Those involved in the justice system face numerous health risks and are more likely to have high blood pressure, asthma, cancer, arthritis, and infectious diseases than those not involved in the system. And among those who are currently incarcerated, more than half experience mental health issues.
When people are in jail or prison, the facility is responsible for providing health care services, but, upon release, those who were previously incarcerated face several obstacles, like finding a job, safe housing, and the right doctors. Those who were previously incarcerated who don’t have the right support system after release are more likely to experience homelessness. And those experiencing homelessness are more likely to be involved in the justice system, leading to a continuous cycle of recidivism for many people who simply need better care and more community support.
Barriers to health care for the previously incarcerated
In the United States, we have the highest incarceration rate in the world, with more than two million people in jails and prisons. While people can apply for Medicaid while still incarcerated, they won’t be covered until after their release.
In the past, it was typical for a person’s Medicaid coverage to be terminated once they were incarcerated, meaning they would need to reapply upon release. Today, many states have policies that suspend someone’s Medicaid during incarceration so the person doesn’t have to reapply after their sentence ends, providing faster access to medications and health care professionals.
One study recently sought to understand the barriers to Medicaid enrollment faced by those who are currently or have been previously incarcerated. They found that the most significant obstacles were:
- Lack of understanding of how Medicaid works
- Insufficient transportation to and from the Department of Health and Human Service Office
- Lack of "Proof of Incarceration" paperwork
- Challenges navigating community agencies
- Lack of a cell phone, email, or home address for communication
- Unmet basic needs, like housing and food
The study found that better collaboration between jails and community partners improved the transition from incarceration to release.
Working together to drive better health outcomes
A report by the Prison Policy Initiative found that 203 out of every 10,000 formerly incarcerated people were homeless, and 570 out of every 10,000 were housing insecure, meaning they are homeless or living in marginal housing like rooming houses, hotels, or motels. Safe and secure housing is the foundation of success for those recently released from prison, but the report shows that many people can’t find stable homes due to factors like discrimination by public housing authorities and property owners. Without secure housing, previously incarcerated individuals see reduced healthcare services, have more difficulties finding jobs, and have a harder time accessing educational programs.
The report recommends solving this problem by expanding social services, ending the criminalization of homelessness, banning the practice of excluding those with criminal records from housing applications, and improving education and systems that help incarcerated individuals understand housing options before their release.
Together, health plans and community-based organizations (CBOs) can work together to support the rehabilitation of people who were previously incarcerated by providing better information and coordination around work, housing, health and mental health care, and reintegration into the community. This will not only improve recidivism rates but also drive better overall health outcomes.
Community organizations providing reentry services
Transitions Clinic, a national network of medical homes for those with chronic health conditions recently released from incarceration, has served thousands of patients. Their clinics are typically located in neighborhoods with high concentrations of formerly incarcerated people. Transitions gives each patient quick access to primary care upon release with the goal of using “healthcare as a means to help recently released individuals live healthy and productive lives on the outside.” They provide physicians who are familiar with the previously incarcerated population referrals to community organizations for social support and case management from previously incarcerated health workers.
The data exchange program in Arizona is also dedicated to supporting people involved in the criminal justice system. Every day, jails in the pilot program provide information to the Medicaid agency about people who were booked or released that day. At that point, the system transfers that data to either suspend coverage for those who were booked or reinstate it for those who were released. The state also gives notice to managed care organizations and community providers, so they can reach out to those who have enrolled or re-enrolled.
In Indiana, CareSource’s Reentry Program provides those who were previously incarcerated with a life coach that can help them with college enrollment, job applications, and finding appropriate housing. CareSource’s goal is to help participants eventually enroll in employer-sponsored health insurance. In 2018, this program provided pre-release education to nearly 700 offenders.
Healthify works with health plans, providers, and CBOs to meet the social needs of members. Our intuitive platform makes it easy to refer patients to resources they need, like job assistance, skills training, tutoring, GED classes, ESL classes, food programs, housing assistance, and other social services.
We work directly with healthcare organizations to develop geo-targeted and intervention-focused relationships with CBOS. Informed by your organization’s strategic goals, contracts are designed with your community’s social needs in mind.
Learn more about the services offered in Healthify’s platform and how we’re building social service referral networks. Visit us here.