Health Care Needs of Returning Prisoners and How Unmet Health Needs Affects the Reentry Experience and Success in Reintegrating Back into Communities

Prison inmates are disproportionately sicker than the general population and upon release from prison often face serious gaps in potential access to care (accessibility and capacity of safety-net providers), particularly among certain racial ethnic groups and for specific types of service (primary care, mental health care, or alcohol/drug treatment). To explore the challenges that ex-offenders face in meeting their health care needs (i.e., realized access) and identify policies and programs to improve access for this population, we conducted eight focus groups with newly released offenders and health care providers that serve parolees in three counties with high concentrations of parolees (Los Angeles, San Diego, and Alameda). Focus group participants included Latino and African-American males, as well as female ex-offenders. We found that parolees face many challenges to meeting their health care needs, including lack of insurance, lack of information about available services and how to access them, and difficulties communicating with providers. We also found that not being able to address health needs often makes it difficult for ex-offenders to obtain employment and housing and re-integrate with their families. Finally, we found that developing linkages between the re-entry population and safety net providers is key to addressing their health needs. We discuss the implications of our findings in terms of facilitating linkages to services for the reentry population, how recent changes in California's parole policy impacts the referrals of ex-offenders to mental health and substance abuse services, and strategies for improving access to health care services for the reentry population.