Leveraging Health Care Reform to Increase Recovery and Reduce Incarceration

• Issues Health Care Reform (HCR) may dramatically increase access to treatment for substance use, psychiatric disorders and chronic health conditions. New services can be leveraged to reduce incarceration and increase health status, especially among low-income, minority populations. The authors detail current system limitations, changes through HCR and steps to create better, more just outcomes.

• Description The authors detail limitations of the current system for people who are incarcerated and lay out policy, planning and practices needed to achieve gains in health status and reductions in arrests and incarceration. Nine million adults pass through local jails annually. Research shows high rates of substance use (70%) and psychiatric disorders (16%), infectious diseases and chronic medical problems. Because detainees lack health insurance, they receive only episodic care in jail and community. Proven models linking detainees with community care have demonstrated major health improvements and reductions in incarceration and rearrest as high as 80%. HCR can facilitate tremendous reductions in incarceration and major improvements in health status across this vulnerable population.

• Lessons The authors are working with communities in Illinois to implement recommendations. Results by October 2011 will be described in our presentation.

• Recommendations Collaborative planning is needed to leverage opportunities and improve outcomes. The criminal justice system should screen all detainees for chronic substance use and psychiatric disorders as well as chronic medical conditions, and should enroll detainees in Medicaid/insurance so they can enter community services at release. Planning should begin now to integrate with state HCR planning.