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Health Care Behind Bars: A Key to Population Health?


Friday, August 01, 2014

This briefing explored innovations and challenges in delivering health care to a growing population of inmates, and also the prospect of health care in the correctional setting as a key to improving population health. This is an expensive group because of the large number of people with mental illness, addiction disorders, conditions associated with aging and Hepatitis C. Indeed, corrections spending is the second fastest-growing state expenditure, behind Medicaid, according to the Pew Charitable Trusts.

Some corrections systems are turning to approaches that include contracting with private companies and bringing more services in house. At the same time, states expanding Medicaid are quickly signing up inmates. Medicaid may pay for hospitalizations during incarceration, and provides full coverage when inmates transition out of the corrections system.

Panel I

Steve Rosenberg, president, Community Oriented Correctional Health Services (COCHS), outlined the demographics of the corrections population and the health problems that result in repeated incarcerations.

Debra Rowe, a Washington, DC resident and advocate for inmates and those transitioning to the community, described her own incarceration in the 1980s, and the parallels she sees between the treatment of inmates at the time who were struggling with AIDS and those in the system now who have Hepatitis C.

Jacqueline Craig-Bey, a Washington, DC resident, described her personal experiences receiving health care while incarcerated.

Panel II

Sharon Lewis, statewide medical director, Georgia Department of Corrections, talked about the challenges and innovations in providing health care to a large and aging population, while her budget is decreasing. She also will explain her approach to bringing many services inside the facilities.

Asher Turney, statewide medical director, Centurion, which Tennessee contracts to provide health care in its corrections system, addressed the financial difficulties in treating Hepatitis C.

Moderator: Ed Howard, executive vice president, Alliance for Health Reform

Follow the briefing on Twitter: #PrisonHealth

Contact: Marilyn Serafini (202)789-2300 mserafini@allhealth.org

The event was sponsored by the nonpartisan Alliance for Health Reform and the Centene Corporation.
 
KEY BRIEFING POINTS

*Electronic health records do not exist in most corrections facilities, but it would greatly enhance the quality of care, said Sharon Lewis.
 
*Corrections facilities are facing an influx of aging inmates, and also those with Hepatitis C. Hepatitis C is causing economic challenges for corrections systems, and, therefore, states, said Steve Rosenberg. More than 10 percent of inmates over the age of 50 have Hepatitis C, and that is more than twice the incidence in the general population, he said. He and Sharon Lewis said that the cost of the new drug Sovaldi is often prohibitive for this population.


*It is important for the corrections community to focus on prevention and wellness so as to improve health and decrease recidivism, and there are many programs in place to achieve that goal, said Asher Turney.


*There is a lack of privacy in receiving medical care while incarcerated, said Jacqueline Craig-Bey, who, as an inmate, received exams in hallways. She also said that waits for care can be long and noted a one-year wait for a dental appointment as an example.


*To reduce costs and improve quality, many corrections facilities are bringing more services in-house, and are also contracting with private companies to provide health care services.
   

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Transcript (Adobe Acrobat PDF), 8/1/2014
Full Webcast/Podcast: Full Video

Speaker Presentations

Steve Rosenberg Presentation (Adobe Acrobat PDF), 8/1/2017
Sharon Lewis Presentation (Adobe Acrobat PDF), 8/1/2014
Asher Turney Presentation (Adobe Acrobat PDF), 8/1/2014

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Agenda (Adobe Acrobat PDF), , 8/1/2014
Materials List (Adobe Acrobat PDF), , 8/1/2014
Source List (Adobe Acrobat PDF), , 8/1/2014
Speaker Biographies (Adobe Acrobat PDF), , 8/1/2014

Offsite Materials (briefing documents saved on other websites)

County Jails and the Affordable Care Act: Enrolling Eligible Individuals in Health Coverage (Adobe Acrobat PDF),National Association of Counties, 3/1/2012
Ethical Dilemmas In Prison and Jail Health Care, Health Affairs Blog, 3/1/2014
Health Coverage and Care for Youth in the Juvenile Justice System: The Role of Medicaid and CHIP (Adobe Acrobat PDF),The Kaiser Family Foundation, 5/1/2014
Public-Private Partnerships in Correctional Health Care (Adobe Acrobat PDF),Reason Foundation, 7/1/2014
The ‘Invisible’ Crisis of Correctional Health Care, The Crime Report, 10/1/2013
How the ACA Can Revolutionize Inmate Healthcare, The Nation, 6/1/2014
Pew: State Prison Health Care Spending Trending Down Since Peak, The Pew Charitable Trusts, 7/1/2014
Should Prisoners Get Expensive Hepatitis C Drugs?, USA Today, 3/1/2014
Ex-Inmates and HIV: ‘Falling Into the Abyss', The Crime Report, 5/1/2014
For Women Just Out Of Jail, Health Care Could Be Key To Better Life., Kaiser Health News, 6/1/2014
Released Prisoners More Likely to Suffer Early Death, Georgia State Study Finds, Health Canal, 5/1/2014
Report: Managing Prison Health Care Spending, The Pew Charitable Trusts, 5/1/2014
Report: State Prison Health Care Spending, The Pew Charitable Trusts, 7/1/2014
State and Local Correctional Healthcare Privatization Update, Reason Foundation, 5/1/2013

Photos

It is important for the corrections community to focus on prevention and wellness so as to improve health and decrease recidivism, and there are many programs in place to achieve that goal, Asher Turney, statewide medical director, Centurion, stated at an August 1 Alliance briefing, Health Care Behind Bars: A Key to Population Health?


There is a lack of privacy in receiving medical care while incarcerated and inmates receive exams in hallways, stated Jacqueline Craig-Bey, Washington, DC resident, and former inmate, at an August 1 Alliance briefing, Health Care Behind Bars: A Key to Population Health?

Electronic health records do not exist in most corrections facilities, but it would greatly enhance the quality of care, said Sharon Lewis, statewide medical director, Georgia Department of Corrections, at an August 1 Alliance briefing, Health Care Behind Bars: A Key to Population Health?

 

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