CIRA Affiliated Project

CHOICES is an innovative integrated treatment approach incorporating evidence-based components of buprenorphine treatment, assertive community treatment and money management to facilitate continuity of care for released correctional inmates with or at high risk for HIV/AIDS in New Haven, CT. This will be addressed through coordination of a newly established treatment-on-demand Walk-In Center and the Community Health Care Van (CHCV). Through a collaborative effort with the Connecticut Department of Correction and the well established CHCV, operated by the Yale University AIDS Program, CHOICES will provide expansion of buprenorphine (BPN) treatment and enhancement of CHCV services to develop a treatment-on-demand, walk-in center where mental health/psychiatric care, intensive case management, and money management services are coordinated into a prison-release program. For those individuals who have been released from jail or prison within two years, CHOICES will utilize outreach from the CHCV, a nexus of community collaborations, and self-referral to enroll this vulnerable population that desperately needs integrated services as it attempts to reintegrate into the community. This work builds on our previous SAMHSA experience with Project BEST, the country’s first BPN induction and stabilization program administered through a mobile health care program.

CHOICES anticipates enrolling 100 unique individuals annually and 443 over five years, providing ~9,400 combined services as part of our targeted capacity expansion/enhancement. It will not only provide treatment to a new population of released prisoners that include drug users who are unable to access or have failed traditional drug treatment programs, but will also increase the number of available treatment slots in New Haven, The overall goals are to provide stability as these individuals transition into the community, and increase their quality of life through decreased substance use, mental health treatment, and ultimately reduced recidivism to prison and the spread of HIV/AIDS.

The provision of services and evaluation are likely to result in a successful program due to the 1) high unmet drug treatment and psychiatric needs in the New Haven community; 2) collective collaborative experience between the Yale University AIDS Program and the Connecticut Department of Correction; 3) creative integration of diverse, but evidence-based interventions for a population of prisoners with or at risk for HIV; 4) novelty of providing opiate substitution therapy before and continuously after release to the community; 5) novelty of adapting or modifying assertive community treatment and money management interventions for released prisoners; 6) collective expertise of Yale University in development of novel interventions for released prisoners with co-occurring substance use disorder and mental illness; and 7) likelihood that the intervention will be sustainable and replicable through the efforts of the investigators through their dissemination at national meetings and within peer-reviewed journals.

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