(Michael Coghlan/flickr)

Every day people leave correctional custody and begin the long process of rebuilding their lives. The organizations we represent – sheriff’s offices and community health centers – play an integral role in ensuring these returning citizens have the access to care they need on the road to rehabilitation and successful reentry.

We saw proof of this on a recent tour of the Lowell Community Health Center, one of the many centers with which the Middlesex Sheriff’s Office partners daily. It was there that we saw a gentleman in the waiting room holding a reentry kit containing educational materials, contact information, and Narcan. The kit had been provided to this man as he left the Middlesex Jail & House of Correction.

Think about it: this man’s very first stop after his release from jail was to his community health center because he wanted to continue the care he received while inside the facility.

This idea of continuity of care is one that we discuss frequently in public health and public safety circles, as well as the need for a “warm handoff.” But building a post-release bridge like this one is not easy. For every successful connection to community health after incarceration, there are many more cases with less favorable outcomes.

There were more than 10 million people released from jails or houses of correction across the United States in 2019. Those first weeks and months are a particularly vulnerable time. Returning citizens face numerous barriers, especially in accessing health care. They may have lost insurance coverage while incarcerated or may have never even had a primary care provider prior to their incarceration. Many need to focus on getting a job or getting an apartment before taking care of their mental, oral, vision, substance use disorder, or overall physical health.  Oftentimes, they try to balance all of this without vital social supports. 

It underscores the critical need for post-release supports such as case management, a service provided at many community health centers and at the Middlesex Jail & House of Correction, but often inaccessible to those without a connection to a “medical home.”

If people cannot address their basic needs, including timely access to needed health care, those unmet needs inevitably become the factors that drive people back through the doors of our jails. It is what we have come to call “medical recidivism” and it is unacceptable in a state that prides itself on high quality health care and smart criminal justice leadership.

That’s why we’re applauding a new initiative by the Health Resources and Services Administration, the federal agency that oversees the nation’s nearly 1,500 community health centers. The agency is investing more than $50 million in building up these kinds of connections, like those in Lowell and the 98 percent of Massachusetts communities served by a community health center.

The Health Resources and Services Administration is making this investment to ensure that, as people return to their communities following incarceration, their access to health care doesn’t miss a beat. The related policy changes also support community health center partnerships with jails and prisons to start providing some healthcare and support services before people are released, so that there is a more seamless transition during that individual’s reentry.

This builds on a nationwide effort to improve access to health care throughout reentry by changing the way Medicaid works within the justice system. Massachusetts is one of 24 states that have proposed allowing Medicaid to cover care provided pre-release. Massachusetts and 10 other states have been approved, and implementation is now underway on this vital innovation.

Efforts like this aren’t just good for public health, they’re good for public safety, families, and communities. When treatment needs go unmet, it leads to more complex and expensive health care and to greater recidivism. People should be able to access the care they need, in the communities where they live. When they do, they, their families and communities can thrive.

Massachusetts is the birthplace of community health centers and health reform, and we continue to lead the way in finding innovative approaches to improve access to care. The renewed focus on improving health care at reentry – among criminal justice professionals, policymakers of both parties, and all parts of the health care system – is a major part of making that access a reality for all, in the Commonwealth and across the country.

Peter Koutoujian is the Sheriff of Middlesex County, Michael Curry is the CEO of the Massachusetts League of Community Health Centers.