In Lockdown, ‘Tele-Health’ Offers High-Tech Lifeline to Justice-Involved

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In just a few months, COVID-19 has drastically reshaped our lives. Even as it has caused havoc and tragedy to many, it has also offered an opportunity to “unstick” the technology that has long been a part of our lives, but was rarely exploited to its full potential.

Take for example the kind of communications technology that goes under the heading of what I would call “tele-whatever.” Tele-medicine, tele-health, tele-diagnosis, and tele-treatment—even tele-car repair, tele-counseling and tele-home design—have become increasingly sophisticated.

We take this technology for granted, as the “new normal.”  But ideas about how to apply it for maximum benefit have emerged at a slow—even a glacial—pace.

Until now.

A new “tele” concept that you could call “tele-deflection” builds on existing strategies of pretrial diversion: deflecting individuals from the penal system that has long dominated how we’ve thought about criminal justice into behavioral counseling.

Indeed, the price paid for not getting this technology up to speed so that it can provide individuals with an equitable alternative has been borne mostly by those cut off from the ordinary channels for help in our society.

Think of rural areas where treatment alternatives to jail or prison were not available less than two hours away. Think of crime-ridden urban areas where going to treatment might have presented a high risk. Think of a mother faced with the choice of leaving her kids unattended at home or participating in substance abuse counseling.

“Tele-whatever” has been deployed to a limited extent as one of the strategies available to justice professionals in ordinary times.  Now, in extraordinary times, it’s the only sound approach.

We’ve known for a very long time, decades actually, that the use of health strategies to intervene with folks who are having contact with or end up in the justice system often stems from underlying behavioral health issues, such as substance-use and mental health disorders.

We’ve known that when we treat those underlying issues people (and families and children) get better, and when people get better they don’t keep having contact with the justice system.

The pandemic has made tragically clear how the lack of access to health care due to longstanding inequities has a disproportional impact on the poor and people of color.

Tele-whatever fills that gap. Making it available to as many people as possible is now a matter of life and death for those at the margins of our society who have been further isolated by COVID-19.

Pandemic Opens Path to New Technology

While the potential has been around for a while, only in the past three or four months have organizations, like mine, been able to see the path to scale it up to deliver on its promises. Out of the devastation of the pandemic, has come the way. The federal government has waived regulations that had previously restricted accessing care via tele-health.

This is good news for now, and allows those currently receiving treatment and counseling to keep receiving those services. However, the waivers are temporary and will expire once our shared Public Health Emergency is over.

PTACC, the national voice of the field of deflection and pre-arrest diversion, is actively working alongside many other national organizations to make tele-deflection and tele-whatever stick. One way in which we are doing this is by educating state and federal government officials, state Medicaid offices, and insurance companies on why the federal tele-health waivers must be made permanent.

We invited all those interested in this critical issue to join with us, and add your voices— and the voices of deflection clients (do not forget the voice of those we serve!)—to the weight of the argument that the waivers are needed after the formal period of the coronavirus health emergency.

We  have been  strengthened by the recently introduced bipartisan Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act, co-sponsored by Sen. Rob Portman (R-OH) and Sheldon Whitehouse (D-RI)). The TREATS Act would make permanent key waivers, including the ability to prescribe Medication Assisted Therapies (MAT) and other necessary drugs without needing a prior in-person visit and the ability to bill Medicare for audio-only telehealth services.

Jac Charlier

Jac Charlier

The legislation is also supported by: American Society for Addiction Medicine, American College of Medical Toxicology, Kennedy Forum, National Association of Addiction Treatment Providers, National Association of Behavioral Health, National Safety Council, Shatterproof, and Well Being Trust.

Why take the time to do this in the midst of all that you have going on?

The coronavirus has changed everything.  Borrowing the old adage to never let a good crisis go to waste, “tele-whatever” offers a huge opportunity at the intersection of justice and behavioral health.

We should not miss it.

Jac Charlier is executive director of the Police, Treatment, and Community Collaborative (PTACC).

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