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 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.

What's New

Stories and news items of note impacting healthcare within corrections
The Reentry Act: Vikki Wachino's Letter
COCHS
In a letter to our partners and friends, Vikki Wachino, COCHS CEO, stresses that the Reentry Act would strengthen Medicaid’s role and allow it to support reentry services as an essential component of an overall public health strategy to reduce transmission of the coronavirus and mitigateal future COVID surges. Under current law, Medicaid does not cover health services when people are incarcerated. Incarcerated people are considered “inmates of a public institution” and barred from receiving Medicaid benefits, even though most detained individuals are Medicaid eligible.
Addressing Racial Inequities In COVID-19 Infection And Death
Health Affairs
In recent months, states and municipalities have begun releasing data on COVID-19 infections and death that reveal profound racial disparities. This gap in incidence can be traced to differences in risk of assembly and exposure. Factors such as crowded living conditions and lack of paid sick leave have been identified as risk factors for exposure that disproportionately affect low-income, disadvantaged populations. Additionally, Black and Hispanic Americans are overrepresented in low-wage jobs that are considered essential and therefore are more likely to commute to work during the pandemic.
How COVID-19 in Jails and Prisons Threatens Nearby Communities
PEW
Two new studies show that jails can contribute enormously to coronavirus case totals outside their walls. Depending on the social distancing measures put in place, community spread from infections in jails could add between 99,000 and 188,000 people to the virus’ U.S. death toll, according to a modeling study recently published by the American Civil Liberties Union in conjunction with researchers from the University of Pennsylvania, the University of Tennessee and Washington State University.


( What's New postings are updated weekly --previous postings are archived. )

COCHS' Weekly Update

COCHS sends out a weekly update of news stories covering healthcare 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.