So How Do We Reduce the Costs of Health Care in our Jails and Communities?
One of the programs I advocate is a community approach to correctional health care. This program was introduced by the sheriff of Hampden County Massachusetts and has received praise from the entire correctional health care community. It has proven to be effective at not only lowering the cost of health care at the jail, but throughout the entire community.
The root cause of the high costs of health care in our communities can be traced directly to a lack of care to our poor and uninsured populations. This population is also the population most likely to end up in our county jails. For most people that go to jail, their appointment with the doctor for their intake screening is the first time they have ever seen a medical professional. Unfortunately, due to the transitory nature of jail inmates (prisoners are released or transferred in very short periods of time, the population in a county jail turns over 36 times/year on average), there is usually no follow up care.
In jail, the infection rates for communicable diseases like Hepatitis, TB, and many STDs is 5 times as great as in the community. Couple that with the short stays, and quick releases, and we are actually pushing disease into our community. These inmates are being released to the same population that does not have health care, and is too poor to afford anything but a trip to the ER. A recent survey found that 46% of the women found to have STDs reported having sex with a male that had been an inmate within the preceding 6 months. This is the root of the extreme costs of health care in our jails and our community.
What the sheriff of Hampden County did, and what has been replicated throughout the country, is a community approach to health care. Instead of hiring private company in the effort to reduce costs, the jail recruited community providers, public health officials, and other professionals to provide services at the jail on a volunteer/discounted basis, and then act as the primary care provider to inmates that have been diagnosed with an issue, back out in the community upon their release. This continuity of care has greatly reduced the overall health care budget for every community that has implemented this program.
In addition to the community health care program, adding treatment programs, housing assistance, and job training has also greatly reduced recidivism rates in these counties. I believe that this type of program is the answer to the rising costs of health care in our jails and communities on a whole.
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