3,262,
  State Prison = 678, INS=115 Releases per
  Day
• Let's not forget about overcrowding.
  Inmates on lesser charges get out in 14
  days or less. In most cases those 14
  Days are cut down to 4 days.
Is it Really A Captive Audience?
•   Constant movement
•   Lockdown
•   Food time
•   Out on work assignment
•   Visitation
•   In the hole
•   Class time
•   Down at medical
•   Released
•   Out to court
•   INS hold
•   Simply does not want to cooperate
   What Keeps Public Health Moving
        in Times of Frustration
• Total team participation and buy in
• Everyone working for the good of the
  common goal
• The offering of one’s time and talents as a
  service to others
• The attitude that we will make ourselves
  better when we work together to make
  things better for others

				
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