Establishing a $1.2 million healthcare pilot program in New Jersey for Medicaid-eligible offenders re-entering society is needed to help a population stalled by addiction and other chronic medical conditions, a new report from the New Jersey Reentry Corporation states.
Healthcare access and education/job training serve as the two cornerstone areas of emphasis in the report, titled Reentry: From Prison to the Streets, Making it Work. The New Jersey corporation, which has developed a social service model that has led to a 62% employment rate and 19.7% recidivism rate among the transitioning clients it has served, is recommending healthcare and vocational training pilot programs that would address the needs of 210 individuals in six counties.
A team consisting of a licensed social worker, a registered nurse and a case manager would work with each individual to remove health barriers to successful reintegration. Recidivism and the reduction of expensive healthcare visits would be among the project's primary outcomes, with substance use outcomes and adherence to medication among those considered secondary.
Although the two suggested pilot programs have a price tag of around $3.5 million, the corporation's recommendations carry significant weight in New Jersey, with a bipartisan group of five former state governors serving on the corporation board. Former Gov. James McGreevey serves as board chairman for the organization, which works with public and private entities to improve reintegration prospects for offenders.
Moreover, “The total proposal will cost only $5,714 per participant, nearly one-tenth the cost of a year of incarceration,” the report states. “Given the evidence that good health and primary care access promotes self-sufficiency and lowers recidivism, the pilot will save significant state funding.”
The report cites limited access to health services behind bars as a major contributor to unsuccessful community reintegration for released inmates.
“The absence of treatment is particularly striking for those suffering from opioid abuse and addiction,” the report states, citing a statistic revealed this year by The New York Times that showed only 31 of the more than 5,100 U.S. prisons offer access to medication treatments such as methadone or buprenorphine for opioid dependence.
The report's healthcare recommendations draw from a care model for populations with complex needs that was developed by the Camden Coalition of Healthcare Providers. It involves team-based interventions that offer flexible but intensive case management. The report cites three coalition best practices that are likely to benefit the reentry population greatly: motivational interviewing, trauma-informed care, and harm reduction.
The proposed healthcare pilot would enroll all individuals also participating in the proposed vocational program. Each individual would be screened to assess substance use, mental health and general health needs. Intensive case management, including home visits, would be offered over a one-year period.
“All these clients will be Medicaid-eligible, so savings in Medicaid costs can be rerouted to fund the program,” the report states. The Reentry Corporation would partner with various healthcare providers to offer links to needed services.
The report cites a National Association of Drug Court Professionals statistic finding that 60% to 80% of incarcerated offenders with drug abuse problems reoffend after release. “The provision of drug and addiction treatment, however, has failed to keep up with the growing need for services,” the report states.
It concludes with regard to its recommendations, “The creation of pilot education and healthcare programs based in the local community, the integration of corrections and parole with reentry, and the establishment of an interagency commission to connect reentry across services, will improve long-term employment outcomes, and will therefore reduce costs and improve public safety.”