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From the Field: The Opioid Crisis and Evolving Challenges in Jails and Prisons
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Home Eliminating Financial Assessments for Health Care Services: Updated Position Statement
NCCHC is opposed to fees, copays, or any kind of disincentives – monetary or other – that limit access to health care. We encourage all correctional leadership to create an expectation of unobstructed access to health care for people who are incarcerated and advocate against mandates, policies, and cultural norms that create barriers to care and treatment.
NCCHC recently revised its position statement, formerly titled “Charging Inmates a Fee for Health Care Service,” which had been in place since 1996. on this subject. NCCHC’s position is now unequivocal since recent studies have clearly demonstrated the harms of charging fees. Public health approaches are suggested for those systems where the position is not followed. However, the extensive changes were made as it is now clear that fees and other financial disincentives limit access to care and create an inequitable system that:
There is unequivocal evidence that such financial assessments do harm. The American Medical Association, the American Public Health Association, and others are well-aligned with NCCHC’s updated position statement on the subject.
This position documents NCCHC’s support of unobstructed access to health care for people who are incarcerated and reminds the reader that access to health care among incarcerated people is a constitutional right under Estelle v. Gamble (1976).
Despite the evidence of harm and call to eliminate financial assessments for health care services during incarceration, NCCHC recognizes that such practices continue. Thus, guidelines to help mitigate the harms imposed by financial assessment are strongly recommended including:
NCCHC strongly encourages all jurisdictions to take the right next steps to eliminate financial assessments for health care services during incarceration.
Read the position statement in its entirety.
See all NCCHC position statements.
Alison O. Jordan, LCSW, MSW, CCHP, is an owner/member of ACOJA Consulting LLC, a New York City-certified M/WBE. She represents the American Public Health Association on the NCCHC Board of Representatives.