In February, 2018 TOVA attempted to launch a pilot program to offer Sickle Cell consultations and trait screenings for inmates serving time in the Delaware Department of Corrections (DOC) in partnership with Connections, CSP and DOC. This new pilot program aimed to extend access to primary specialty care services for inmates with Sickle Cell and offer sickle trait screenings and
counseling. There has been a call to action to improve access to medical care for inmates from the inmates, the community and families who have loved ones serving time. U.S. has the largest prison population in the world and about 70%released are re-arrest within 3-years. Having a family member who is incarcerated with multiple chronic conditions and suffers from polysubstance abuse disorders moved me to want to extend services to improve access to specialty care. On early morning security rounds, my uncle was found lifeless in his cell unable to get a sick call for chest pain. His cell mate called medical. CPR was started immediately and he was rushed to a local hospital which was able to bring him back to life from a massive Heart Attack! Though his rap sheet of charges is too long to report, my uncle served in the U.S. Military (Veteran) and is a college graduate who once had a successful construction business. There are so many opportunities for the community to get involved and advocate for programs as an inmate does their time behind bars. Program initiatives below have been successful in lowering recidivism rates (inmates returning back to prison) such as:
· Offering GED, trades and College Education Degree programs to inmates
· Allowing birthing mothers to care for their babies in prison
· Conjugal visits for inmates on good behavior to spend time with their spouse
· Family involvement programs
· Dog training programs for the disabled
· Multidisciplinary Drug Treatment programs
Famous Russian novelist, Fyodor Dostoyevsky states “The degree of civilization in society can be judged by entering its prisons.” DOC contracts should allocate resources (10% of the $60M healthcare contract) for these programs and others which are deemed important by the community. Lets Go Forth!
TOVA Community Health
Primary Specialty Care
For more information visit, www.tovacommunityhealth.org
Like us on Facebook #tovacommunityhealth
With the national opioid epidemic crisis, many states have been closely addressing the misuse of pain killers as well as doctors who prescribes them freely. As a result, studies have been performed evaluating how effective pain medications are in treating chronic pain. Chronic pain is described as pain lasting over 3 to 6 month past the healing stage. The Minneapolis Veterans Administration (VA) has been in the spot light nationally for their study that showed opioids are no better than other non-opioid alternatives to treat chronic pain. The Minneapolis VA study group consisted of two groups of veterans who suffered from chronic pain in backs, hips, or knees. Group 1 took Opioids for a period of 9 months, and reported no further improvement. Group 2 managed their pain with nonsteroidal anti- inflammatory meds and other alternatives, such as physical therapy, showed continue improvement after a 9 month period. Studies show that those who take opioids over a long period of time develop a tolerance and the medications are no longer effective, which may possibly what happen to Group 2 according to Dr. Erin Krebs. 
As you know transition of persons with complex chronic medical conditions is dear to my heart. I can remember like it was yesterday one of my young adult patients lay lifeless in the local ER who we we unable to transition into an adult sickle cell program. From that point, I always asked myself -what went wrong? Why wasn't he able to articulate with the ER staff information about his condition and to call Marian Anderson Comprehensive Sickle Cell Center for the doctors to obtain specialty recommendations for providing care for crisis in other complications in the ER. Also,these outcomes were around the time when the New England Journal, 1995 published research findings on Hydroxyurea. Studies found that sickle cell crisis and acute chest were cut in half and became a game changer in the mid-nineties for sickle cell population. Moreover, Philadelphia, PA and Atlanta, GA both have Comprehensive Adult Sickle Cell programs. 