Best Practices for Jail Medicaid Enrollment: TASC in Modern Healthcare Article

(Chicago) Modern Healthcare has published an article on best practices for Medicaid enrollment at jail intake, noting approaches which TASC has helped implement in Cook County and is sharing with other jurisdictions around the country.

Harris Meyer writes:

Like inmates throughout the country, most people entering the Louisville Metro Jail lack health insurance and many suffer from long-untreated chronic conditions.

At least partly as a result, some people, particularly those with serious mental illness and drug or alcohol addiction, keep getting re-arrested and returning to jail, increasing costs to taxpayers.

In Louisville, Kentucky, there are processes to sign up people for Medicaid at jail intake, as well as provide support at release for individuals with multiple needs who often cycle in and out of jail. The program is based on initiatives begun at Cook County Jail in Chicago.

In these locations and in a number of jurisdictions across the country, the aim is to increase the number of people who have Medicaid when they are released from jail, so as to improve their access to healthcare in the community and reduce their likelihood of recidivism.

…But there are tough challenges, including poor coordination between local jail authorities and state Medicaid agencies, lack of funding to hire enrollment assisters, and chaotic conditions during jail intake, said Maureen McDonnell of the Chicago-based not-for-profit Treatment Alternatives for Safe Communities. In addition, there is sometimes political opposition to offering public health insurance to accused lawbreakers.

“Typically, these programs start with a motivated jail director, county commissioner or county behavioral health director who sees the writing on the wall about how many people have substance abuse and mental health conditions,” said McDonnell, who advises jail officials around the country in starting Medicaid enrollment programs. “The current national focus on mental health and substance abuse is helping a lot.”

Through these collaborative approaches, and with Medicaid coverage, people with long-untreated substance use, mental health, and other medical conditions may have new means to access healthcare services. Read the full article at modernhealthcare.com.
Modern Healthcare (MH) best practices for helping people in jail get Medicaid, including input from TASC. Source and image credit: Modern Healthcare

Modern Healthcare (MH) best practices for helping people in jail get Medicaid, including input from TASC. Source and image credit: Modern Healthcare

 

National Reentry Week Highlights Key Elements of Criminal Justice Reform

The U.S. Department of Justice has designated April 24-30 as National Reentry Week, highlighting efforts to support successful community reintegration for men and women who have been incarcerated.

Renewed community reentry strategies are part of a wave of criminal justice reforms across the country. These initiatives involve reversing decades-old policies and practices that not only have fueled record incarceration rates, but also have created substantial reentry barriers for people who have paid their debt to society. Such barriers include practices and policies that bar or inhibit people with offense records from accessing rehabilitative care, employment, and affordable housing.

The collateral consequences of a criminal conviction extend beyond the direct consequences issued by a sentencing court. These penalties and disadvantages are now well understood to contribute to stubborn recidivism rates. According to Department of Justice data, half of those released from state prisons returned within three years. Illinois’ recidivism rate mirrors the national trend, with 47 percent of individuals released from prison returning within that time frame.

Compounding the harms of collateral consequences are disproportionately high rates of substance use disorders among incarcerated individuals, and sparse treatment and recovery support within institutions and following incarceration. Research has identified problem substance use as a “criminogenic” need—a dynamic risk factor that can be changed—and it is increasingly recognized by reform efforts that seek to apply evidence-based approaches to reduce recidivism.

Reentry in Illinois

Faced with a prison population that increased by 650 percent since the 1970s and a system built to house 32,095 individuals with greater than ten thousand more than that currently behind bars, Illinois has undertaken efforts in recent years to reverse these trends.

In 2014, the Illinois state legislature convened a bi-cameral, bi-partisan Joint Criminal Justice Reform Committee to examine the current system, study the impact of current sentencing structure, and consider strategies for reform. In 2015, Governor Bruce Rauner issued Executive Order 15-14, creating the Illinois Criminal Justice and Sentencing Reform Commission, and tasking it with a goal of mapping out strategies to decrease the state prison population by 25 percent within 10 years. TASC President Pam Rodriguez is an appointed member of the Commission.

In its work to date, the Commission has affirmed that appropriate substance use treatment not only helps address the health and social problems among those involved in the justice system, but also decreases crime and recidivism:

“Building community capacity to address the criminogenic needs of offenders, such as behavioral health services, job training, and access to social services, is critical to reducing the prison population safely and sustaining the reduction over time.”

“Recommendation 12—Enhance rehabilitative programming in IDOC. Implement or expand evidence-based programming that targets criminogenic need, particularly cognitive behavioral therapy and substance abuse treatment. Prioritize access to programming to high-risk offenders. Evaluate those programs identified as promising and eliminate ineffective programs.”

Successful Reentry Models

Proven, evidence-based, and nationally recognized reentry models already exist in Illinois. The Sheridan and Southwestern prison drug treatment and reentry programs offer drug treatment services, both within the prison facility and in communities after release, and comprehensive reentry services, including TASC reentry case management and recovery support.

The programs have been rigorously evaluated. Individuals in the Sheridan prison reentry program have a 15 percent lower likelihood of return to prison within three years of release than comparable releasees who did not receive these services. Those successfully completing the program had even better recidivism outcomes, with a 44 percent lower likelihood of return to prison. The program operated at Southwestern Correctional Center has demonstrated comparable outcomes. A subsequent evaluation of the Sheridan program found that its recidivism benefits were still intact seven years after release.

Additionally, the programs were found to have generated combined annual savings of $5 million in reduced incarceration costs.

“There is substantial research on what works in reentry policies and practices,” says Rodriguez. “The more that our public systems, communities, and families understand and apply this knowledge, the more successful we can be together in reducing recidivism and restoring men and women to full citizenship in communities.”

Sheriff Tom Dart, Bill O’Donnell Receive TASC Leadership Awards; Access to Healthcare and Recovery Highlighted at Annual Event

(Chicago) – TASC held its 2015 Leadership Awards Luncheon on December 10, honoring Cook County Sheriff Tom Dart and entrepreneur Bill O’Donnell for their advocacy on behalf of people with mental health and substance use disorders.

“Sheriff Dart has called national attention to the injustice of using county jails to house people with mental health conditions,” said TASC President Pam Rodriguez in presenting TASC’s Justice Leadership Award. “He has supported Medicaid enrollment and other activities to ensure continuity of care for people detained at the Cook County Jail.”

To the applause of more than 300 guests at the Westin Michigan Avenue in Chicago, Dart reported that 12,000 people have successfully signed up for insurance at the jail via the Affordable Care Act (ACA). “People who never had insurance now have insurance,” he said. “It is absolutely amazing what this collective work has done.”

Since 2013, the Cook County Sheriff’s Office, working with TASC and the Cook County Health and Hospitals System, has enabled individuals detained at the jail to apply for health insurance. Prior to the expansion of Medicaid under the ACA, the vast majority of people entering U.S. jails lacked insurance, hindering their access to treatment for chronic substance use and mental health conditions that often contribute to rearrest.

The prevalence of these conditions in the justice system is not new, Dart observed. “These are issues that have been around for a while. And it’s with partnerships, working with TASC, that we’ve been able to make incredible change.”

TASC Public Voice Award Recipient Bill O’Donnell noted that he might well have gone to jail for his behavior while he was in the throes of addiction. Coming from a family driven to “achieve, achieve, achieve,” O’Donnell was a successful businessman who became addicted to alcohol and cocaine in the 1970s.

“It wasn’t until I got into treatment the second or third time… that I ever asked myself the question, ‘Why is it that I even need the marijuana, the booze, the coke, to change the way I felt?’” O’Donnell recalled. “Recovery and life and awareness is an inside job. You get can get help, you can get direction, you can get love, you can get guidance—but it’s an inside job.”

O’Donnell went on to found Sierra Tucson in 1983, an internationally-recognized treatment center that was among the first to involve family members in the recovery process.

TASC Executive Vice President Peter Palanca praised O’Donnell for his openness and high-profile voice for recovery. “Twenty-three million are in long-term recovery in this country and it’s still the most stigmatized illness,” said Palanca. “Bill was one of the first corporate leaders to speak openly about his addiction. He is a powerful voice for recovery.”

The value of helping one another was highlighted in two videos accompanying speakers’ remarks. Dart introduced a video depicting personal stories of people who now have health insurance thanks to enrollment efforts at the jail, and Rodriguez presented a video featuring participants in Winners’ Circles, which are peer-led recovery support groups for people who have been involved in the justice system.

TASC has been engaged in initiatives at the intersection of health and social justice since 1976, explained TASC Board Chair Cecil Curtwright. “I believe that our highest human calling is to help others—directly, if possible, and if not possible, to support those who do, with whatever means and talents available to us,” said Curtwright, who is the associate vice provost for academic and enrollment services at the University of Illinois at Chicago.

Among other dignitaries attending TASC’s event were previous honorees, including Gino DiVito, retired appellate court justice; Melody Heaps, TASC founder and president emeritus; and Toni Preckwinkle, president of the Cook County Board of Commissioners.

Chairing TASC’s 2015 event committee was John Zielinski, vice president and financial advisor at William Blair, who, along with other volunteers and generous donors, guided TASC’s most successful fundraising campaign to date. Zielinski extended special thanks to Blue Cross and Blue Shield of Illinois, the presenting sponsor of the event, along with numerous other generous sponsors and raffle prize donors.

“TASC is successful because we work together,” said Rodriguez. “Thanks to science and treatment parity, thanks to the Affordable Care Act and the efforts of TASC and our community partners, and especially thanks to all of you, more and more men and women are finding the treatment, the support, and the hope and tenacity needed to build and strengthen those delicate roots into lifetimes of recovery.”

TASC 2015 Leadership Awards Luncheon. Left to right: TASC Board Chair Cecil Curtwright, Justice Leadership Award Honoree Tom Dart, Public Voice Leadership Award Honoree Bill O'Donnell, TASC President Pam Rodriguez. Photo by Uk Studio.

TASC 2015 Leadership Awards Luncheon in Chicago. Left to right: TASC Board Chair Cecil Curtwright, Justice Leadership Honoree Tom Dart, Public Voice Leadership Honoree Bill O’Donnell, TASC President Pam Rodriguez.

Supporters filled the Westin Michigan Avenue ballroom for TASC's 2015 Leadership Awards Luncheon. Photo by Uk Studio.

Supporters filled the Westin Michigan Avenue ballroom for TASC’s 2015 Leadership Awards Luncheon. Photos by Uk Studio.

TASC President Appointed to Governor Rauner’s Criminal Justice Reform Commission

(Springfield) – TASC President Pam Rodriguez has been appointed to Governor Bruce Rauner’s Illinois State Commission on Criminal Justice and Sentencing Reform.

Established by the Governor’s executive order in February, the new Commission will examine all aspects of Illinois’ criminal justice system, sentencing practices, community supervision, and the use of alternatives to incarceration.

Twenty-eight members were named to the Commission, including lawmakers, researchers, nonprofit leaders, and criminal justice experts. Former U.S. Attorney Rodger Heaton, who was named in January to serve as the state’s public safety director, will chair the Commission.

A primary goal of the Commission is to issue recommendations to reduce the population of the state’s crowded prisons by 25 percent within 10 years.

“With the state’s leadership and all of us working together, I feel confident that we can achieve that goal sooner,” said Rodriguez, a projection she echoed in an interview with WICS in Springfield on Wednesday.

“We know what works,” she said. “We have an opportunity to implement evidence-based alternatives to incarceration on a far broader scale, and at the same time achieve better results in terms of cost savings and reduced recidivism.”

The Commission will issue its initial findings and recommendations to the Governor by July 1, and a final report to the Governor and the General Assembly by December 31, 2015.

TASC President Pam Rodriguez, named to Governor Rauner's criminal justice reform commission, is interviewed by WICS Newschannel 20 at the Illinois Capitol in Springfield.

TASC President Pam Rodriguez, named to Governor Rauner’s criminal justice reform commission, is interviewed by WICS Newschannel 20 at the Illinois Capitol in Springfield.

 

Governor Rauner Boosts Criminal Justice Reform; Solutions Include Diversion and Alternatives to Incarceration

At the signing of executive order establishing criminal justice commission, Governor Rauner greets Mike Torchia, director of Court Services for Sangamon County Adult Probation.  (Photo by TASC.)

Governor Bruce Rauner (right) greeted Mike Torchia, director of Court Services for Sangamon County Adult Probation, at the February 11 signing of an executive order establishing a criminal justice reform commission. (Photo by TASC.)

OP-ED: Governor Bruce Rauner signed an executive order on Wednesday to establish the Illinois State Commission on Criminal Justice and Sentencing Reform. Given that Illinois’ prison population has grown by 700 percent in the past 40 years, the commission will make recommendations to reduce the state’s prison population by 25 percent.

At the same time, the Illinois General Assembly’s Joint Criminal Justice Reform Committee, created last May and chaired by State Representative Michael J. Zalewski (D-23) and State Senator Michael Noland (D-22), recognizes the need to reduce incarceration of individuals with non-violent offenses and those with mental illness and addiction.

These initiatives by the Governor’s office and the General Assembly are critical and timely. They can be accelerated by leveraging proven solutions already working in Illinois.

First, sound reforms must recognize that the Illinois prison system is one of largest under-funded health operations in the country. Half of adults in prison have a mental health problem, and two thirds of adults in jail and prison have a substance use disorder requiring intervention. Many have co-occurring conditions. However, failed policies of the past 40 years have favored incarceration over treatment, driving prison and jail crowding and the clogging of courts.

Second, to slow the flood of non-violent offenders who churn through Illinois prisons, prosecutors and judges across Illinois must have means to systematically identify and divert non-violent defendants who have substance use or mental health conditions out of the justice system and into licensed treatment programs in the community.

More than 31,000 people were admitted to Illinois prisons in FY 13 (the most recently published data), with an estimated 57 percent sentenced for non-violent offenses eligible for diversion. Meanwhile, Illinois is paying $21,000 per year to incarcerate each of these men and women, when treatment and case management are only one-fifth that cost. No Entry diversion policies and programs—from “drug schools” to mandated community-based treatment with case management—reduce recidivism, save system and taxpayer costs, and address the behavioral health and social issues that often contribute to criminal behavior.

Last year, for example, TASC (Treatment Alternatives for Safe Communities) diverted more than 2,000 non-violent defendants away from prison and into supervised drug treatment in the community, saving the State of Illinois $35 million.

We know what works. To achieve real reform and cost savings, Illinois must bring these proven approaches to scale.

Pamela F. Rodriguez

President & CEO

TASC, Inc.

 

Pamela Rodriguez Op-Ed in Daily Herald: Is Illinois Ready for Criminal Justice Reform?

In a guest opinion-editorial for the Daily Herald, TASC President Pamela Rodriguez discusses the timely and promising opportunities for criminal justice reform in Illinois.

The General Assembly’s new Joint Criminal Justice Reform Committee, chaired by State Rep. Michael J. Zalewski (D-Riverside) and State Senator Michael Noland (D-Elgin), recognizes the need to reduce incarceration of non-violent offenders and those who struggle with mental illness and addiction, asserts Rodriguez. “We can begin to make significant reforms that allow people to get treatment for behavioral health issues as soon as or even before they come in contact with the criminal justice system,” she writes.

Read Rodriguez’s op-ed, including the unique opportunities for reform presented by Medicaid expansion.

Illinois Lawmakers, Quinn Remove Employment Barriers Resulting from Criminal Records

(Chicago) – Illinois lawmakers approved multiple pieces of legislation during the spring legislative session to eliminate barriers to gainful employment for people with non-violent criminal records, including a measure to expand the number of felony conviction records eligible to be sealed.

On August 2, Governor Pat Quinn signed a new law, House Bill 3061 (PA 098-0142), sponsored by State Representative La Shawn Ford (D-Chicago) and State Senator Kwame Raoul (D-Chicago), that allows individuals to petition the court to order the sealing of criminal records for certain additional non-violent convictions.

As a result of the new law, felony conviction records that can now be sealed by a court include certain non-violent theft, forgery, and drug possession offenses. Research shows that these types of non-violent offenses often correlate to drug use. For instance, nearly two-thirds of individuals discharged from state prisons after serving time for non-violent offenses indicated they had been using illegal drugs in the month preceding the commitment offense, and 37 percent reported using drugs at the time of the offense.

“Often we see individuals who got in trouble long ago when drugs had overtaken their lives,” said TASC President Pamela Rodriguez. “Even if they’ve since left their criminal behavior far behind, and have been clean and sober for years, they still are barred from employment opportunities because of past records.”

Petition to seal these records is not allowed until four years after termination of the person’s last sentence, and any person petitioning to seal a drug offense must pass a drug test within 30 days preceding the filing of the petition to seal. These conditions regarding record sealing were already in place before, and they remain applicable under the new law.

“When individuals have paid their debt to society for past mistakes, we have to make sure the system actually allows for them to continue on paths of gainful employment and citizenship,” said Rodriguez. “This is the first successful legislative effort since 2005 to expand the eligible categories of non-violent crimes for which records can be sealed. It will give more people the opportunity to seek and obtain secure, stable employment, which is the foundation of any community safety strategy.”

Sealing does not erase eligible criminal records, but instead makes them generally unavailable without a court order. Certain agencies and organizations – law enforcement, schools, and child services, to name a few – retain access to sealed records.

Before Quinn’s signature on the new law, only a few felony convictions had been eligible for sealing: possession of cannabis, possession of a controlled substance, certain methamphetamine and steroid offenses, and prostitution.

“Governor Quinn, Representative Ford, Senator Raoul, and all of the bill’s supporters deserve congratulations and gratitude for advancing a sophisticated approach to reducing crime, stabilizing neighborhoods, and giving people fair opportunities to contribute to their families and communities,” said Rodriguez.

Twitter @TASC_CHJ