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Since March 2022, approximately 12,000 minimum security prisoners were allowed to serve a portion of their prison term on home confinement instead of in a federal prison as a result of The CARES Act. These releases were based on the President’s COVID-19 National Emergency Declaration. The Public Health Emergency runs until April 11, 2023. But prison populations continue to experience spread of the disease.
In an opinion piece, Peter J. Koutoujian, sheriff of Middlesex County, MA, writes: For millions of Americans with serious health care needs, their treatment is not being provided at a hospital or clinic, but at the county jail. This is why I’ve been working with both state and national leaders to eliminate the Medicaid Inmate Exclusion Policy that bars any eligible incarcerated person from accessing Medicaid services.
The omnibus bill allows states to choose to make substantial structural changes to how correctional healthcare is financed for eligible, incarcerated beneficiaries and provides a pathway forward for further reforms to improve care for justice-involved people. Sections 5122 of the law amends the Social Security Act to allow states to choose to allow incarcerated young people to maintain their Medicaid benefits as they await disposition of their charges.
Congressman Paul D. Tonko, Due Process Continuity of Care Act, Medicaid Reentry Act, Omnibus Appropriations Bill, Senator Bill Cassidy
Re-entry from incarceration is an important – and vulnerable – time. Recently-released adults face substantial health risks. Per the Social Security Act’s “inmate exclusion” policy, Medicaid cannot provide coverage for people who are incarcerated. This policy prevents ccess to healthcare including substance use and mental health services that help mitigate multiple challenges for the formerly incarcerated.
The president instructed the Justice Department on Wednesday to take various steps over the next seven months to improve public health and conditions overall in federal jails and prisons. This directive was part of the executive order President Biden signed on the second anniversary of the killing of George Floyd.
COCHS Announces Critical Support from RWJF and Aspen Health Strategy Group’s New Report on Health and IncarcerationCOCHS
COCHS is pleased to announce that COCHS is the recipient of another grant from the Robert Wood Johnson Foundation to further our essential work. This announcement comes on the heels of the release of a report Reducing the Health Harms of Incarceration from the Aspen Health Strategy Group (AHSG). A key recommendation from the AHSG’s report is to eliminate the inmate exclusion policy found in the Social Security Act
New England Journal of Medicine
The Medicaid Reentry Act is a first step toward addressing deficiencies in correctional health care delivery, but additional changes could be incorporated before its final passage to improve the health of people who are incarcerated. We support the recommendation of the National Association of Counties and the National Sheriffs’ Association that Congress amend the Social Security Act to permit the continuation of federal benefits, such as Medicaid, for people who are detained before trial.
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.
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.
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.
This is the third report as required under the First Step Act of 2018. It includes data on federal prisoners provided to BJS by the Federal Bureau of Prisons (BOP) for calendar year 2020. Under the FSA, BJS is required to report on selected characteristics of persons in prison, including marital, veteran, citizenship, and English-speaking status; education levels; medical conditions; and participation in treatment programs.
Health Affairs Blog
Allowing Medicaid funding for individuals as they prepare to return to the community is especially important in the jail setting where the population disproportionately consists of individuals with substance use disorder. Various states have already taken it upon themselves to enroll individuals in Medicaid before returning to the community. But the gradual, state-by-state approach to enrolling individuals in Medicaid is insufficient.
The federal Bureau of Prisons is a hotbed of abuse, graft and corruption, and has turned a blind eye to employees accused of misconduct. More than 100 federal prison workers have been arrested, convicted or sentenced for crimes since the start of 2019, including a warden indicted for sexual abuse, an associate warden charged with murder. In some cases, the agency has failed to suspend officers who themselves had been arrested for crimes.
Health and Human Services Secretary Xavier Becerra unveiled the Biden administration’s drug overdose prevention plan, aiming to increase access to care among those with substance use disorders. The administration intends to funnel resources into research to detect fentanyl hidden in drugs, supporting syringe exchange services, and boosting access to opioid overdose reversal treatments.
Florida and Georgia as well as Texas, provide even less information than they once did, according to researchers. The Behind Bars Data Project noted that while prison reporting had been “plagued by deep inadequacies” since the start of the pandemic, corrections systems cut back even more on public data in recent months. States have explained that they cut back on public data because of a decline in cases, even though they began making the change before the surge of the delta variant.
Health Affairs Prison And Jail Reentry And Health In this policy brief, Health Affairs presents a summary of the many challenging health care issues that people reentering society confront. Two the key points were that aass incarceration is a public health crisis that disproportionately affects Black and Brown people and that public officials should include health care as a key component of community reentry programming by supporting access to Medicaid.
A growing number of state and local governments are using a new set of data produced by the U.S. Census Bureau to recalculate the residences of hundreds of thousands of prison inmates who are serving their sentences far away from their homes. Legislatures in Connecticut and New Jersey have passed new laws this year that require state redistricting panels to count those who are incarcerated as living at their home addresses.
US Chamber of Commerce
An estimated 70 million people in the U.S. have an arrest or conviction record, and over 600,000 men and women are released from jail each year. Successfully reintegrating these individuals brings many advantages. First, there are advantages to these individuals who can get a fresh start supporting and taking care of themselves and their families. Second, employers can benefit by tapping into a talented labor force to meet their workforce needs.
Incarceration Transparency features an interactive map of Louisiana’s sixty-four parishes (the state’s equivalent of counties). If a user clicks on a parish, the names of the correctional facilities within its borders appear, along with a list of people who have died in those facilities in recent years. Next to each entry are the person’s race and sex. There are links to documents related to each case.
Office of Senator Sheldon Whitehouse
The Senate has passed the bipartisan Residential Substance Use Disorder Treatment Act of 2021 by Senators Sheldon Whitehouse (D-RI) and John Cornyn (R-TX). The bill will expand access to substance use treatment in jails and prisons around the country, and help those exiting correctional facilities continue their treatment in the community. The bill’s passage follows Whitehouse and Cornyn’s success in passing federal corrections reforms in 2018.
Office of Senator Bill Cassidy
U.S. Senators Bill Cassidy, M.D. (R-LA), Jeff Merkley (D-OR), and Ed Markey (D-MA) introduced the Due Process Continuity of Care Act. The bill amends Medicaid Inmate Exclusion Policy (MIEP) to ensure that pre-trial detainees are not kicked off Medicaid prior to ever being found guilty of a crime. MIEP denies federal benefits to individuals who are incarcerated and applies both to those who have been found guilty of a crime and those held pending adjudication.
Medicaid expansion doesn’t just provide more people health insurance — it appears to cut medical debt enormously. The Affordable Care Act offered states a huge infusion of federal money to expand Medicaid eligibility to low-income adults, and about 30 states took that deal right away. Since then, new medical debt in those states has fallen 44 percent, a bigger drop than was seen in the states that refused to expand the program. Those states showed only a 10 percent decline.
Mortality trends in most of America’s 3000 local jails are almost impossible to discern because jail-by-jail death data collected by the federal government is kept secret—unavailable to the public, news organizations and researchers, and even government officials. Reuters filled the information gap by requesting 12 years of death data from 523 local jails. This data shows that mortality rates in these institutions are two or three times the national average.
Two families called 911 to get help for their sons. They didn’t know that they’d be thrusting them into a complex and often brutal system. Death rates—especially suicide rates—in American jails continue to rise. Most people sucked into the system are at the mercy of forces outside their control, and diversion opportunities remain rare.
Executive Order on Reforming Our Incarceration System to Eliminate the Use of Privately Operated Criminal Detention FacilitiesWhite House
From President Joe Biden's executive order: More than two million people are currently incarcerated in the United States, including a disproportionate number of people of color. To decrease incarceration levels, we must reduce profit-based incentives to incarcerate by phasing out the Federal Government’s reliance on privately operated criminal detention facilities.
Reuters journalists filed more than 1,500 public records requests to gain death data from 2008 to 2019 in the nation’s biggest jails. Jail by jail and state by state, Reuters is making that information available to the public. Reuters examined every large jail in the United States, those with 750 or more inmates. And, to ensure it examined deaths across the country, it obtained data for the 10 largest jails in each state. The data covers 523 jails or jail systems and are available both in PDFs and CSV files.
The National Academies of Sciences Engineering Medicine
This report of the National Academies of Sciences, Engineering, and Medicine recommends corrections officials and public health authorities work together to determine the optimal population for jails and prisons. To mitigate the spread of COVID-19, authorities should use their discretion to minimize incarceration in prisons and jails — and facilitate testing, quarantine, social supports, and individualized reentry plans for those released.
Gov. Gavin Newsom (D-CA) has ushered in a number of criminal justice reforms, including changes to the systems of adult probation, juvenile justice and policing. AB1950 would reduce probationary periods from three years to one for misdemeanors and five years to two for most felonies. According to the REFORM Alliance, violations of California's probation and parole system cost the state about $2 billion per year.
Office of the Assistant Secretary for Planning and Evaluation
On October 1, HHS published a notice in the Federal Register soliciting nominations of individuals to serve on a stakeholder advisory committee on Medicaid reentry transitions, as required by Congress in the SUPPORT Act. The purpose of the group is to provide advice and consultation to the Secretary on innovative strategies to help individuals who are inmates of public institutions, and otherwise eligible for Medicaid. Nominations are due October 23, 2020.
Department of Corrections err on the side of caution when it comes to quarantining incarcerated individuals who may have had contact with a COVID-19 positive individual. Health experts warn that the use of punitive medical isolation can deter prisoners from reporting symptoms, and that solitary confinement has been shown to weaken the immune system, making its use an obstacle to protecting health.
National Commission on COVID-19 and Criminal Justice
Using data from a variety of sources, this report contributes to the understanding of COVID-19 outbreaks within state and federal prisons by addressing: 1) How do overall COVID-19 case and mortality rates within state and federal prisons compare with rates for the general population, both before and after adjusting for the age, race/ethnicity, and sex of people in prison? 2) How do COVID-19 infections vary by the type and location of a prison?
Mass Testing for SARS-CoV-2 in 16 Prisons and Jails — Six Jurisdictions, United States, April–May 2020CDC
Correctional facilities that resisted mass coronavirus testing for inmates erred in their decision to only test inmates with symptoms, leading to large initial undercounts, a recent study by the Center for Disease Control and Prevention suggested. The study released this week examined 13 prisons and jails. Most of the institutions waited several days or weeks before the first identified case of COVID-19 and the beginning of mass inmate testing.
Lawyers For Equal Justice
The Hawai'ian Supreme Court designed a process that allowed individuals incarcerated for lower-level offenses to petition lower courts for release. The process provided an opportunity for prosecutors to object to release, and allowed releases only if the judge was satisfied release would not endanger the public. Despite this success, media coverage of the release initiative was overwhelmingly negative.The outbreak that the Supreme Court tried so desperately to avert in April is now upon us.
The COVID-19 pandemic has focused attention on the more than 700,000 people in jails across the United States because of the potential for spread of the virus to those working and confined there. Concentrated efforts to reduce admissions and increase releases from jails in recent weeks have resulted in significant population drops in many of these local facilities. This change represents a sharp contrast to pre-pandemic trends.
One immediate way to protect people in prison and prevent the spread of the coronavirus is to substantially reduce (PDF) the prison population. Media’s attention has been on the federal government’s failed response in federal prisons, but scant attention has been paid to state prisons. Some prisons have started doing so, trailing behind efforts by jails, but it is not enough. Further, these releases have increased racial disparities; states such as Illinois are releasing Black people from prison at lower rates than their white counterparts.
Congress Must Respond to Deep Health Inequities for Black People During COVID-19: Medicaid is the LeverCommunity Catalyst and National Medical Association
Community Catalyst and National Medical Association has prepared a policy paper on actions the United States Congress can take to acknowledge the structural inequities of our health care system by investing in what people need during a health crisis that threatens their security. These include: invest in the Medicaid program, invest in Medicaid providers, incentivize states to expand Medicaid, support Medicaid connections in reentry, and extend Medicaid postpartum to reduce mortality.
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.
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 mitigate 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.
Scripps National News Interviews Vikki Wachino about the Reentry Act and Correctional Health CoordinatorsScripps National News
Vikki Wachino discusses how relief legislation moving through Congress needs to address COVID-19 in prisons and jails. She describes how the Reentry Act would allow Medicaid to cover incarcerated people 30 days before release, improving public health and safety. Vikki also mentioned the potential impact of COCHS' proposal for Correctional Health Coordinators to improve the COVID emergency response in prisons and jails.
The United States of Care
The United States of Care's handbook on COVID-19 preparedness lists five actions states should be taking to reopen safely. For protecting and fortifying sites at a high risk of transmission the handbook recommends that states need to build a strong, coordinated criminal justice system response plan in partnership with jails and prisons, including designating a person in charge of coordinating and implementing the state’s COVID response. The recommendation (page 7) provides a link to COCHS' proposal for state and federal Correctional Health Coordinators.
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.
Releasing individuals who are incarcerated without connections to healthcare providers, medical coverage, safe and stable housing, or a support system can greatly increase their risk of relapse, overdose, and death. To stem the spread of COVID-19 and prevent a further escalation of drug overdose deaths, Congress must pass bipartisan legislation to ensure that Americans who are incarcerated and at high risk for infection and poor outcomes can access the medical services they need.
The United States House of Representatives
On May 15, the United States House of Representatives passed the HEROES Act (H.R. 6800), which included a provision relating to the health of justice-involved individuals. Section 30110 would amend the Social Security Act to allow for Medicaid to pay for services to detained individuals thirty days before release. If the Senate were to also include this provision in its legislation, it would result in a substantial step forward removing the discontinuities in the healthcare system caused by the Social Security Act's ban of Medicaid services for Medicaid-eligible inmates of a public institution.
The New England Journal of Medicine
Although Covid-19 is currently affecting a wide enough swath of the U.S. population, so that it is unlikely in the near term to make the pandemic a "racial" issue, but in the future, the communities that are least able to buffer themselves against infection may find their ranks disproportionately represented in Covid-19 data, and the door may be opened to all-too-familiar mobilizations of racialized rhetoric.
In March 2020, in the face of the increasing danger posed by Covid-19 to people held in jails and prisons, the UCLA Prison Law and Policy Program launched the UCLA Covid-19 Behind Bars Data Project. The Project tracks Covid-19 conditions in jails and prisons and the efforts — both in and out of court — to decrease jail and prison populations and improve conditions to ensure the safety of residents and staff.
The Washington Supreme Court late Friday told Gov. Jay Inslee to protect the health of inmates in the state during the coronavirus outbreak and gave officials until Monday to detail the steps that have been taken. At least seven inmates at the Monroe Correctional Complex — the second largest prison in the state — have the disease and officials are awaiting results on 54 other cases, according to Department of Corrections.
New York Times
Picture thousands of cruise ships jammed with guests but short on hand sanitizer, protective gear and medical care. Every week, a quarter of the passengers get off, replaced by new people with the potential to either infect or be infected. There is a place like that in your community: the county jail, with a local sheriff, in charge of preventing Covid-19 outbreaks but having limited supplies and no say who enters and leaves.
San Francisoc Chronicle
California judicial leaders, to help courts cope with the coronavirus, voted Monday, April 6, 2020 to eliminate bail for defendants charged with misdemeanors and most nonviolent felonies and to allow pretrial proceedings to be conducted remotely. The temporary measures, which also included limits on evictions and home foreclosures, are intended “to preserve rights and ultimately preserve lives,” Chief Justice Tani Cantil-Sakauye said at the teleconference of the state Judicial Council.
San Diego Union Tribune
Elected leaders in San Diego County should consider taking a more comprehensive approach to the health care provided to thousands of inmates housed in local jails, a new study commissioned by the county says. Dr. Homer Venters, the report’s co-author said the Board of Supervisors and Sheriff Bill Gore should redefine the level of care inmates receive in custody.
The New York Times
In jails and prisons across the country, concerns are rising of a coronavirus outbreak behind bars. Already, cases have been reported. On Friday, someone who works in a Washington State prison tested positive for the virus, and the day before, the sheriff in Hancock County, Ind., said a staff member at the local jail was being isolated at home after a positive test. On Tuesday night, an employee at the Sing Sing Correctional Facility had tested positive.