Facilitating Outreach & Enrollment for the Justice-

Involved Populations

David Young, Community Health Specialist, MSUdyoung@montana.edu

Jen Gross, Field Operations Manager, Planned Parenthood of Montana

jen.gross@ppmontana.org

Introductions

Questionnaire

Learning Objectives• To provide an overview of the Montana

correctional system• To define the justice-involved populations• To share results of two health-focused projects

in a county jail• To provide an example of putting theory into

practice• To discuss challenges for the future

Justice-Involved Populations

• Inmates in jails & prisons• Residents of prerelease centers• Residents of treatments centers• Returning citizens on probation or parole

Definitions

• Parole – The supervised release into a community of an inmate prior to the completion of a sentence, as a result of a decision by the state Board of Pardons and Parole, and subject to conditions imposed by the board.

• Probation – The court’s release of an offender, subject to supervision by the department and under direction of the court. Juvenile probation is supervised by the Montana Supreme Court.

Top 10 Adult Conviction OffensesFY 2010 2014‐

Males Females1 Felony DUI 1 Possession of drugs2 Possession of drugs 2 Theft3 Criminal endangerment 3 Criminal endangerment4 Theft 4 Distribution of drugs5 Burglary 5 Felony DUI6 Distribution of drugs 6 Issuing a bad check7 Partner/family member assault 7 Fraudulently obtaining drugs8 Assault with a weapon 8 Forgery9 Possession & intent to distribute 9 Burglary10 Criminal mischief 10 Possession with intent to distribute

OMIS Data Extracted 8/6/2014From: MT DOC 2015 Biennial Report.

Health-Related Projects

Inmates Have High Incidence of Chronic Health Conditions

• Asthma• Hypertension• Tuberculosis• Diabetes• Hepatitis• HIV/AIDS• Substance Abuse & Mental Health Issues

NRC Publications 2013 & 2014

Two-Part Project*• Part I – Improving Health Literacy and Personal

Health Management of Inmates October 1, 2011 – August 31, 2012

• Part II – Promoting Health Insurance and Enrollment Literacy with Inmates

October 1, 2013 – August 30, 2014

*Express Outreach Awards, National Network of Libraries of Medicine (NNLM) Pacific Northwest Region (PNR), University of WA, Seattle, WA

Administrative Core Team - HIL

• Jackie Keery, PD, Program Director, GCDC• Dave Young, Co-PD, MSU• Erin Hamilton, MSU Student Intern• Katie Liebenstein, MSU SCOPE Student Intern• Morgan Bennett, AmeriCorps*VISTA volunteer• Cody Warner, Department of Sociology &

Anthropology, MSU• Clarann Weinert, College of Nursing, MSU

Collaborators/Partners• Gallatin County Detention Center • Montana State University (Extension, College

of Nursing, Dept of Soc & Anthro & Library)• Gallatin City-County Health Department• Community Health Partners• Gallatin Mental Health Center• Bozeman Public Library• Gallatin County Reentry Task Force

Overall Goal

to engage, educate and prepare inmates to enroll in health insurance coverage under the ACA upon release from the Gallatin County Detention Center (GCDC)

By the year 2014 nearly all Americans will be required to have health insurance or pay a penalty.

Why Have Health Insurance?

Things you will learn:•How to get started•How to review health insurance plans•How to choose the best plan•How to enroll in the health insurance marketplace

This project is a collaborative effort between the Gallatin County Detention Center and Montana State University

This workshop on health insurance coverage and the Affordable Care Act will run two hours per day, Monday through Friday, for one week.

The Affordable Care Act will affect everyone. Attend this workshop and find out how it affects you and your family.

Interventions

• Nine Handouts • Three Instructor-Led Workshops– Four Teaching/Learning Modules (PPTs & videos)• Staying Healthy – Health Literacy & Health Insurance

Literacy• Affordable Care Act & Your Health• Financial Literacy & Health• Making a Smart Choice – Plan Selection

• Two Self-Directed Study Sessions

Workshop Format

Day

Time

Activity

Monday

9:00am – 11:00am

Introduction, Consent Forms, Q1, Module #1

Tuesday

2:00pm – 4:00pm

Self-directed study in Computer Lab

Wednesday

9:00am – 11:00am

Modules #2 & #3

Thursday

2:00pm – 4:00pm

Self-directed study in Computer Lab

Friday

9:00am – 11:00am

Module #4, Q2, Receive Grad Certificate

Resources - NACo

Resources - NACo

1. Questions & Answers: The Affordable Care Act and County Jails – October 2014

2. Health Coverage and County Jails: Inpatient Exception – November 2014

3. Health Coverage and County Jails: Suspension vs. Termination – December 2014

4. Questions and Answers: The Affordable Care Act and County Jails – May 2015

Resources - CMS

1. Ten ways jails can help make connections to new health insurance opportunities.

2. Ten ways corrections systems can help link returning offenders to health insurance.

3. Ten ways court systems can help link returning offenders to health insurance.

4. Ten ways probation & parole officers can help link people to new health insurance opportunities.

Lesson’s Learned• Health-based instruction with inmates must

include– Health literacy– Numeric/financial literacy– Health insurance literacy

• Adequate health insurance for inmates is dependent upon– Medicaid expansion– Medicaid suspension/termination upon arrest

Connecting the Dots

Putting Theory into Practice

Targeting Justice-Involved Individuals

In Billings:• Alpha House (Sept 2014)

– 27 presentations– 195 individuals educated

• Passages (March 2015)

– 22 presentations– 140 individuals educated

• Montana Women’s Prison (August 2015)

– 2 presentations– 12 individuals educated– 54 staff educated

Getting Started: TacticsTactic #1Leverage existing partnerships

Ask yourself these questions:• Who do I already work with?• If I don’t have existing

relationships within justice-involved organizations, who do I know who does?

• What is my angle? • How do I help potential &

current partners understand the value?

Getting Started: TacticsTactict #2Program layering

• Planned Parenthood Health Care Providers

• Planned Parenthood Outreach Educators

• Planned Parenthood Advocates

Efficient Use of Resources = More Bang for Your Buck

Getting Started: TacticsTactic #3Education for staff

• MT DOC Clinical Services Division– 54 staff educated

• Alpha House– 12 staff educated

• MT Women’s Prison

Opportunities:• Staff meetings• One-on-ones• Stakeholder meetings• Presentations

Challenges

• Medicaid coverage gap & lack of income• Prerelease not defined by CMS for the

purposes of the ACA• Unable to preemptively submit applications

for Marketplace coverage (before release)• Stress of reintegration to society• Mandated vs. self-motivated enrollment

Lessons Learned

• The time is right – DOC mandate• Follow up is key for justice-involved

populations• Moving from education to action – help others

discover their own self-interest• Track O/E work within justice-involved

populations – be specific

Looking Ahead

Where to Start?

• Determine what facility or facilities are is in your county/community working with offenders

• Contact your local Sheriffs Office/Department• Contact your local jail administrator• Contact your local Probation & Parole Office• Establish partnerships with county health

office and nearest community health center