Can Better Health Care Help Ex-Inmates Avoid Returning to Jail?

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Photo by Health Care Corporation of America via Flickr

Returning inmates need cooordinated and effective health care coverage to escape the “revolving door” that cycles many of them back to jail or prison, according to a policy guide released Friday by the Urban Institute.

The guide, prepared by the Urban Institute and the law and consulting firm Manatt, Phelps & Phillips, is aimed at helping justice-involved individuals enroll efficiently in Medicaid and other health coverage to obtain “coordinated physical and behavioral health care.”

Currently, the “revolving door” between incarceration and the community leaves many people alternating between correctional and community-based providers, the guide said.

Better-coordinated health coverage will “enhance public safety, reduce recidivism, and more efficiently use public resources,” wrote the authors of the guide.

If states can improve health care for released inmates, they “will be in a stronger position to address (the) substance abuse issues, chronic physical and mental illness, unemployment and employment instability, and homelessness that result in many justice-involved people cycling in and out of jail or the hospital,” the authors wrote.

Maintaining health coverage is a common problem for released prisoners.

Prison inmates have four times the rate of active tuberculosis found in the general population, nine to ten times the rate of Hepatitis C, eight to nine times the rate of human immunodeficiency virus (HIV) infection, three times times the rate of serious mental illness, and four times the rate of substance abuse disorders, the guide said.

Jail populations have similar high levels. Many inmates fail to get needed care, and when they are released, they often face disruptions in medical care that contribute to recidivism, drug use, and poor and costly health outcomes. One study found a 12-fold increase in the risk of death in the two weeks after release.

Another study of people returning from prison in Ohio and Texas found that, within 10 months of release, a fifth had been hospitalized, and a third had sought care in emergency rooms.

The project, supported by the U.S. Justice Department, is called the “Connecting Criminal Justice to Health Care Initiative” (CCJH), and was developed by corrections and health care officials in Maryland and Los Angeles County, Ca.

The Urban Institute issued two related reports on Friday, Strategies for Connecting Justice-Involved Populations to Health Coverage and Care and Connecting Criminal Justice-Involved People with Medicaid Coverage and Services: Innovative Strategies from Arizona.

The Arizona publication describes six strategies that the state has used to connect former prisoners with Medicaid coverage and health care services. The strategies include automating data-sharing arrangements between justice agencies and the state Medicaid program, automatically re-enrolling people who are about to be released into their previous Medicaid plan, and co-locating enrollment assistance and behavioral health services at probation and parole offices.

The report called the strategies “an innovative model that could be replicated in other jurisdictions.”

Ted Gest is president of Criminal Justice Journalists and Washington bureau chief of The Crime Report. Readers’ comments are welcome.

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