From Corrections to Community: Reentry Health Care
Connecting people leaving jail and prison to community-based health care
In California, on any given day, some 200,000 people are in state prison or county jails. In addition, every year, 36,000 people are released from California prisons, and a million more are admitted to and released from jails. This “reentry” population — people returning to the community from jail and prison — have acute health needs but often have difficulty accessing timely, appropriate care on the outside.
People involved with the justice system experience high rates of physical and mental health problems within complicated social contexts, including trauma, unemployment, and poverty. Many have complex health conditions: An estimated 60% of California prison inmates have substance use disorders, one-quarter have a serious mental illness, and many also have multiple physical health conditions including hypertension, infectious diseases, and asthma. California’s expansion of Medi-Cal to cover single individuals without children means that many people in the reentry population who previously lacked insurance now have Medi-Cal coverage. Counties, providers, and plans are taking notice of this vulnerable population and their needs for appropriate, competent care.
CHCF is funding projects that highlight system changes to improve the coordination and delivery of care for people leaving correctional settings and returning to the community. Please see a summary of our current work in this area below.
Background and Landscape
- California Health Policy Strategies’ publication Reentry Health Policy Project: Meeting the Serious Health and Behavioral Needs of Prison and Jail Inmates Returning to the Community (PDF) describes the landscape and makes recommendations for policy and payment changes to improve access to care. (2017)
- A CHCF Almanac report on mental health in California, as well as a second one on substance use disorder in the state (to be published fall 2018) includes the interactions between the criminal justice and behavioral health systems.
- CHCF supported a review of guidance on sharing of behavioral health data, Overcoming Data-Sharing Challenges in the Opioid Epidemic, written by attorneys at Manatt, Phelps & Philipps. Data-sharing is an essential building block for integrating care for people with complex needs, including people at reentry.
- Advancing the work of the Transitions Clinic Network, a national network of clinics, including eight in California, that is implementing a model of integrated, culturally-competent care designed to serve people returning to the community from incarceration. (Ongoing)
- Supporting California’s Whole Person Care (WPC) pilots via a Learning Collaborative that focuses in part on reentry projects in 8 of the 25 WPC pilots. (Ongoing)
- Working with the Council on State Governments’ Stepping Up Initiative, a national initiative to reduce the number of people with mental illnesses in jails. (Ongoing)
CHCF’s reentry work is part of our focus on people with complex needs and on behavioral health: building integration essentials (data transparency and data sharing, new financing models, and policy solutions) and supporting care transformation, including complex care integration and integration initiatives in the Medi-Cal program. CHCF is also participating in a statewide effort to address the opioid epidemic, a component of which focuses on increasing access to integrated addiction treatment.
For more information, please contact CHCF’s Catherine Teare.