A recently expanded program in Indiana connects people about to leave prison with health care and other resources. The Indiana Re-Entry Program is run by CareSource, one of the health care companies that the state contracts with to provide Medicaid. Indiana Public Broadcasting’s Jill Sheridan spoke with Care Source medical director Dr. Cameual Wright who gave an overview of the program that is now serving all 15 Indiana state-run prisons.
Jill Sheridan: Could you talk about some of the reasons that ex-offenders in Indiana are so vulnerable upon release?
Cameual Wright: Absolutely, we know that a returning citizen has about a 12 and a half times normal chance of dying in the first two weeks after release from prison. The reasons for that are things that you may be able to guess: suicide, homicide, drug overdose. But then there are also some cardiovascular complications as well.
We know that individuals need support. And the second thing we know is that they need health care. And also, we are extremely concerned with something that we call social determinants of health, those are all the things that aren't healthcare related, but impact your health. So that's things like housing, employment, food, all of those things that returning citizens really have challenged is around.
Sheridan: So talk about this program, the Indiana Re-Entry Program is aiming to connect with people in prison before they're released.
Wright: That's absolutely right. So what we find out is that once they're out, oftentimes, it's too late to engage. This tends to be transient population, housing is insecure. And we can't wait until someone's released to start making inroads.
So what we do at CareSource is we engage offenders while they're still incarcerated. We are currently working very closely with the Indiana Department of Corrections. And we have a physical presence and all 15 state run prisons. And what we do is we have a dedicated re-entry team who enters into the prisons, and participates with their prerelease curriculum. They talk about the Healthy Indiana Plan, or the HIP plan, which is one of the Indiana Medicaid plans.
We also talk, most importantly, about how to reconnect with us, once they are released, once a member is ready, they have the option of being connected with a life coach. And that life coach actually will work with them for up to two years,
Sheridan: I would imagine that a life coach, that a person like that – really hand in hand, walking through the hierarchy of needs, is very important.
Wright: I think so many people come out of incarceration, and they don't necessarily have family, they don't have friends who are positive role models, and they are really lost. And I think it's critical to have somebody who says, I'm here for you. And you can do this. But let's figure out what we need to put in place.
Sheridan: What are some of the challenges when you're trying to do this type of prevented work.
Wright: So I would say the largest challenge is to engaging the members, individuals oftentimes will move from house to house, there's a significant rate of homelessness. So being able to really reach those members and engage them and keep them engaged, is actually quite a bit of a challenge.
Sheridan: So you’re seeing some interesting data, that this is really benefiting people in Indiana,
Wright: Our data is pretty young. But what we are noticing is that individuals who engage with our reentry team are much more likely to establish care with a primary care physician, much more likely to achieve appropriate follow up after hospitalization, much more likely to complete that health needs screening.
And I don't have data to support this, but I would predict that we'll see much less individuals losing coverage.