Jail Healthcare

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 Effect of Public Health Insurance on Criminal Recidivism
SSRN
The decomposition of recidivism rates shows that this reduction is driven by marginal recidivists who, but for Medicaid expansions, would be reconvicted for the type of crime for which they were previously convicted. Analyses of potential mechanisms show an increase in criminal justice referrals to addiction treatment, which may reduce impulsive behavior. Back-of-the-envelope calculations also indicate that there are substantial cost reductions from providing Medicaid coverage to former inmates.
Five Evidence-Based Policies Can Improve Community Supervision
PEW
Probation systems in all 50 states collectively supervise roughly four times as many people as do parole systems. States have adopted key policies to help strengthen and shrink those systems. Research suggests that five policies can help states achieve key community supervision reform goals: limit probation terms, provide earned compliance credits, limit incarceration before a violation hearing, and prohibit driver’s license suspension for inability to pay fines and fees.
Incarcerated workers: overlooked as essential workers
BMC Public Health
The Centers for Disease Control and Prevention recommended that incarcerated people be prioritized for vaccination primarily due to the risk present in congregate style prison and jail facilities. Furthermore, our review found that many incarcerated people perform labor that should be considered “essential”, which provides another reason why they should have been among the first in line for COVID-19 vaccine allocation.


( 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.