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How Jail Survey Affects Health Care

survey released this week on health coverage for California inmates and those on probation presents a golden opportunity to change people’s lives through health care, according to the survey author.

“These are populations that typically have not been eligible in the past for coverage,” said Jenny Montoya Tansey, director of a program called Health Matters at the Californians for Safety and Justice advocacy group. “Many of them have unaddressed mental health and drug addiction needs that can contribute to cycles of crime.”

Tansey said her survey showed uninsured rates for people in jail can be as high as 90% and three-quarters of Californians on probation don’t have any kind of health insurance. It makes no sense to have drug abusers and the mentally ill go without medical care to address their glaring health needs, she said.

“There are high rates of mental illness in jails, and many people see the jail as their primary source of care,” Tansey said. “It’s tough for them to connect to mental health services outside of prison, so they wind up back in jail. That is a costly and ineffective way to treat mental illness.”

If that population is accessing care at all, it’s through emergency departments, which is another costly treatment area, she said.

“The critical piece is having people get enrolled and connected to a health home,” Tansey said. “That has a tremendous potential to help people manage their disease, whether its diabetes, hepatitis C or drug and alcohol use.”

If this population can get a health home through Medi-Cal, that would be a bridge between jail and the outside world — and that transition time is when most people with mental illness or addictions fall back into the same destructive patterns, she said.

“We have the potential to disrupt the cycles of the seriously mentally ill or drug and alcohol abusers,” Tansey said. “This could be a stabilizing force in their lives.”

Tansey also is working on focus groups within this population to find the best ways to reach them with information so they can be signed up and use the care offered by the state.

“We found that some people are not seeing any difference yet [because Medi-Cal expansion is so new], but for the people who are, they talk a lot about this emotional component,” Tansey said. “They say, ‘For the first time in my life it feels like my parole officer might actually be interested in my well-being.'”

Before being on Medi-Cal, she said, people reported that there was an impossible struggle to get care. “Now there’s a structure in place to take care of yourself,” she said.

She has convened six focus groups in five counties, and plans to produce marketing materials county workers and jail facilities could use to reach out to this population, such as video on the closed-circuit televisions in county jails.

Beyond the hope of health homes through Medi-Cal, Tansey said the other big health care piece for this population is the drug Medi-Cal waiver.

“I don’t know why we’re not moving forward with that more aggressively,” she said, “when it’s clearly such a need here.”