Policy Proposals

In response to the COVID-19 pandemic and its impact on incarcerated people, COCHS has published proposals including the establishment of federal and state Correctional Health Coordinators and an 1115 Waiver allowing for facilities to be created that specifically serve individuals from correctional institutions.

Establishing State and Federal Correctional Health Coordinators to respond to the COVID-19 Pandemic

The national response to the COVID-19 pandemic is exposing life-threatening gaps in the health system’s response for people who are in involved in the criminal justice system. There are large and immediate health risks to people who are incarcerated and correctional officers. In Establishing State and Federal Correctional Health Coordinators to respond to the COVID-19 Pandemic, COCHS proposes that states should establish correctional health coordinators to coordinate the emergency response for incarcerated people.

We believe that the creation of a Correctional Health Coordinator with state and federal coordinating authority could cut across silos. States could move forward immediately to create a Correctional Health Coordinator through funding available in the CARES Act, but new coronavirus relief legislation could establish a leadership role and grant program in HHS that funds new state-level correctional health coordinators.

A public health approach to COVID-19 and the health crisis in America’s criminal justice system
National Alliance on Mental Illness (NAMI) in a letter to congressional leaders wrote: We urge Congress to act on recommendations from the Community Oriented Correctional Health Services’ proposal “Establishing State and Federal Correctional Health Coordinators to respond to the COVID-19 Pandemic”. This proposal emphasizes the importance of creating a coordinated response across the criminal justice system.
Vikki Wachino's Written Testimony Before the National Commission on COVID-19 and Criminal Justice
In testimony before the National Commission on COVID-19 and Criminal Justice, Vikki Wachino, COCHS' former CEO, described how people involved in the justice system, including correctional staff, face serious health risks from COVID-19. These risks are significant for minority groups, who are overrepresented in the justice system. Vikki proposed establishing Correctional Health Coordinators, adopting the Medicaid Reentry Act, and expanding access to community-based physical and behavioral health services.
A Policy Brief for an 1135 Medicaid Waiver

As COVID-19 spreads throughout correctional facilities, there will be an urgent need for inpatient care of patients who develop serious complications. Over half of incarcerated people have a serious physical or behavioral health problem and many are over 60 years old.

Policymakers have specific tools available to them during a National Emergency declared by the president. Under section 1135 of the Social Security Act, the Health and Human Services Secretary may temporarily waive certain Medicare, Medicaid and CHIP requirements at the request of states.

On March 20, COCHS disseminated a policy brief (Addressing the Needs of Justice-Involved People During the COVID-19 Pandemic: An 1135 Waiver Approach) suggesting an 1135 waiver that provides guidance on how such waivers may offer potential solutions to the issue of accessing inpatient levels of care for incarcerated patients.