Is your health care organization seeking to work with incarcerated and justice-involved populations? Through waivers and other initiatives, more states are aligning health care services with the reentry process, both to provide for the health care needs of people leaving jails and prisons and to reduce recidivism and the social and economic costs of incarceration. California, through its CalAIM initiative, will be the first state in the nation to extend Medicaid coverage for select services in the 90 days prior to release, with the goal of creating better outcomes for the state’s reentry population. Additional guidance from the Centers for Medicare & Medicaid Services encourages other states to do the same.
Mental health conditions, substance use disorder, and homelessness are social and health factors that contribute to high rates of incarceration. Individuals’ health often worsens while incarcerated, and those leaving incarceration face stark health risks. These include more hospitalizations than the general population and greatly enhanced mortality rates — the risk of overdose death alone for the reentering population is 129 times higher than the general population. By connecting reentering populations with health care and other resources prior to release and upon reentry in the community, health care professionals can help reduce the risk of both adverse health outcomes and re-incarceration.
To address the health care needs of the justice-involved population and create effective partnerships, health care professionals need to speak the language and understand the goals of the criminal legal system and reentry services. To that end, CHCS, in partnership with Community Oriented Correctional Health Services and the California Health Care Foundation, developed CalAIM Explained: Caring for Californians Leaving Incarceration, which serves as a 101 guide for California stakeholders looking to partner with the criminal legal system. The foundational lessons within are applicable for health care professionals everywhere who want to learn the basics of the correctional system, the reentry process, and find key partnership opportunities to serve and improve the health outcomes of this population.
We’ve assembled an overview of some of the guide’s top suggestions below.
Learn the Basics
Understanding the criminal legal system is an important first step to improving health care access for reentry populations. Like health care, the justice system and corrections sector offer a world of industry-specific language, nomenclature, and culture. This guide can help you learn the difference between jails and prisons, parole and probation, diversion and deflection. The guide offers a glossary of key terms and other basics of the criminal legal system that will help you better navigate the system.
Collaborate and Coordinate
Identifying and addressing health and social needs across areas like mental health, substance use disorder, and housing insecurity is an important step to improving population health and addressing recidivism. That work can’t happen in a silo; to do it effectively means collaborating across sectors and coordinating crucial health and social services prior to release, such as primary care, medication, housing, public benefits, substance use disorder treatment, and mental health care. CalAIM Explained: Caring for Californians Leaving Incarceration offers recommendations for successful cross-sector collaborations to coordinate pre-release planning and connect reentering populations with health care coverage and other community-based health services.
There are significant new opportunities for health care stakeholders to partner with those in the criminal legal system. The chance to interrupt the cycle of recidivism and worsening health outcomes is a major opportunity to increase health equity, as well as structural and institutional racism, which lead to disproportionate rates of criminal legal system involvement for people of color. This 101 guide offers easy on-ramps for collaboration across areas like Medicaid enrollment, pre-release planning, and probation and parole collaboration. It also contains real-world examples and existing best practices from across California.