Health and Prison Reentry: Your pathway to the Greater Cincinnati Area.

If you are part of this returning community, this website is here in hopes of motivating men and women, just like you, as follows:

• to seek healthcare,

• to provide information about using healthcare coverage, and

• to assist you with free or low-income based resources

All in an effort which can put you on a path toward the sustained use of health care that meets your needs. While there is a vast variety in the nature of the crimes committed by justice-involved individuals, there is also a vast spectrum of willingness in justice-involved individuals to put their best foot forward and take an active role in shaping their futures. The decision must be a conscious one with the realization that, men & woman just like you have been successful & you can too. We encourage you to take the right path.

Reentry: According to an Ohio Department of Rehabilitation and Corrections (ODRC) Reentry official, approximately 30-50 justice-involved individuals are returning to our neighboring counties (Warren, Butler, Montgomery, and Hamilton) every month. Upon returning to the community, the justice-involved population is ten times more likely to have complex health needs, including mental, social, and emotional health conditions and substance dependency. In addition to housing, jobs, education and social/spiritual care needs, justice-involved individuals coming from prisons and jails need healthcare services that begin upon their release.

Trending Health:

• Over half of justice-involved individuals reported suffering from a chronic physical health condition after release.

• At least 10 percent of incarcerated people are infected with hepatitis C which has a 1 percent commonness in the general population.

• 29 percent showed symptoms of depression, and 20 percent showed signs of post-traumatic stress disorder.

• Drugs and alcohol were a problem for many individuals during the first year after release.

• Over 30 percent reported drug use or alcohol intoxication in the 30 days prior to the one-year followup.

• At least 95 percent of people incarcerated in state prisons will be released back to their communities at some point.

• It is estimated that in Ohio, over 26,000 adults and 800 juvenile offenders will be released from institutions during the next year (ODRC 2019 Annual Report).

Case

Mr. C was released two months ago after a four-year prison sentence, shortly after having coronary artery bypass surgery for early onset atherosclerotic heart disease. At 42 years old, he was surprised and scared when his chest pain was diagnosed as a heart attack, necessitating major surgery while he was incarcerated. He was also told that there might be some problems with his kidneys, although he is unclear as to the specifics and does not have a copy of his medical records or his medications. Upon release he was homeless and has been staying with his mother in subsidized housing. This is a source of stress for her; because her son has a felony record, she worries that she is violating housing authority policy and could be evicted.

During his first visit to the community clinic, Mr. C shares with Joe, his community health worker, and subsequently with the health care practitioner that he is fearful of being reincarcerated. He feels weak and has not followed through with cardiac rehabilitation because he doesn’t have transportation. His parole officer tells him that if he remains unemployed he will be in violation of his parole. Mr. C’s stress has brought on cravings for heroin, which he has not used since being incarcerated. Mr. C’s clinician and community health worker wonder if there is anything they can do to help him.

Conclusion:

So what can Mr. C’s health care practitioner and community health worker do both to help him receive health care that is just and addresses the specific health risks he faces and to help him obtain social services? Mr. C’s health care practitioner can develop a plan for early initiation of medication-assisted treatment to prevent Opioid relapse and prescribe Naloxone to prevent overdose. Furthermore, the health care practitioner and community health worker can speak to his parole officer, with Mr. C’s permission, to advocate for the medical necessity and safety of this plan. They can assess Mr. C’s health literacy and offer guidance on self-care and medication adherence, with the understanding that he has never had to manage his own medications before. This guidance might involve identifying a convenient pharmacy, reviewing Mr. C’s medication labels with him, and teaching him how to take the medication and how to obtain refills. The community health worker can work with the local housing authority (which manages low-rent or rent-free housing) and housing organizations (which assist those who don’t otherwise qualify for housing) to advocate for Mr. C, identify housing resources of which he is not likely aware, and help circumvent the barriers and stigma that Mr. C will probably encounter because of his felony record. In each of these circumstances, knowing Mr. C has just returned home from prison provides critical context for understanding how best to create feasible action plans for chronic disease management and obtaining social services.

Take Away:

• There is a great coalition in Greater Cincinnati, Tri state, Ohio, and Nationwide trying to help justice-involved individuals. Though it may feel like the initiative is far behind and cannot begin to support all of your needs; clinicians, policy makers, individuals, church's, non-for-profits are working hard for you. Don't stop telling your story. Keep trying. Your story is rich and full of valuable lessons on humanity and community.