grantmakers in health workshop november 17, 2006 steve rosenberg, president community oriented...

Grantmakers in Health Workshop

November 17, 2006

Steve Rosenberg, President

Community Oriented Correctional Health Services

COCHS and Inmate Re-entryCOCHS and Inmate Re-entry

22Community Oriented Correctional Health ServicesCommunity Oriented Correctional Health Services

Keith Barton Staff Physician

Ben Butler Chief Technology Officer

Kathryn Saenz Duke General Counsel

Steve Scheibel Medical Director

Paul Sheehan Chief Operating Officer

COCHS Staff


In last decade, U.S. jail population increased 31% per capita – 193 incarcerated in jail per 100,000 residents; 1995– 252 incarcerated in jail per 100,000 residents; 2005

At midyear 2005, 800,000+ people in local jails

7+ million people released from jails every year

More People Being Jailed


1.5 million people released every year

from incarceration with a communicable disease.

10% of jail population has 1+ serious mental disorders that needs treatment.

High diseaseburden with inmates


Jails’ budget and administration separate from other community health and social services.

Correctional health care (jails and prisons) is required and protected by U.S. constitution. U.S. Supreme Court in 1976 articulated the government’s constitutional obligation to provide medical care to people it has incarcerated.

$67.2 billion spent on corrections in 2006.

$6-10 billion (est.) correctional health care expenditures in 2006.

Jail administration and health services


Majority of jail inmates from five zip codes.

Contracts created for a community health center in each zip code area to provide physicians and some case managers to treat inmates from their catchment area.

As chronically ill inmates’ release dates approach, health center appointments made for continuing care.

Hampden County History


Cited as a national model Cited as a national model of correctional health care byof correctional health care by

Confronting Confinement, A Report on Safety and Abuse in America’s Prisons, June 2006.

Report of the Reentry Policy Council: Charting the Safe and Successful Return of Prisoners to the Community – Co-funded by the Dept. of Justice, Labor, Health and Human Services, 2004.

Response to Hampden County model


Community Oriented

Correctional Health Services (COCHS)

Developed and supported by the

Robert Wood Johnson Foundation

COCHS


“Jail inmates” “People temporarily displaced from their community.”

“Jail” “Site with leverage to find/create medical homes for temporarily displaced residents.”

Connectivity is the key: connecting jail and community services.

COCHS model reframes thinking


Create RHIOCreate RHIOContract with Unity Health Contract with Unity Health

Discharge planning / Case Mgmt.Discharge planning / Case Mgmt. Continuity of careContinuity of care

- Jail- Jail - Health Center- Health Center - Hospitalization- Hospitalization

Expanded Public Expanded Public Health ScreeningHealth Screening

Dept. of HealthDept. of Health Orasure HIVOrasure HIV Urine GC - ChlamydiaUrine GC - Chlamydia

Link to HealthLink to HealthInsurance EnrollmentInsurance Enrollment

Income Maintenance Dept. Income Maintenance Dept. Alliance cards issued Alliance cards issued upon dischargeupon discharge

DCDC JAILDCDC JAIL

Past (history intake)Past (history intake)

Present (EMR)Present (EMR)

Future Future (discharge planning / case management )(discharge planning / case management )

D.C. is first COCHS siteD.C. is first COCHS site


JAILJAIL CHC(s)CHC(s)

SHAREDDATA

Supported by the Langeloth Foundation

Regional Health Information Regional Health Information

OrganizationOrganization (RHIO) (RHIO)


Current activity Primary Care Redesign & Linkage

Future opportunities Behavioral Health Substance Abuse Juveniles Community Corrections

ConnectivityConnectivityKey to Post Release System of CareKey to Post Release System of Care

grantmakers in health workshop november 17, 2006 steve rosenberg, president community oriented...

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