Healthcare in Jails

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.  Jail inmates are disproportionately male, people of color, and poor.

Many of these individuals experience serious health problems. Half of jail inmates and prisoners have a chronic health condition. Nearly two thirds of jail inmates 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.

COCHS' Mission

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 seldomly 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.

What's New

Stories and news items of note impacting healthcare within corrections
Corrections budget shows savings due to Medicaid expansion...
The Community-Based Substance Abuse Treatment portion of the Idaho Department of Correction budget shows a big drop in the governor’s recommended budget for next year – 29.7% less in state general funds. That’s almost entirely due to Medicaid expansion. Josh Tewalt, state corrections chief, said 93% of the parolees and probationers currently receiving services through the division are eligible for the newly expanded Medicaid program, so the state will save $2.8 million.
County jail to adopt new healthcare system
The Madison County jail will transform methods of providing healthcare to prisoners, as county commissioners accepted a proposal from Southern Health Partners to provide on-site and remote care for $62,120 a year. The change comes as a result of the Sandra Bland Act passed by the Texas legislature in 2017, which mandates county jails divert people with mental health and substance abuse issues toward treatment and requires that independent law enforcement agencies investigate jail deaths.
Three years after East Baton Rouge privatized jail health care, inmate death rate remains high
In August 2015 a group of nurses at the East Baton Rouge Parish Prison described dire staffing shortages and inadequate mental health services that advocates blamed for an outsized inmate death rate in the jail. As a result, the parish Metro Council, contracted with CorrectHealth. But advocates, have so far been skeptical about CorrectHealth's accomplishments because people are still dying — double the national average. CorrectHealth 's internal investigations into the deaths are being withheld from public view.

COCHS' Media Scan

COCHS sends out a weekly media scan of news stories covering healthcare delivery within correctional institutions. These stories range from stories about local correctional institutions all the way to national initiatives. Occasionally, we will post announcements about COCHS or one of our partner organizations.