Many ex-convicts struggle to get medical care after release
When Matthew Boyd was released from a Georgia prison in December 2020, officials said he was sent home without the drugs he uses to manage his chronic heart and lung condition and high blood pressure. He said.
Less than a month later, he spent eight days in the intensive care unit. Since then, he was the first of more than 40 hospital admissions. These days, he can barely get out of bed at his home south of Atlanta.
Boyd, 44, who has chronic obstructive pulmonary disease, said, “It makes my life so miserable. I told my story.
Medicaid is generally prohibited from paying people for prisons and services received while in prison, but the Biden administration opened the door A federal program to cover care shortly before a person is released and to better manage their health condition during the transition. during February Administration announced states could use Medicaid too Pay for substance abuse treatment in state prisons and prisons. Congressional efforts to restart Medicaid before inmates are released nationwide have so far failed.
and in much of the south, Many states haven’t expanded Medicaidre-entry services connecting people like Boyd to medical resources are often minimal or non-existent.
600,000+ Released from state and federal prisons in the United States each year, the majority are in poor health. A 2019 judicial ruling suggested Those incarcerated have a constitutional right to an adequate medical discharge plan prior to release, including provision of drugs and prescriptions.
In Georgia, correctional institutions are supposed to create discharge plan This includes making medical appointments and providing medicines. Joan Heath, director of public affairs for the Georgia Department of Corrections, did not respond to questions about why official policy was not followed in Boyd’s case.
Despite official policy, people often leave prison or jail without medication, medical records, provider appointments, or health insurance. About 84% of the incarcerated men and his 92% of women had a physical or mental health condition or substance use disorder, according to the report. sample of people The Urban Institute, a nonprofit that studies issues of equity, interviewed him before and after his release from prison.
Without timely care, previously incarcerated patients are more likely to develop health crises and end up in costly emergency rooms. Or they’ll experience a mental health episode or commit a crime related to a substance use disorder and end up back in jail or prison.
Said “There is no bridge” Stephanie Jones-Heath, CEO of Diversity Health Center, a federally accredited health center in southeastern Georgia. By the time formerly incarcerated patients come to the center, their health status is uncontrolled and there are no medical records. said.
in the United States, Highest incarceration rate in the worldConditions such as solitary confinement, limited access to medical care, high stress, and poor diet can also cause or exacerbate illness.
“This is the sickest population in the country,” he said. Dr. Mark Stern, a member of the University of Washington School of Public Health who previously worked in the state’s Department of Corrections. Stern co-authored one of his few studies on this topic.That 2007 study found that those imprisoned 3.5 times more likely to die As with residents of other states, many deaths occurred within the first two weeks of being released.
in January, California became the first state Obtain a partial waiver allowing inmates to receive services through Medicaid 90 days prior to release. Over a Dozen Other States I am seeking a similar exemption. They argue that more seamless care could reduce overdose deaths, a leading cause of death among people getting out of prison, improve health and save money by keeping patients out of the emergency room. I’m here.
In Georgia, even basic hospital discharge planning can be rare, says Craig Burnes, a certified peer support specialist for inmates. In 2014, he was released from state prison after accidentally using an unactivated $20 debit card he had used for nearly 15 years. Burns, who suffers from bipolar and post-traumatic stress disorder, depression and anxiety, said he found his way to The Safety Net Foundation for Mental Illness Treatment near his home in Dalton.
Most of the people Barnes works with don’t know how to access care. They often lack family support and stable housing, suffer from mental health and substance abuse problems, and lack the skills to navigate the bureaucracy that comes with returning to life from prison. increase.
“It’s a terrible circle with no beginning,” he said. Burns regularly sends people to the emergency room so they can get medicine or refer them to free clinics.
After being released from prison in Alabama in 2011, Stephen McCary, 40, could not find a cure for his heroin addiction.
In May 2019, an addiction recovery facility informed me that funds were not readily available to pay for his treatment. McQuarrie, who also suffered from regular homelessness, never followed up. He suffered an overdose, was re-arrested for pharmacy theft, and is currently serving another prison sentence.
“If I had a place to go, I wouldn’t have committed these crimes,” he said in a call from Alabama’s Ventress Correctional Facility.
Alabama has not expanded Medicaid, which would have helped McCary secure medical care after he was released. Study in Connecticut We found that people were less likely to be hospitalized or readmitted if they were connected to primary care after being admitted. save state money.
“We have to see the big picture,” he said. Dr. Shira ShavitHe is a clinical professor of family and community medicine at the University of California, San Francisco, executive director of the Transitions Clinic Network, and has worked on research.
Blacks more likely than the general population imprisoned and Not covered by insurancehas been disproportionately affected by the lack of post-containment medical services.
One of the reasons people overlook it, he said, is because no agency is responsible for the problem. Dr. Evan AshkinProfessor of Family Medicine at the University of North Carolina at Chapel Hill, Previously imprisoned migrants in North Carolina A program that helps ex-convicts manage their health. He said the health care system often does not distinguish between the needs of those incarcerated and those of others who do not have insurance. The justice system has no budget or mandate to care for people who have left custody. About 90% of patients at the program’s clinics are uninsured, and while North Carolina has yet to expand Medicaid, lawmakers recently struck a deal to do so.
An important part of California’s new exemption is that providers can get reimbursement to coordinate care. This is especially important for those coming out of prison. “All their basic needs are up in the air at once, and health care is often an afterthought,” she said.
Medicaid expansion and program to enroll patients on Medicaid just before release helped those coming out of Louisiana Notoriously harsh prison medical systemSaid Dr. Anjali Niyogi, a professor at the Tulane University School of Medicine who founded a clinic serving those who were once incarcerated. Still, insurance coverage alone isn’t enough to make up for the lack of care people receive while in detention, she said.
Anthony Hingle Jr. The results of a biopsy taken days before his release from Louisiana State Prison in Angola in 2021 after 32 years of imprisonment were unavailable.
Hingle, 52, found out he had prostate cancer after calling a New Orleans hospital and asking for biopsy results. He had Medicaid insurance, but had to wait a few more months for his job insurance to take effect before undergoing treatment and surgery to remove his prostate. Hingle, who works as his assistant at The Office of the Voice of the Experienced, a nonprofit that advocates for incarcerated and former incarcerated people, wondered how his life would have played out had he been diagnosed earlier. I’m wondering if it was.
Without a prostate, he said, “I would never have children with my wife.”
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with Policy Analysis and Polling, KHN is one of three major operational programs. KFFMore (Kaiser Family Foundation). KFF is a donated non-profit organization that provides information on health issues to the public.
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