Prisoner Re-entry and Health
This project was made possible with a generous grant from Community Voices: Healthcare for the Underserved at the National Center for Primary Care at Morehouse School of Medicine. For more information or to receive notices on this project, please contact Tara Lubin at 202-624-3558 or tara.lubin@ncsl.org.
Health care for prisoners re-entering society – An introduction
Health care for prisoners re-entering the community is an important issue for states for a number of reasons. The prison population and numbers of returning offenders continue to grow, and the rising costs of corrections and services for offenders returning home add to state budget strains. Returning prisoners are very dependent on public health resources. At the same time, better access to health services in the community may improve re-entry and lower recidivism rates.
The problem
According to The Health Status of Soon-to-be-Released Inmates, by the U.S. Department of Justice, about 11.5 million Americans cycle in and out of jail or prison each year (the great majority of them short-term jail inmates). The report suggests that inmates are disproportionately likely to suffer from a variety of chronic communicable diseases, mental health problems, and substance abuse issues:
- more than 18 percent of hepatitis C virus (HCV) carriers in the country pass through the jail or prison system annually, as do
- 8 percent of those with HIV and
- one-third of those with active tuberculosis (TB).
- A comprehensive study by Human Rights Watch released in October of 2003 found that as many as one in five of the 2.1 million Americans in jail and prison are seriously mentally ill, far outnumbering the number of mentally ill who are in mental hospitals.
- According to the 2002 Survey of Inmates in Local Jails, 68 percent of jail inmates reported symptoms in the year before their admission to jail that met substance dependence or abuse criteria.
As detainees rejoin society, there is a crucial time of transition that has far-reaching impact. In order for investments in health made during incarceration to improve the long-term prospect of rehabilitation, and to help former prisoners continue to function when they return to the community, continuity of care is essential.
It is vital to the individual’s health and to public health and public safety that they be able to access mental and physical health care services upon release from prison and jail. However, studies indicate that needed services are often not available or accessible. Individuals who have stabilized or improved while incarcerated are stranded without needed medical supports, further stacking the odds against successful re-entry.
State role
Many of the laws and programs that states have implemented for health solutions for returning prisoners are part of larger efforts aimed at smoothing re-entry. New Jersey has a number of initiatives, including exploring expansion of substance abuse treatment capacity through increased use of Medicaid. In Rhode Island, there is a Steering Committee on Corrections Reform and Prisoner Re-entry, which established memoranda to support five projects aimed at improving re-entry, including substance abuse and mental health treatment. The Michigan Prisoner Re-Entry Initiative is based around the Transition Accountability Plan that is prepared for each inmate during the prison intake process to ensure the system of services that are essential for a successful transition.
A purely legislative example can be found in California, where a measure directed the Department of Corrections and Rehabilitation to conduct three pilot projects with counties on the subject of re-entry and evaluation upon coming into the system, so that the county probation department and the county social services departments would be in charge of the program for the individual that came to corrections.
State legislators have a valuable role to play in bringing visibility to this problem, ensuring that programs get funded and implementing best practices that save money, lower recidivism rates and help protect public health.
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