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.  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.

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
Montana Expands Medicaid Coverage for Housing Assistance and Transition from Prison
Flathead Beacon
CMS has approved three distinct expansions of Medicaid in Montana. Those expansions include housing support for people with a serious mental illness or substance use disorder; 30 days of pre-release health care for people exiting state prisons; and therapeutic “contingency management,” an incentive-based treatment for people addicted to stimulants.
Criminal Justice Reform Is Health Care Reform
Given the burden of medical needs in the carceral setting and the profound health risks associated with incarceration itself, criminal justice reform and health care reform are inextricably linked. Although federal legislation, such as the First Step Act, does not directly alter state prison or county jail practices, it does establish norms across the country.
FAQs About the New Statutory Changes to Medicaid
In December of 2022, President Biden signed the Consolidated Appropriations Act of 2023, which contained two provisions that will fundamentally change the way healthcare is delivered in carceral settings. These frequently asked questions will help justice system stakeholders understand what these provisions will mean for them.

( 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.