Community Health Centers Pose as Major Stepping Stone in Post-Incarceration Healthcare

Community Health Centers (CHCs) remain a key healthcare access point for people returning to their communities following incarceration.

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With over 31.6 million patients served in 2022, CHCs play a vital role in maintaining healthcare continuity for folks before, during, and after incarceration, according to a recent analysis published in The Commonwealth Fund.

Providing support to those transitioning into life after incarceration is crucial. This group often faces complex health risks after their release, and maintaining consistent access to substance use disorder treatment plays a significant role in reducing the risk of reincarceration, relapse, and overdose.

As federal and state policymakers continue to reshape Medicaid's role in covering health services for this group, it’s important to explore the current and potential contributions of CHCs in pre- and post-release care delivery.

Today, CHCs serve as private nonprofit or public entities, driven by community boards mainly made of patients. They receive federal grants, providing operational support for 90% of all centers, and as a main source of primary care for Medicaid beneficiaries, they are strictly accountable for care quality and accessibility.

As Medicaid becomes more involved in covering people who are in jail or prison, it's important to note that CHCs serve one out of every six Medicaid beneficiaries.

To understand the current and potential impact of CHCs on pre- and post-release care, researchers of The Commonwealth Fund analysis conducted interviews with 21 stakeholders, including CHC leaders, clinical staff, patients, correctional officials, and policy leaders.

The insights gathered shed light on the challenges and opportunities in providing effective reentry care.

Key challenges found include the lack of information about incarcerated patients' health conditions after their release and the extended periods without contact between CHCs and these folks.

To address these challenges, stakeholders recommended ten key principles for CHCs and partners:

• Build trust from the beginning of the provider–patient relationship by creating meaningful and direct connections between patients, health professionals, and CHCs.
• Create and maintain partnerships across corrections, legal/law enforcement, medical, public health, behavioral health agencies and more.
• Use interdisciplinary care teams, integrating physical and mental healthcare, and care for substance use disorders.
• Incorporate community health workers who have lived experience of incarceration into care teams.
• Initiate a pre-release patient–provider relationship wherever possible.
• Employ trauma-informed care approaches.
• Train providers to understand the culture of incarceration and people’s needs after release.
• Work at an organizational level to identify shared goals across community health providers, correctional entities and other service organizations.
• Establish the CHC as a hub for connections to other services, including housing, food, employment and other social supports.
• Include people and communities impacted by incarceration in the development of organizational policies, programs, implementation plans, and evaluation strategies.

CHCs could serve as vital partners for state Medicaid programs and other system leaders striving to enhance reentry care, authors of the analysis encouraged.

By aligning with CHCs, Medicaid programs can tap into their experience in delivering accessible, equitable and integrated care.

However, achieving these goals requires addressing financing, workforce, data-sharing, and operational challenges, which can be navigated through investments in evidence-based programs and innovative care and payment models.

As CHCs already successfully serve lower-income, underserved communities, authors suggest adopting policies with new healthcare models will be pivotal in reaching the national goal of enhanced reentry care and better outcomes for this population and other communities.