This team seeks to develop a strategy for implementing the Transitions Clinic Network (TCN) model in Miami to serve people with chronic health conditions that are returning to the community from the Miami Dade county jail. TCN is an evidenced-based model that was developed by Dr. Shira Shavit (UCSF) in collaboration with formerly incarcerated patients to provide a community-based primary care home for people leaving prison. The TCN model of care is associated with fewer acute care visits, higher rates of primary care, and retention in HIV care. The goals are to (1) build trust and engagement among team members and collaborators and build sustainable and meaningful partnerships with government and community partners; (2) identify strategies to enhance the adaptation, adoption, and sustainment of the TCN model in Miami; and (3) develop an application for funding to conduct a hybrid type-2 clinic trial examining clinical, service, and implementation outcomes of the adapted TCN compared to treatment as usual. Kathryn Nowotny (Sociology), Edwad Suarez (Psychiatry and Behavioral Health), Zinzi Bailey (Oncology)
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