This article explains how the use of telehealth - the interactive electronic exchange of information for diagnosis, treatment, support, or care management - can be a useful component for grantees of the Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP), which focuses on a collaborative intervention strategy to address substance abuse.
Patient safety systems use redundancy (double checking) procedures to minimize errors and prevent adverse and near-miss clinical events. However, redundancy and back-up procedures alone do not guarantee that patient morbidity and mortality will be reduced. In fact, patient safety literature now identifies the human factor as an essential element in outcomes. The human factor includes personal issues, task-oriented issues and interactions among staff. Most literature on patient safety calls for cultural changes in health care systems to minimize the human factor.
This report describes the implementation and outcomes of a pilot study in Connecticut to enroll people who were arrested and detained pretrial into Medicaid so they would have health coverage upon release. Jails can offer a “public health opportunity” (Greifinger 2007) to connect otherwise hard-to-reach, low-income people with health insurance. People in jail have substantial health needs, including behavioral health conditions that can contribute to a cycle of relapse and reoffending.
While some level of in-custody deaths are inevitable - for example, the passing of elderly inmates from old age - certain types of mortality are highly preventable with the proper interventions. This effort convened a panel of prison and jail administrators, researchers, and health care professionals to consider the challenges related to inmate mortality in correctional facilities and opportunities for improved outcomes.
During 2015, the latest year for which data are available, there were 10.9 million admissions to these correctional facilities, which hold individuals who are awaiting trial or serving short sentences. The government running the jail—usually a county—has a constitutional mandate to provide people booked into these facilities with necessary health care.
In an effort to better understand the role of pharmaceuticals in the state correctional setting and budget, and in a state’s overall health care strategy, The Pew Charitable Trusts, in partnership with the Vera Institute of Justice, administered a survey in 2016 to each state’s department of corrections, receiving responses from every state except New Hampshire.
Mass incarceration disproportionately impacts lower-income communities, communities of color, and persons with disabilities, creating a barrier to achieving health equity. People who are incarcerated face greater chances for chronic health conditions, both while confined and long after their release. Incarceration exposes people to a wide range of conditions, such as poor sanitation and ventilation and solitary confinement, that are detrimental to long-term physical and mental health.
Most people leaving prison have at least one chronic problem with physical health, mental health, or substance use (Mallik-Kane and Visher 2008). These health problems make it harder to successfully reintegrate into the community after incarceration— affecting people’s ability to avoid offending and maintain employment, housing, family relationships, and sobriety. Historically, most people returning from prison lacked health insurance, impeding receipt of care for chronic health conditions and leading to high levels of emergency room use.
The mission of the National Commission on Correctional Health Care is to improve the quality of health care in jails, prisons and juvenile confinement facilities. NCCHC establishes standards for health services in correctional facilities, operates a voluntary accreditation program for institutions that meet those standards, produces resource publications, conducts educational conferences and offers certification for correctional health professionals. NCCHC is supported by the major national organizations representing the fields of health, mental health, law and corrections.
Since its beginning Community Oriented Correctional Health Services (COCHS) has worked to bridge the gap between correctional and community providers. COCHS' major emphasis has been to re-frame jail healthcare not as a place separate from the rest of the community but as another healthcare delivery site within the community.