Brockmann et al. Respond

Autor: Dora M. Dumont, Bradley W. Brockmann, Andrew M. Cislo, David L. Rosen, Josiah D. Rich
Rok vydání: 2014
Předmět:
Zdroj: American Journal of Public Health. 104:e4-e5
ISSN: 1541-0048
0090-0036
DOI: 10.2105/ajph.2014.302067
Popis: Birnbaum et al. raise several important points in their letter. A key issue they note is ensuring that former prisoners in Medicaid expansion states who are eligible for benefits have access to medical and behavioral health care immediately upon release. In Medicaid expansion states, we are aware of significant administrative hurdles to gain timely access to postrelease benefits in both states with policies of Medicaid suspension and those with policies of termination. Greater efforts are necessary to understand and leverage the role of these policies to improve released prisoners’ access to care. However, in both suspension and termination states, what appears to be most important to overcoming hurdles to access benefits is the extent to which there is prerelease support for (re)enrolling in Medicaid, significant interagency cooperation that facilitates both (re)enrollment and receipt of benefits, and motivated leadership. Key is the recognition by relevant state and community actors that health care coverage is an indispensable tool in released prisoners’ successful return to the community. To achieve this critical goal, former prisoners require not only the ability to access and link to care, but also sustained engagement in care. For that to happen, releasees’ often more pressing reentry needs must be addressed. Justice-involved individuals suffer from high rates of poverty, unemployment, homelessness, and unstable housing, among other problems. On release from incarceration, individuals must juggle these competing needs with few resources and little support. Failure to address these survival needs reduces the chances of sustained engagement in primary care. These are the next hurdles that must be addressed if former prisoners are to remain in care long-term as part of the road to successful reintegration into the community. Cross-agency collaboration that bridges diverse treatment and support arenas in the community is essential to successful reentry, but difficult. However, innovative models of postrelease programs that successfully link justice-involved populations to community-based care do exist.1 One of the most promising models is the Transitions Clinics,2 which combine transitional and primary care services with intensive case management and staff that understands and addresses the range of challenges facing returning inmate populations. Collaboration across multiple domains is required to engage this population in long-term care in the community. Successful engagement in long-term care can play a powerful role in supporting the health of released prisoners and that of the families and communities to which they return.
Databáze: OpenAIRE