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COCHS and Inmate Re-entry

COCHS and Inmate Re-entry. Grantmakers in Health Workshop November 17, 2006 Steve Rosenberg, President Community Oriented Correctional Health Services. COCHS Staff. Keith Barton Staff Physician Ben Butler Chief Technology Officer Kathryn Saenz Duke General Counsel

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COCHS and Inmate Re-entry

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  1. COCHS and Inmate Re-entry Grantmakers in Health Workshop November 17, 2006 Steve Rosenberg, President Community Oriented Correctional Health Services

  2. COCHS Staff Keith Barton Staff Physician Ben Butler Chief Technology Officer Kathryn Saenz Duke General Counsel Steve Scheibel Medical Director Paul Sheehan Chief Operating Officer Community Oriented Correctional Health Services

  3. More People Being Jailed • In last decade, U.S. jail population increased 31% per capita • 193 incarcerated in jail per 100,000 residents; 1995 • 252 incarcerated in jail per 100,000 residents; 2005 • At midyear 2005, 800,000+ people in local jails • 7+ million people released from jails every year Community Oriented Correctional Health Services

  4. High diseaseburden with inmates • 1.5 million people released every year from incarceration with a communicable disease. • 10% of jail population has 1+ serious mental disorders that needs treatment. Community Oriented Correctional Health Services

  5. Jail administration and health services • Jails’ budget and administration separate from other community health and social services. • Correctional health care (jails and prisons) is required and protected by U.S. constitution. U.S. Supreme Court in 1976 articulated the government’s constitutional obligation to provide medical care to people it has incarcerated. • $67.2 billion spent on corrections in 2006. • $6-10 billion (est.) correctional health care expenditures in 2006. Community Oriented Correctional Health Services

  6. Hampden County History • Majority of jail inmates from five zip codes. • Contracts created for a community health center in each zip code area to provide physicians and some case managers to treat inmates from their catchment area. • As chronically ill inmates’ release dates approach, health center appointments made for continuing care. Community Oriented Correctional Health Services

  7. Response to Hampden County model Cited as a national model of correctional health care by • Confronting Confinement, A Report on Safety and Abuse in America’s Prisons, June 2006. • Report of the Reentry Policy Council: Charting the Safe and Successful Return of Prisoners to the Community – Co-funded by the Dept. of Justice, Labor, Health and Human Services, 2004. Community Oriented Correctional Health Services

  8. COCHS Community Oriented Correctional Health Services (COCHS) Developed and supported by the Robert Wood Johnson Foundation Community Oriented Correctional Health Services

  9. COCHS model reframes thinking “Jail inmates”  “People temporarily displaced from their community.” “Jail”  “Site with leverage to find/create medical homes for temporarily displaced residents.” Connectivity is the key: connecting jail and community services. Community Oriented Correctional Health Services

  10. D.C. is first COCHS site • Expanded Public • Health Screening • Dept. of Health • Orasure HIV • Urine GC - Chlamydia • Link to Health • Insurance Enrollment • Income Maintenance Dept. • Alliance cards issued upon discharge DCJAIL • Contract with Unity Health • Discharge planning / Case Mgmt. • Continuity of care - Jail - Health Center - Hospitalization Create RHIO Past (history intake) Present (EMR) Future (discharge planning / case management ) Community Oriented Correctional Health Services

  11. Regional Health Information Organization (RHIO) JAIL CHC(s) SHARED DATA Supported by the Langeloth Foundation Community Oriented Correctional Health Services

  12. ConnectivityKey to Post Release System of Care Current activity • Primary Care Redesign & Linkage Future opportunities • Behavioral Health • Substance Abuse • Juveniles • Community Corrections Community Oriented Correctional Health Services

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