Authors: John Sawyer, Silicia Lomax, Sara Rosenbaum, Vikki Wachino, Margot Cronin-Furman
States considering how to strengthen access to care for Medicaid beneficiaries exiting incarceration have a natural place to turn in community health centers (CHCs). While challenges remain, these health centers can potentially serve as a “turnkey” source of care for justice-involved individuals.
CHCs are community-based providers of integrated primary care and related services that focus on medically underserved patients and communities. They have extensive experience in providing comprehensive physical and behavioral health care to populations facing high risks, including poverty and health disparities, and are a major source of care for many people, including people who are involved in the justice system. CHCs reached 31.6 million people in 2022 and exist in every state.
As states seek to improve public safety and implement Medicaid and reentry policies serving formerly incarcerated individuals, CHCs can serve as a provider of reentry services. CHCs already provide reentry services in their communities, and additional policy and practice changes will allow them to expand their role in the care of people leaving incarceration.
A group of 21 stakeholders interviewed by HARP offered key insights into how best to position CHCs to meet the needs of Medicaid recipients exiting incarceration.
Recommendations include:
- Build trust from the beginning of the provider–patient relationship by creating meaningful and direct connections between patients, health professionals, and CHCs.
- Create and maintain partnerships across corrections, legal/law enforcement, medical, public health, and behavioral health agencies, managed care organizations, and other community-based organizations such as reentry service providers.
- Use interdisciplinary care teams, integrating physical and mental health care, care for substance use disorders, and other professionals where appropriate.
- Incorporate community health workers who have lived experience of incarceration into care teams.
- Initiate a pre-release patient–provider relationship wherever possible.
- Employ trauma-informed care approaches that take into account the trauma resulting from, or intensified by, incarceration itself.
- Train providers to understand the culture of incarceration and people’s needs upon release.
- Work at an organizational level to identify shared goals across community health providers, correctional entities, and other service organizations.
- Establish the CHC as a hub for connections to other services, including housing, food, employment, and other social supports.
- Include people and communities impacted by incarceration in the development of organizational policies, programs, implementation plans, and evaluation strategies.
Going forward, workforce and service capacity, aligning service models with payment, and addressing data infrastructure and data sharing needs will also support effective CHC provision of reentry services.