Simply having health coverage can significantly reduce the odds that an individual involved in the criminal justice system will be arrested or incarcerated in the future. Yet enrollment during release and probation can be difficult. Interested in learning how the enrollment community and probation organizations can work together to help meet the promise of access for this special population? Check out the slides of this webinar from August 4, 2015, on how to navigate new partnerships with the criminal justice system, promising practices for consumer engagement, and post-enrollment support.

1. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
© 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Working with the Criminal Justice
System: Education and Enrollment
Strategies for the Recently
Incarcerated

2. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org2
• Provide attendees with
pathways to work with
the justice population
• Offer a variety of
concrete suggestions for
starting partnerships
between criminal justice
agencies and health
organizations
Outline and Objectives
I. Why It Matters
II. Examples of
Initiatives
III. Getting Started
IV. Places to Look for
Partnerships
V. Maintaining
Momentum
VI. Best Practices
VII. Q & A

3. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Jennie Sutcliffe, Moderator
Sargent Shriver National Center on Poverty Law, Chicago, IL
Deanna Adams, Program Director
Friends Outside, Santa Cruz County, CA
Jennifer Hawkins
Office of the Deputy County Manager, Maricopa County, AZ
Anne Peak
Kentuckiana Regional Planning & Development Agency (KIPDA)
Panelists

4. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
WHY IT MATTERS
Jennie Sutcliffe

5. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Health Status of the Justice Population
Only 1 in 10 of the individuals involved in the criminal justice system
already have insurance
Rates of inmates with mental health issues range from 56% at state
prisons to 64% at county jails
Justice-involved individuals disproportionally suffer from chronic
diseases and disorders
– Hypertension
– Asthma
– Arthritis

6. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Health Care Patterns Upon Re-Entry
Returning citizens are more like to obtain episodic care that is not
managed or coordinated
More than 70% of recently released inmates utilized some sort of
health services in the 10 months following release
– One study found that re-entering citizens used the ER an
average of 3.6 times per person in the first year post release
– 44% of study participants used the ER within the first three
months post-release

7. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Health Care as a Cost Savings Tool
Provision of healthcare is estimated to save criminal justice agencies a
lot of money
$1 of treatment provided will save $2.58 in criminal justice costs
Example: Substance use treatment
• Access to substance use treatment will prevent escalation of
other physical and mental conditions
Example: Mental health treatment
• High recidivism rates for individuals with mental health
diagnoses can be combated with continuous access to quality
care

8. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
EXAMPLES OF
INITIATIVES
Kentucky
Maricopa County, Arizona
Illinois
Santa Cruz & Sonoma, California

9. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Healthy Re-Entry Coalition of Kentucky
Coalition started by state assister organizations as a subset of another
broader work-group
– Targeting harder to reach/previously untargeted populations
Priorities:
– Health and health care access
– Successful reentry
– System improvements
Wide range of enrollment and advocacy activities
Over 50,000 justice involved individuals have enrolled
– Large increase since the HRC

10. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Maricopa County, AZ
- Adult Probation Offices & Jails - Message: “Help is available”
- GetCoveredAmerica.org - Client contact info and follow-up
- Customized for jail inmates: release date - Paper and digital

11. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Illinois
Workgroup on Justice Populations
• Convened senior level state officials in corrections and health
• Training for criminal justice personnel
• Technical assistance for county jails
• Health literacy tools for the justice-involved population

12. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Santa Cruz County, CA
Contract with CBO with existing relationship with criminal justice population
– Expand partnerships with criminal justice agencies and CBOs
Initiatives:
– Health care enrollment video
– Health care informational classes
– Multiple enrollment locations
Joint Efforts:
– Benefits Collaborative
– Informational training for law enforcement

13. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
GETTING STARTED

14. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Research and Prep
Build on current momentum
Assess the landscape
– What organizations/services are doing this work?
– What state policies impact this work?
• Medicaid expansion
– Benefits covered
• Medicaid suspension vs termination
• Facility coordination
Link with enrollment assister groups

15. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Criminal Justice Intercepts
Explore enrollment opportunities

16. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Coalition Development
Decide on an approach
– Within organization
– Coalition
– Work group
– Government lead task force
Select leadership

17. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
PLACES TO LOOK FOR
PARTNERSHIPS
Anne Peak

18. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Essential
• Local, State and Federal Correctional Facility’s
• Department of Medicaid Services
• State Based Exchange
• State DOC and related state offices (Justice/Public Safety
Cabinet)
• County Jail Representatives
• Probation and Parole
• Reentry Councils, Family and Friends of the Incarcerated
• Enrollment assister groups – IPA, Navigator, CAC, FQHCs
• Social service providers (Catholic Charities, Freedom 101 etc.)
• ACLU – essential to our beginning process
• Health or Outreach and Enrollment Coalitions
• National Partners – Chicago, Denver, Oregon Etc,
• Behavioral Health Departments

19. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Nice to have
• National Institute of Corrections
• Judges
• Drug Courts
• Halfway Houses
• National Criminal Justice Association
• Department of Public Advocacy
• Social Workers
• VA
• Jailers Association
• Community Mental Health Centers
• Department of Juvenile Justice
• City and/or County Offices (Mayor, Justice Commission Etc)
• QHP’s Qualified Health Plans

20. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Unexpected
- Adult Education Council on Postsecondary Education
- Fairness Campaign
- Job Corps
- University
- Local Community College
- Planned Parenthood
- Family Planning
- Local Health Care Providers

21. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
MAINTAINING
MOMENTUM
Jennifer Hawkins

22. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Seek out the Right Partners
– Identify your needs
• Target population(s)
– Race, gender, language, age, income, health
care needs
• Service delivery
– Enrollment assistance, education, referral
– Service location (jail, probation offices, clinics)
– Delivery method (hands-on vs. education)
• Reporting and outcomes
– Outcome measures
– Data format, delivery and timelines

23. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Identify Barriers and Resources
Identify and Combat Barriers
• Policies, practices, cultural
norms
• Background checks
• Badging
• Parking and building access
• Safety
• Written agreements
• Hours of operation
Identify Existing Internal
Resources
• Personnel
• Funding
• Equipment
• Office Space

24. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Match Your Needs to Theirs
• Target populations that fit a partner’s mission or grant
requirements
• Use data to incentivize partners

25. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Assign the Right Tasks to the Right People/
Partners
• Identify points of contact
• Go to the leadership level
• Develop and reiterate goals
• Identify action items/give people something to do
• Follow through & follow up

26. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
• Follow up cards
• Behind the scenes coordination
• Enrollers in facilities
• Enrolling families during visiting hours
• Rural outreach
• Tailoring materials and media
• Re-entry groups and classes
• Safety training/ addressing concerns about safety
• Training for criminal justice personnel
See handouts for sample materials and other information on
the various initiatives.
Recap: Best Practices

27. © 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
© 2015 Enroll America and Get Covered America
EnrollAmerica.org | GetCoveredAmerica.org
Questions?