Prison, while not the ideal venue, can often be the first entry point into the healthcare system for someone with a substance use disorder or mental health issue. Nationally, and in Pennsylvania costs of healthcare provided in prison are rising, according to a report issued by the Pew Trusts in 2014. In 2011, the Commonwealth spent $4,705 per inmate for a total of $262 million on correctional healthcare. This critical investment often helps an inmate get the medical attention needed to stabilize and improve her or his health. However, too often, this money can be wasted when an inmate is released from prison without the proper follow up care.
The Pennsylvania Health Access Network (PHAN), through its statewide helpline, has helped many returning citizens apply for benefits upon release and has heard countless stories of people being released with a week’s supply of medication – often the medication they need to prevent them from relapsing into their prior situation and potentially returning to prison. Thirty-one states have made this transition easier by suspending Medicaid benefits either for the duration of an inmate’s incarceration or for a specific time. This means that upon release the inmate has Medicaid reactivated so that they can walk into the pharmacy or see their health care provider quickly after release. Pennsylvania was one of only 19 states that did not do this.
With the unanimous passage by both the Pennsylvania House and Senate of budget-related changes to the Human Services Code, Pennsylvania will join the majority of states that improve efficiency of government operations and get needed care to vulnerable Pennsylvanians by suspending Medicaid benefits during incarceration. This move is common sense. It suspends Medicaid benefits for up to two years for those in either state prison or county jail. Inmates incarcerated for more than two years would need to reapply for benefits upon release. Importantly, it ensures that for a large number of inmates, the thousands of dollars spent on medical care are not wasted, while it reduces the burden on the county assistance offices, since nothing has changed during the incarceration that would affect the inmate’s eligibility.
While we applaud this as a step in the right direction, we believe that more can be done to prevent those with untreated mental illness or substance use disorders from even entering the prison population in the first place. PHAN recently began advocating for law enforcement assisted diversion (LEAD) programs for people who commit minor offenses and have untreated behavioral health conditions. We believe that prison shouldn’t be the main venue for treatment and primary care, but rather that existing community supports with supervision and accountability can keep people out of jail and get them healthy. Stay tuned for more updates.