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Contents of these proceedings include: meeting highlights; Domestic Preparedness and the Impact on Large Jails by Sue Menser; meeting participants discussion of issues; Role of the Jail in Public Health Policy by Don Leach; MRSA (Methicillin-Resistant Staphylococcus Areus by Dennis Williams; response by jail and public health officials to contagious disease emergencies; National Sheriffs Association: Weapons of Mass Destruction Initiative: Jail Evacuation Planning and Implementation by Mike Jackson and Joseph Oxley; Legal Issues in Jails2004" by Bill Collins; Topics for the Next Large Jail Network Meeting by Richard Geaither; meeting agenda; and meeting participants list.

Proceedings of Cover

Contents of these proceedings include: meeting highlights; "Cost Containment for Inmate Health Care" by Rebecca Craig; "Taming the Cost of Health Care in Detentions: What Works in San Diego County" by William Sparrow; "Confronting Costs for Medical Care: Open Forum Discussion"; "Increased Medical Costs: Managed Care and Private Contracts" by David Parrish and Dennis Williams; "Public Health and Jails: Challenges and Current Activities" by Roberto Hugh Potter and Dennis Andrews; "Succession Planning: Mentoring and Training Future Middle Managers" by Rocky Hewitt and Al Johnson; "Preventing Jail Suicides" by Jim Babcock; "Update on Large Jail Issues"; "Topics For the Next Large Jail Network Meeting" by Richard Geaither; meeting agenda; and participant list.

Proceedings of Cover

"The implementation of the Affordable Care Act (ACA) has set off reforms in health care systems across the country, including in county jails … Many of those who cycle in and out of county jails may now be able to obtain health insurance through the Health Insurance Marketplace or expanded Medicaid. County jails are therefore in a unique position to connect those in their custody with health insurance during pretrial detention or prior to discharge. Evidence suggests this could contribute to reduced health care and criminal justice costs to the county and lower jail operating costs. This brief will answer some of the most commonly asked questions about the ACA and how it relates to county jails" (p. 1). Answers provided cover: which offenders are eligible for coverage under the ACA; whether jails can bill Marketplace insurance plans for pretrial detainees; whether jails can bill Marketplace insurance plans for sentenced inmates; whether jails can bill Medicaid for pretrial detainees or sentenced inmates; whether Medicaid or Marketplace insurance plans will pay for court-ordered services; the 10 categories of items and services that are considered Essential Health Benefits; what to do if the open enrollment period has closed for the year; the number of inmates a jail can enroll; the differences between suspending and terminating Medicaid coverage; the states that suspend rather than terminate Medicaid; whether individuals can enroll if your state did not expand Medicaid; and how you can find out what your state and county are doing to implement the ACA.

The Affordable Care Act Cover

As jurisdictions across the nation attempt to do more with less, the effects of pharmacy management today will have long lasting and costly effects on the broader health care outcomes of tomorrow, in particular, the effectiveness of treatments for inmates with chronic illnesses, infectious diseases and comorbidities. This program will provide clarity around pharmacy management, why it is important to all jurisdictions, and methods for improving existing operations. This 3-hour program broadcast on April 6, 2011 addresses the costs and issues surrounding correctional pharmacy management. After watching this program, participants will: develop new insights regarding current practices for prescribing medications in correctional facilities and the need to manage that process; gain a deeper understanding of the principles, practices, and guidelines of a well-designed formulary management system; acquire a new appreciation for the current evidence and data used to guide formulary decisions; understand best practices related to the delivery of pharmaceuticals and biological medicines; have the skills to improve the coordination of care for offenders between correctional and non-correctional systems; and be able to explore the trends and foreseeable challenges to correctional pharmaceutical management in the future. The broadcast will also help viewers find answers to the following questions: What is a formulary and why is this concept important to my agency? What are the benefits of an effective correctional pharmacy management system? How does a pharmacy management system reduce costs and liability while enhancing healthcare services? What does the evidence tell us? Is there value in collaborating for the purchase of pharmaceuticals and biologicals? How does pharmacy management affect offender reentry?

Reduce Costs, Lower Risks, Enhance Healthcare Services: The Promise of Effective Pharmaceutical Management Cover

“The overall goal of the SOC [Standards of Care] is to provide clinical guidance for health professionals to assist transsexual, transgender, and gender nonconforming people with safe and effective pathways to achieving lasting personal comfort with their gendered selves, in order to maximize their overall health, psychological well-being, and self-fulfillment … While this is primarily a document for health professionals, the SOC may also be used by individuals, their families, and social institutions to understand how they can assist with promoting optimal health for members of this diverse population” (p. 1). Sections of this publication are: purpose and use of the SOP; global applicability; the difference between gender nonconformity and gender dysphoria; assessment and treatment of children and adolescents with gender dysphoria; mental health; hormone therapy; reproductive health; voice and communication therapy; surgery; postoperative care and follow-up; lifelong prevention and primary care; applicability of SOP to people living in institutional environments; and applicability of SOP to people with disorders of sex development. Appendixes include: glossary; overview of medical risks of hormone therapy; summary of criteria for hormone therapy and surgeries; and evidence for clinical outcomes of therapeutic approaches.

Standards of Care for health cover

"Under the landmark 1976 Estelle v. Gamble decision, the U.S. Supreme Court affirmed that prisoners have a constitutional right to adequate medical attention and concluded that the Eighth Amendment is violated when corrections officials display “deliberate indifference” to an inmate’s medical needs. The manner in which states manage prison health care services that meet these legal requirements affects not only inmates’ health, but also the public’s health and safety and taxpayers’ total corrections bill. Effectively treating inmates’ physical and mental illnesses, including substance use disorders, improves their well-being and can reduce the likelihood that they will commit new crimes or violate probation once released" (p. 1). Sections included in this report are: overview; spending trends; distribution of spending; spending drivers; cost-containment strategies; and conclusion. Also provided are the following report charts: Total Prison Health Care Spending Grew; Peaked in 34 States Before 2011; Components of Prison Health Care Spending; State and Federal Prisoners 55 and Older Increased by 204%; Share of Older Inmates in State Prisons Varied; Per-inmate Spending Higher in States with Older Inmate Populations. Correctional health care spending rose 13%. Due to the decrease in prison populations, per-inmate costs increased 10%. The statewide growth in the elderly inmate population caused those states with more senior inmates (per total inmate population) to have higher per-inmate costs.

State Prison Health Care Spending: An Examination cover

"The Affordable Care Act (ACA) is expected to help lower county jail healthcare costs, reduce recidivism, and create healthier individuals, families and communities partly because of provisions for expanded Medicaid eligibility and other healthcare affordability measures available to previously uninsured populations, including the offender population in county jails. This guide is meant to help Sheriffs and County Jail Administrators consider practical strategies and suggests steps that support cost savings while producing other benefits through the implementation of healthcare enrollment protocols, education of the inmate population, enrollment assistance and facilitation of the application process upon inmate release" (p. i). Sections of this brief are: why you should implement an ACA plan; some of the expected benefits of provisions of the ACA to county jails and their communities; Step 1—assemble the team and lead from the top; Step 2—determine offender needs/scope; Step 3—develop a screening process and related forms; Step 4—Limited Durable Power of Attorney; Step 5—hire Enrollment Specialists; enrollment reminders; Step 6—educate offenders; inmate program—Healthy Living; Step 7—train and educate staff, and draft procedures; Step 8—track, measure, report (and refine); and facts about the ACA.

The Affordable Care Act Cover

“This brief provides an overview of the implications of the ACA [Patient Protection and Affordable Care Act] for adults involved with the criminal justice system, as well as information about how professionals in the criminal justice field can help this population access the services now available to them” (p. 1). Sections of this publication cover: the opportunity to increase access to community health for offenders by removing financial barriers to obtaining health insurance; what ACA means to people involved with the criminal justice system—the range of provisions relevant for offenders; the “individual mandate” of ACA—the prescribed minimum level of health insurance; and the role of criminal justice agencies—determine eligibility, facilitate enrollment, and collaboration. The preparation of Illinois for the newly eligible correctional population for Medicaid is also highlighted.

The Implications of the Affordable Care Act on People Involved with the Criminal Justice System Cover

"The Patient Protection and Affordable Care Act (ACA) provides an historic opportunity for millions of low-income individuals to obtain insurance coverage for their physical and behavioral health care needs. For the last several years, diverse behavioral health advocates, health care providers and community-based prevention organizations, have worked to understand the implications of the ACA on the justice-involved population. Much of the conversation has been centered on the disproportionately high rates of physical and behavioral health care needs amongst this previously uninsured population … Access to treatment services through the ACA at pretrial decision points creates a notable opportunity to interrupt the cycle of crime exacerbated by chronic physical and behavioral health issues" (p. 1). This publication provides a general idea of what the ACA entails and explains how it can be used with pretrial detainees. Sections contained in this document include: an overview of the ACA; the major opportunities it can provide for pretrial justice; ACA as the front door to coverage; and a call to action for pretrial services—actively represent pretrial in collaborative planning efforts, develop a plan for screening and enrollment, and begin addressing larger policy questions.

The Patient Protection and Affordable Care Act and the Pretrial System: A "Front Door" to Health and Safety Cover

Health insurance options available through the Affordable Care Act (ACA) offer new opportunities to enroll individuals involved in the criminal justice system into coverage and provide access to physical and behavioral health services critical to their successful reentry into the community. Many individuals involved in the criminal justice system are now eligible for Medicaid under the ACA, including many young, low-income males who did not previously qualify for Medicaid. With one exception, federal law prohibits using federal Medicaid funds to pay for medical care provided to incarcerated individuals. However, Medicaid enrollment processes can begin prior to an individual’s release from incarceration, as there is no federal prohibition on incarcerated individuals being enrolled in Medicaid and federal law requires states to permit individuals to apply for the program at any time. Drawing on interviews with state officials, this toolkit highlights the efforts of selected states [Colorado, Illinois, New Mexico, Ohio, Rhode Island, Washington, and Wisconsin] to enroll in health coverage individuals involved with the criminal justice system. The toolkit is designed to provide state officials with actionable information about policies and practices available to connect justice- involved individuals to health care coverage through Medicaid." Access is provided to the sections of the Toolkit: the ACA, Medicaid, and justice-involved individuals; policy and process changes; enrollment as part of pre-release planning; post-release outreach; beyond eligibility and enrollment strategies; cross-agency coordination and partnerships; looking forward—future issues to address; state-specific strategies; Webinar: "Corrections and Medicaid Partnerships: Strategies to Enroll Justice-Involved Populations--Efforts in Colorado, New Mexico and Wisconsin"; and links to additional resources. Also presented is the interactive chart "Enrollment Process" which explains where, when, who, how, and whether individuals leave the facility with a Medicaid card. This resource is also available as a PDF chart.

Toolkit: State Strategies to Enroll Justice-Involved Individuals in Health Coverage cover


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