Jails are local correctional institutions that are on the front-line of healthcare in the criminal justice system. They process 13 million admissions a year. People incarcerated in jails are disproportionately male, people of color, and poor.
Many of these individuals experience serious health problems. Half of them have a chronic health condition. Nearly two thirds meet clinical criteria for substance abuse or dependence, and more than 40 percent have a history of a mental health problem.
Public safety stakeholders are not unaware of this trend. Sheriffs and wardens throughout the country frequently comment about how their institutions have become de facto mental health institutions and how jails are poorly equipped to serve in that role.
Even though jails are not considered healthcare delivery sites, considerable resources are dedicated to medical care in these settings, including intake assessments, sick call, chronic medical and mental health care, emergency responses.
Whether a justice involved person receives treatment in a jail or the community, there is little coordination between jail and community providers. As a result, treatments are interrupted impacting the health of the individual and potentially the health of the community.
Since its beginning Community Oriented Correctional Health Services (COCHS) has worked to bridge the gap between correctional and community providers. COCHS' major emphasis has been to re-frame jail healthcare not as a place separate from the rest of the community but as another healthcare delivery site within the community.
This perspective has many advantages. Coordination of care between community and correctional providers helps reduce interruption of treatments and the negative impact these interruptions can pose to individual health, community health, and community resources.
As part of its mission, COCHS provides technical assistance to assist communities in finding ways to improve healthcare in local correctional facilities as well as providing expertise on health information technology to create connectivity and data sharing. COCHS has also been the leader in identifying policies at the federal, state, and local levels that help local jurisdictions address the healthcare needs of their community members who are temporarily displaced within correctional institutions.
Stakeholders whether they be criminal justice professionals, policy makers, or health care providers seldom interact. COCHS has convened multiple conferences and working groups so these groups can exchange ideas and find solutions to the health crises that lead many people to cycle through jails.