NCCHC News

Searching for Common Ground: One Year Progress Report
by R. Scott Chavez, PhD, CCHP-A, and Lambert King, MD, PhD

Two years ago, NCCHC, in its report to Congress on the Health Status of Soon-To-Be-Released Inmates, found that very few correctional health systems had well-developed, effective transitional health care planning programs. We recommended to Congress that the few programs that did foster continuity of health services be identified, analyzed and replicated. Over the past year, the Commission, funded by the JEHT Foundation, has conducted a search for excellent models and best practices in community reentry.

The Searching for Common Ground project is designed to explore, understand, stimulate and facilitate prerelease discharge planning and continuity of health care for men and women returning home from jails and prisons. The SCG is identifying those systems that have developed solutions to the barriers to ensuring continuity of care.

Unfortunately, policies and procedures too often are not followed and as a result services may be inadequate. Even when a discharge policy provides for a supply of medication, for example, the policy may not be followed because of logistical problems such as the inmate being released by the courts without being processed through the jail, or prison staff responsible for preparing a discharge may not inform health staff that the inmate is leaving.

Example of Excellence
The SCG project is identifying best practices such as the North Carolina Department of Corrections’ Transition Services, an excellent program that incorporates inmate participation and ensures that an aftercare plan is written and implemented.

The NCDC policy manual states the following standard for Aftercare Planning for Inmates in Health Services: “Every inmate who is identified as a recipient of mental health or developmental disabilities services and those inmates identified as medically needy by definition with release anticipated within 90 days will have a comprehensive, collaborative, cooperative aftercare plan completed and placed in the health services record no later than 30 days prior to the anticipated date of release.”

The NCDC developed a formal case management system that involves inmates in the planning stages. It ensures that each inmate who meets the criteria receives a “transitions release envelope” containing a copy of the completed aftercare health services plan, a completed medical discharge instructions form and, if appropriate, a 30-day supply of medication. The name, address and phone number of a provider with a specific appointment is in place before the inmate is discharged.

The NCDC Aftercare Planning is one example of a coordinated effort to improve inmate reentry. In the coming months, the SCG project will publish reports and articles on the best transitional practices it has found. In addition, the project will bring national experts to speak on these issues at NCCHC’s upcoming National Conference in New Orleans.

It is through sharing of information and planning that the SCG project will achieve its goal of improving the collaboration, resource management and continuity of care among health care programs in jails and prisons, urban communities, public health agencies and local, state and federal governments.

(Summer 2004)

Searching for Common Ground Project Announces an Essay Competition
to Identify Best Practices in Transitional Planning
by R. Scott Chavez, PhD, CCHP-A, and Lambert King, MD, PhD

The deadline for contest submissions has passed. The winners will be announced soon.
Thank you for your interest in the Search for Common Ground project.

The Searching for Common Ground project, an effort funded by the JEHT Foundation and conducted in collaboration with NCCHC, announces an essay competition to recognize best practices in transitional planning. Up to three entrants will receive air transportation, hotel lodging and registration to NCCHC’s National Conference on Correctional Health Care, Nov. 14-17 in New Orleans, LA. (For background on the project, click here).

There is a great need to have effective and efficient transitional planning in our prisons and jails. It is estimated that 97% of incarcerated individuals will eventually be released to our communities. This translates into staggering numbers: In 1999, nearly 600,000 prison inmates were released. Many of those being discharged from prisons and jails suffer from asthma, diabetes, cardiovascular disease, epilepsy, hepatitis C, HIV infection, serious mental illness and physical disabilities. It is vitally important that effective discharge planning occurs to ensure continuity of health care, through participation in employment, housing, school and church opportunities.

Across the country, many initiatives are taking place to improve the transition process. Some projects help inmates to prepare for a life beyond confinement, other projects work to improve the discharge process and yet others help releasees to adjust to life in free communities.

A goal of the Searching for Common Ground project is to identify and widely communicate replicable models and best practices that measurably improve continuity of care for recently released inmates with serious medical and mental health conditions. The essay competition will help to identify of the best of these models and practices.

Essay Guidelines
The Searching for Common Ground Project will accept essays on Best Practices in Transitional Planning from entrants who work in criminal justice institutions, human service agencies, community and neighborhood organizations, and other agencies that have an interest in improving transition into communities.

Essays must address efforts that contribute to improved public safety by offering better inmate transition through assessment, classification, programming, resource allocation and release preparation practices. Essays may address any of the following seven elements of the transition process:
• assessment and classification
• transitional accountability plans
• release decision making
• community supervision and services
• responding to violations of conditions of release
• termination of supervision and discharge of jurisdiction
• aftercare

The essay should make clear how the described model improves continuity of care for recently released inmates with serious medical and mental health conditions. It also should provide sufficient detail about the success rates of inmates who transition from the correctional institution to the community.

Entrants may wish to describe the collaborative efforts of corrections, law enforcement, human service agencies and other stakeholders in the transition process.

Competition Rules
A panel of correctional health experts will review the entries and select up to three winners. Essays will be evaluated on the basis of clarity and detail relating to the entrant’s success in measurably improving continuity of care for recently released inmates with serious medical and mental health conditions. All decisions are final, including the decision to select no winners if none of the entries are judged worthy.

One person per winning entry will receive the travel, lodging and registration award. Essays will become the property of NCCHC and may be used by the Searching for Common Ground project to highlight special practices in discharge and transitional planning.

Typed essays of 500 words or less will be accepted through Thursday, September 30, at 5 pm. They should be submitted via e-mail at ncchc@ncchc.org, by fax at (773) 880-2424, or by mail to R. Scott Chavez, PhD, NCCHC, 1145 W. Diversey Pkwy, Chicago, IL 60614. Questions may be directed to scottchavez@ncchc.org.

(Summer 2004)

Background
In April 2003, the JEHT Foundation awarded a multiyear grant to NCCHC to conduct a national study exploring the practices and policies that regulate discharge planning in prisons and jails. This project, Caring for the Incarcerated, Community Reentry and Health Policy: Searching for Common Ground, seeks to improve health care systems and discharge planning so that inmates may reenter the community not only more healthy, but capable of maintaining healthy practices.

Based in New York, the JEHT Foundation was established in 2000 to support its donors’ interests in human rights, social justice and community building. The acronym JEHT stands for the core values that underlie the foundation’s mission: justice, equality, human dignity and tolerance. Learn more at www.jehtfoundation.org.

Spearheaded by Lambert N. King, MD, PhD, Caring for the Incarcerated proposes the first comprehensive national study of the present and potential capacity of jail and prison health care programs to perform effective discharge planning, facilitate continuity of care for inmates being released, and help promote health and disease prevention in urban communities.

King, who will serve as principal investigator, is the medical director at Queens Hospital Center in New York City. A renowned authority who has studied the intersection of corrections and public health for more than 20 years, he also was a chronic disease panel member contributing to the NCCHC study on the Health Status of Soon-to-be-Released Inmates study. This landmark report to Congress was issued last year.

Building on findings and recommendations from that study, the JEHT project will critically examine the circumstances that impede or promote collaboration and effective resource management among health care programs in jails and prisons, urban communities, public health agencies, and local, state and federal governments responsible for funding and oversight of health care in correctional institutions.

The project will identify and study replicable models and best practices to facilitate continuity of care for inmates who have serious medical and mental health conditions and are returning to local communities. Finally, it will explore feasibility and produce “art-of-the-possible” recommendations concerning policies likely to foster integration of correctional and mainstream health services.

(Summer 2003)