July 2008

Grant Results

SUMMARY

The Community Voices: Healthcare for the Underserved program of Morehouse School of Medicine (funded by the W.K. Kellogg Foundation) convened two meetings in March and May 2006 to define guidelines for health care access for prisoners re-entering the community.

The meetings, held in Washington and Atlanta, drew 55 invited participants, including health care providers, policy-makers, health policy analysts and representatives of nonprofit community-based organizations and foundations.

Key Findings
The project team reported the following key findings in a summary of the two meetings, Developing an Action Agenda for Prisoners Reentering the Community: Reconnecting to Health Services. (Available online.) Findings included:

  • The prevalence of mental disorders in the prison population is significantly higher (16 percent) than in the general population (5 percent).
  • Incarcerated individuals are more likely than the general population to have untreated oral health problems.
  • Most prisoners re-entering the community are not eligible for Medicaid, as eligibility frequently does not extend to adults between the ages of 21 and 64 who are childless, not pregnant and neither blind nor disabled.

Key Recommendations
The project team reported the following recommendations in Developing an Action Agenda for Prisoners Reentering the Community: Reconnecting to Health Services (available online):

  • Provide Medicaid coverage for ex-offenders re-entering the community, including prevention and treatment services, mental health and substance abuse services and dental health services.
  • Develop a list of mental health and substance abuse treatment providers in the community for ex-offenders and facilitate access to these providers through the use of outreach workers.
  • Collaborate with the American Dental Association and colleges of dentistry to establish a consortium of providers of dental services for ex-offenders re-entering the community.

Funding
The Robert Wood Johnson Foundation (RWJF) supported this unsolicited project with a grant of $29,947 from March 2006 to February 2007.

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THE PROBLEM

According to the Reentry Policy Council, more than 650,000 individuals are released each year from prisons and jails into the community. Many of these individuals have health problems, including drug and alcohol dependence, mental illness and infectious and chronic diseases. Many lack access to health services when they re-enter the community.

Community Voices: Healthcare for the Underserved is a program funded by the W.K. Kellogg Foundation to strengthen community services and make health care available to all, including formerly incarcerated individuals. The Community Voices program at Morehouse is one of eight sites nationally.

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THE PROJECT

Project staff convened two meetings to define guidelines for health care access for prisoners re-entering the community. The first meeting was held in Washington on March 17, 2006. The second meeting was held in Atlanta on May 31, 2006. The meetings drew 55 invited attendees, including health care providers, policy-makers, health policy analysts and representatives of nonprofit community-based organizations and foundations.

The National Academy for State Health Policy, a nonprofit organization that helps states achieve excellence in health policy and practice, organized the meetings.

While this project was underway, the W.K. Kellogg Foundation provided a grant of $4 million to the Community Voices Program in Atlanta to establish a program to facilitate the successful re-entry of former prisoners into the community.

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RESULTS

Project staff published a series of reports, including:

  • A summary of the two meetings, titled: Developing an Action Agenda for Prisoners Reentering the Community: Reconnecting to Health Services. (Available online.)
  • Examining the Needs of the Incarcerated, Soon-to-Be Released and Ex-Offenders. (Available online.)
  • Where Are the Men? The Impact of Incarceration and Reentry on African-American Men and Their Children and Families. (Available online.)
  • Public Housing Policies That Exclude Ex-Offenders: A House Divided. (Available online.)

Findings

The project team reported the following key findings in the meeting summary, Developing an Action Agenda for Prisoners Reentering the Community: Reconnecting to Health Services (available online):

Mental Health

  • The prevalence of mental disorders in the prison population is significantly higher (16 percent) than in the general population (5 percent).
  • Substance use disorders are very common among prisoners, with approximately 80 percent of state prisoners reporting histories of drug and/or alcohol abuse.
  • The length of stay for people with mental illness is longer than those without such problems. This may be attributed to the quality of care that prisoners receive while behind bars: if proper treatment is not received, then their behavior is affected.

Oral Health

  • Incarcerated individuals are more likely than the general population to have untreated oral health problems.
  • Poor oral health is higher among minority, low-income and immigrant populations. A 2002 survey found untreated tooth decay to be 41.3 percent among non-Hispanic black adults, 35.9 percent among Mexican-American adults and 18.4 percent among non-Hispanic white adults.
  • Very few adults, including ex-offenders, receive dental services through state Medicaid programs.

Medicaid

  • Most prisoners re-entering the community are not eligible for Medicaid, as eligibility frequently does not extend to adults between the ages of 21 and 64 who are childless, not pregnant and neither blind nor disabled.
  • The application lag time for Social Security Supplemental Security Income (SSI) is more than one year, so ex-offenders re-entering the community who qualify for Medicaid through SSI eligibility are without Medicaid coverage during that time.
  • Individuals released from prisons and re-entering communities must rely on an inadequate health care safety net consisting of community health centers, charity care or emergency room care.

Recommendations

The project team reported the following key recommendations in the report, Developing an Action Agenda for Prisoners Reentering the Community: Reconnecting to Health Services (available online):

Mental Health

  • Provide Medicaid coverage of mental health and substance abuse treatment for ex-offenders re-entering the community.
  • Develop a list of mental health and substance abuse treatment providers in the community for ex-offenders and facilitate access to these providers through the use of outreach workers.
  • Expand the availability of substance abuse treatment programs in the community.

Oral Health

  • Provide Medicaid coverage of dental services for ex-offenders re-entering the community.
  • Educate the community and policy-makers of the risks and benefits of oral health, and establish an oral health education campaign.
  • Collaborate with the American Dental Association and colleges of dentistry to establish a consortium of providers of dental services for ex-offenders re-entering the community.

Medicaid

  • Provide Medicaid coverage for ex-offenders re-entering the community, including prevention and treatment services, mental health and substance abuse services and oral health services.
  • Begin the application process for SSI benefits during incarceration in order to shorten the lag time to receive Medicaid benefits after re-entering the community.

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AFTER THE GRANT

Since the conclusion of this grant, Community Voices staff has:

  • Worked with members of the Georgia state legislature to develop state programs to provide health care access to former state prisoners.
  • Convened a group of former prisoners nationally to discuss lack of health care access for former prisoners, and assisted members of this group to meet with members of Congress to discuss health care access for former prisoners.
  • Organized the 2008 Community Voices' Freedom's Voice Conference & Soledad O'Brien Awards Gala, April 9–11 in Atlanta.
  • Examined policies that bar ex-offenders from public housing. (Report available online.)

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GRANT DETAILS & CONTACT INFORMATION

Project

Meeting to Define Guidelines for Health Care Access for Prisoners Re-Entering the Community

Grantee

Morehouse School of Medicine (Atlanta,  GA)

  • Amount: $ 29,947
    Dates: March 2006 to February 2007
    ID#:  056858

Contact

Henrie M. Treadwell, Ph.D.
(404) 756-8914
htreadwell@msm.edu

Web Site

http://www.communityvoices.org/about.aspx

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Reports

Developing an Action Agenda for Prisoners Reentering the Community: Reconnecting to Health Services. Atlanta, Ga.: Morehouse School of Medicine, 2007. Available online.

Examining the Needs of the Incarcerated, Soon-to-Be Released and Ex-Offenders. Atlanta, Ga.: Morehouse School of Medicine, 2007. Available online.

Where are the Men? The Impact of Incarceration and Rentry on African-American Men and Their Children and Families. Atlanta, Ga.: Morehouse School of Medicine, 2007. Available online.

Public Housing Policies That Exclude Ex-Offenders: A House Divided. Atlanta, Ga.: Morehouse School of Medicine, 2007. Available online.

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Report prepared by: Carl A. Taylor
Reviewed by: Richard Camer
Reviewed by: Molly McKaughan
Program Officer: Jeane Ann Grisso

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