hot topic | PRISON HEALTH CARE
Correctional Health Care is
COMMUNITY HEALTH CARE by Ann Kelly Nearly half of the inmates in New York’s prisons return to the community each year. New York was also one of three states that housed nearly half the 20,000 state prisoners across the country who had HIV or confirmed AIDS. Correctional health care is not only good for the health of inmates and correctional staff—it’s also about preventing the spread of infections to their families and communities when prisoners are released. “The state prisons have about 60,000 inmates, and each year about 27,000 of them return to the community. Providing essential health care to this population is important to the well-being of them, their families, communities and the correctional staff,” said New York Assemblyman Richard N. Gottfried. He sponsored a bill in 2009 to improve medical care for HIV/AIDS and hepatitis C in the state’s prisons and jails by requiring oversight by the state Department of Health. The issue is so important because people entering correctional facilities have much higher infection levels than the general population for
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everything from tuberculosis and hepatitis to sexually transmitted diseases, including HIV/ AIDS, according to the Centers for Disease Control and Prevention. And when the inmates are released to their communities without connections to adequate medical care, infections can continue to spread in their communities. In New York, where more than 300,000 people pass through jails and prisons each year, the quality of care available to inmates varied widely among facilities. New York Assembly Bill 903 and companion Senate Bill 3842 aim for high quality medical care for all HIV/AIDS and hepatitis C infected inmates through a facility review and inspection process. The bill authorizes reviews of similar services in local correctional facilities to begin in two years. Incarceration provides the state with a public health opportunity to test, treat and educate the inmates who have not had sufficient access to health care prior to incarceration, and have high incidence of chronic and infectious diseases, mental illness and substance abuse problems, according to the bill’s purpose statement.
HEALTH CARE BEGINS BEHIND BARS, CONTINUES IN COMMUNITY KEEPING INMATES HEALTHY IN JAILS AND PRISONS
KEEPING INMATES HEALTHY UPON RELEASE
1. Test for infections on intake, and coordinate care for
1. Begin planning and registering for continuing medical
inmates who are transferred from jail to prison or released into the community prior to treatment. When appropriate, test inmates again prior to release.
2. Offer testing, treatment and prevention education programs for all inmates when possible, focusing on assuring confidentiality and avoiding stigma for those who participate.
3. Offer programs to modify behaviors that put inmates at risk for transmitting infections, including providing condoms and clean syringes.
4. Provide substance abuse and mental health treatment for inmates when needed to avoid further risk of infection.
care and health coverage as soon as possible after incarceration begins.
2. Provide medications for several weeks and instructions on how to obtain affordable refills upon release for those taking prescription medications.
3. Link inmates to mental health and substance abuse treatment, or community condom distribution and syringe exchange programs for those who want to avoid future risk of transmitting infection.
4. Link inmates to community support programs for assistance with homelessness, unemployment and lack of education to help them achieve lifestyles with lower risk of transmitting infections.
