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"Medicaid allows for—and the federal government encourages—continued eligibility for coverage for a person who is incarcerated. Although the ACA [Affordable Care Act] did not address suspension versus termination, for states that are expanding Medicaid the number of inmates eligible for coverage will increase dramatically and the benefits to counties of suspending instead of terminating their coverage will be substantial" (p. 1). This brief addresses issues associated with suspending Medicaid coverage for prisoners. Sections cover: why ensuring access to Medicaid post-release is important to counties; access to treatment positively impacts public safety; what the difference is between suspension and termination of Medicaid coverage; states that suspend rather than terminate; what counties can do with highlights from Maricopa County (AZ), Salt Lake City (UT), California, and Oregon.

Health Coverage and County Jails: Suspension vs. Termination Cover

This webinar explains:

  • what health literacy has to do with accessing health care;
  • what literacy is;
  • what health literacy is;
  • the five steps of health literacy—find health information, understand it, evaluate it, communicate it, and use it;
  • the health literacy of U.S. adults;
  • health literacy is disproportionate;
  • barriers to good health literacy;
  • what needs to be done;
  • prevalence of disease;
  • health risks following release;
  • transitional care—continuity of care;
  • barriers to care;
  • Transitions Clinic Program—patient centered and culturally competent care for returning prisoners;
  • strategies to successful engagement post-release;
  • the need for referrals to the community by criminal justice providers;
  • how to make connections between criminal justice providers and the community;
  • referrals to the community from the jail or prison;
  • referrals to the community;
  • and electronic linkages.
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Research shows that there are a disproportionate number of justice involved individuals suffering from chronic illness and/ or mental health and substance abuse disorders. We also know that a majority of the justice-involved individuals are young adults and unemployed or earn an income that is well below the federal poverty line leaving them without the ability to obtain health care. There is now an opportunity to enhance collaboration between the criminal justice/corrections and healthcare systems. Early estimates indicate a significant number of justice-involved individuals may be eligible for provisions under the Patient Protection and Affordable Care Act (ACA), specifically; enrollment in Medicaid or the ability to purchase health care coverage through state health insurance exchanges. Because of the many health care expansion possibilities for this population we are witnessing an unprecedented opportunity to help connect the justice population to healthcare coverage and the associated healthcare services.

Federal, state and local criminal justice systems are poised to change the way they do business with the advent of the ACA. It is now possible for millions of low income, justice- involved individuals to obtain healthcare or insurance coverage for their physical and behavioral health needs. This far reaching system change will impact every decision point in the criminal justice system from arrest to individuals returning to the community upon release.

Presented on June 18, 2014, this program informed and increased awareness around this historic healthcare expansion opportunity. The broadcast highlighted promising practices by providing resources and strategies to expand healthcare coverage to justice-involved individuals. During this national discussion and broadcast by the National Institute of Corrections, presenters:

  • Established the relevance of the Affordable Care Act to the criminal justice system.
  • Provided concrete examples for collaboration and system linkages between the criminal justice system and healthcare system.
  • Provided healthcare enrollment strategies to increase informed decision-making between criminal justice and healthcare stakeholders.
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Hepatitis C virus (HCV) is a global public health problem in correctional settings. The International Network on Health and Hepatitis in Substance Users–Prisons Network is a special interest group committed to advancing scientific knowledge exchange and advocacy for HCV prevention and care in correctional settings. In this Review, we highlight seven priority areas and best practices for improving HCV care in correctional settings: changing political will, ensuring access to HCV diagnosis and testing, promoting optimal models of HCV care and treatment, improving surveillance and monitoring of the HCV care cascade, reducing stigma and tackling the social determinants of health inequalities, implementing HCV prevention and harm reduction programmes, and advancing prison-based research.

While some level of in-custody deaths are inevitable — for example, the passing of elderly inmates from old age — certain types of mortality are highly preventable with the proper interventions. This effort convened a panel of prison and jail administrators, researchers, and health care professionals to consider the challenges related to inmate mortality in correctional facilities and opportunities for improved outcomes. Through structured brainstorming and prioritization of the results, the panel identified a series of needs that, if addressed, could significantly reduce inmate mortality rates.

This paper “shares insights from the experiences of five jurisdictions working to implement different forms of HIT connectivity. Although there is no turnkey solution, there are lessons to be learned. [The] intent here is to share these lessons with those interested in improving health care in jail environments and with jurisdictions that are looking for ways to create connectivity in their communities” (p. 5). Sections of this report cover: bridging the islands between jail management systems, jail health systems, and community health systems; three guiding principles for connectivity—policy, resources, and champions; and HIT (health information technology) connectivity in Orlando County (FL), Multnomah County (OR), New York City, Hampden County (MA), and Fayette County (KY).

Jails and Health Cover

During 2015, the latest year for which data are available, there were 10.9 million admissions to these correctional facilities, which hold individuals who are awaiting trial or serving short sentences. The government running the jail—usually a county—has a constitutional mandate to provide people booked into these facilities with necessary health care. Counties designing a jail health care program targeted to meet the needs of their incarcerated population have the opportunity to improve the health of people in jail and the broader community, spend public dollars more effectively, and, in some cases, reduce recidivism.

"Sharing health information across correctional boundaries presents many challenges. Three such projects in Connecticut may be of value in informing other jurisdictions of similar opportunities. This article describes the development and implementation of an interagency release of information (ROI) document and process, a voucher program to provide discharge medications at the time of release, and a statewide research-oriented health information network" (p. 1). Sections of this article include: introduction; interagency release of information (ROI) document and process; the Medicaid prescription voucher program; Connecticut Health Information Network (CHIN)—distributed system, security, record linkage, and governance; and conclusion.

Justice-Involved Health Information: Policy and Practice Advances in Connecticut Cover

This issue includes: Foreword, by Richard Geaither, National Institute of Corrections Jails Division; You Can Do It: Putting an End to Pharmacy Cost Increases, by Mike Kalonick, Milwaukee County Sheriff's Office, Detention Bureau; Accreditation for Adult Local Detention Facilities: Moving from Process Measures to Outcome Measures, by Bob Verdeyen, American Correctional Association; Got Training? Training as a Strategic Management Tool for Performance Enhancement, by Tom Reid, National Institute of Corrections Academy, and Connie Clem, NIC Information Center; The Sheriff's Office as a Community Resource in a Hurricane, by Michael L. Wade, Henrico County Sheriff's Office; Inmate Access to Legal Resources & Materials - How Do We Provide Inmates Access to the Courts? by Mark S. Cacho, Orange County Corrections Department; Urban County Issues in New Jail Planning, Design, and Transition, by Barbara Krauth with Michael O'Toole and Ray Nelson; Harris County Sheriff's Office Teams with Community College to Train Inmates, by Jim Albers, Harris County Sheriff's Office; Mission Creep and the Role of the Jail in Public Health Policy, by Donald Leach, Lexington/Fayette Urban County Government; Multnomah County Model Partnership for Custody and Health, by Timothy Moore, Multnomah County Sheriff's Office, and Gayle Burrow, Multnomah County Health Department; Strategic Planning: A 10-Step Approach, by Barry L. Stanton, Prince George's County Department of Corrections, and B. Jasmine Moultri-Fierro

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“This report examines Pew’s findings on state prison health care spending and explores the factors driving costs higher. It also illustrates a variety of promising approaches that states are taking to address these challenges … These examples offer important lessons as policymakers seek the best ways to make their correctional health care systems effective and affordable” (p. 4). Sections of this publication include: overview; the challenge for the states—location, staffing, and inmate transportation, a legal standard for care, prevalence of metal illness and disease, and the growth in the number of older inmates and their associated higher costs; sates responses to growing costs—telehealth technologies, advances in outsourcing of care, Medicaid financing, and the paroling of elderly and/or ill inmates.

Managing Prison Health Care Spending Cover

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