Health Care Behind Bars: A Key to Population Health?

August 1, 2014

This briefing explored innovations and challenges in delivering health care to a growing population of inmates, and also the prospect of health care in the correctional setting as a key to improving population health. This is an expensive group because of the large number of people with mental illness, addiction disorders, conditions associated with aging and Hepatitis C. Indeed, corrections spending is the second fastest-growing state expenditure, behind Medicaid, according to the Pew Charitable Trusts.

Some corrections systems are turning to approaches that include contracting with private companies and bringing more services in house. At the same time, states expanding Medicaid are quickly signing up inmates. Medicaid may pay for hospitalizations during incarceration, and provides full coverage when inmates transition out of the corrections system.

Panel I

Steve Rosenberg, president, Community Oriented Correctional Health Services (COCHS), outlined the demographics of the corrections population and the health problems that result in repeated incarcerations.

Debra Rowe, a Washington, DC resident and advocate for inmates and those transitioning to the community, described her own incarceration in the 1980s, and the parallels she sees between the treatment of inmates at the time who were struggling with AIDS and those in the system now who have Hepatitis C.

Jacqueline Craig-Bey, a Washington, DC resident, described her personal experiences receiving health care while incarcerated.

Panel II

Sharon Lewis, statewide medical director, Georgia Department of Corrections, talked about the challenges and innovations in providing health care to a large and aging population, while her budget is decreasing. She also will explain her approach to bringing many services inside the facilities.

Asher Turney, statewide medical director, Centurion, which Tennessee contracts to provide health care in its corrections system, addressed the financial difficulties in treating Hepatitis C.

Moderator: Ed Howard, executive vice president, Alliance for Health Reform

Follow the briefing on Twitter: #PrisonHealth

Contact: Marilyn Serafini (202)789-2300

The event was sponsored by the nonpartisan Alliance for Health Reform and the Centene Corporation.
*Electronic health records do not exist in most corrections facilities, but it would greatly enhance the quality of care, said Sharon Lewis.

*Corrections facilities are facing an influx of aging inmates, and also those with Hepatitis C. Hepatitis C is causing economic challenges for corrections systems, and, therefore, states, said Steve Rosenberg. More than 10 percent of inmates over the age of 50 have Hepatitis C, and that is more than twice the incidence in the general population, he said. He and Sharon Lewis said that the cost of the new drug Sovaldi is often prohibitive for this population.
*It is important for the corrections community to focus on prevention and wellness so as to improve health and decrease recidivism, and there are many programs in place to achieve that goal, said Asher Turney.
*There is a lack of privacy in receiving medical care while incarcerated, said Jacqueline Craig-Bey, who, as an inmate, received exams in hallways. She also said that waits for care can be long and noted a one-year wait for a dental appointment as an example.
*To reduce costs and improve quality, many corrections facilities are bringing more services in-house, and are also contracting with private companies to provide health care services.


Full Transcript (Adobe Acrobat PDF)

Speaker Presentations

Steve Rosenberg Presentation (Adobe Acrobat PDF)
Sharon Lewis Presentation (Adobe Acrobat PDF)
Asher Turney Presentation (Adobe Acrobat PDF)

Event Details

Agenda (Adobe Acrobat PDF)
Speaker Biographies (Adobe Acrobat PDF)

Event Resources