Delaware Public Media

Christiana Care to explore resources for post-incarcerated patients

Aug 23, 2016

Inmates in Delaware who leave prison in poor health can have trouble getting immediate access to health care when released, but Christiana Care Health System has an idea for how to solve that problem. 

Following the model of just six US states, Christiana Care is looking at establishing a transitions care clinic — a clinic that would provide primary care to patients who were previously in jail. For LeRoi Hicks, the vice president of the Department of Medicine at Christiana Healthcare, that means using resources from a $28 million federal grant designed to help Christiana Care conduct research focused on improving health for former inmates.

When an individual comes into the prison system in Delaware, their Medicaid card is terminated.

“We really need to do something now because we’ve reached this threshold of really critically high rates, particularly among the populations that are at the highest risks,” Hicks said, referring to Delaware’s 15,000 inmates released each year, many of whom suffer from critical health conditions.   

Christiana Care is seeking ways to make sure those leaving prison keep seeing doctors, and they have a $28 million grant sponsored by the National Institutes of Health and others to help them.

They intend to research clinical practices elsewhere and find a solution that can help address this underserved population.

When an individual comes into the prison system in Delaware, their Medicaid card is terminated, said Dr. Vincent Carr, the medical director for the Delaware Department of Corrections.

“They leave with a 30-day supply of medication and they leave with a promise that they will get a Medicaid card soon,” Carr said.

“Before they leave, the prison gets them a Medicaid card again…which takes time,” Carr continued. “So they give them 30 days worth of medicine with gives them (the recently released inmate) time to make contact with a primary care provider.” 

Dr. Nicole Redmond, a medical officer with the National Heart, Lung and Blood Institute said it is estimated that states allocate about $4,000 per inmate to provide each with a community standard of care while in prison. 

"They have a constitutionally protected right to health care," Redmond said. 

Some chronic diseases including HIV and mental illness are disproportionately high among post-incarcerated patients.

That constitutionally protected right to health care is often overlooked once an inmate is released. Hicks said members of the post-incarcerated population might not have access to health care at home, which ultimately could play a role in a cycle landing them back in the judicial system. About 66 percent of the post-incarcerated population lands back in prison within the first three years of their release.

“Once they are incarcerated, many for the first time are actually seeing a doctor, because those same communities where there are a lack of fresh fruits and high crime also have a lack of health care,” Hicks said.

“They receive health care while they are incarcerated, then they go back to the community with less health care, no insurance coverage, or disparities, so it becomes a vicious cycle,” Hicks continued. “The care they receive is sporadic.”

Hicks noted some chronic diseases including HIV and mental illness are disproportionately high among post-incarcerated patients. 

Christiana Care doesn’t yet have a firm timeline for implementing any options for helping post-incarcerated patients get the care they need, saying they’ll take their time to find what will work best in the First State.