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Understanding the Public Health Implications of Prisoner Reentry in California: State-Of-The-State Report [Pehme köide]

  • Formaat: Paperback / softback, 250 pages, kõrgus x laius: 229x152 mm
  • Ilmumisaeg: 16-Dec-2011
  • Kirjastus: RAND
  • ISBN-10: 0833059149
  • ISBN-13: 9780833059147
Teised raamatud teemal:
  • Formaat: Paperback / softback, 250 pages, kõrgus x laius: 229x152 mm
  • Ilmumisaeg: 16-Dec-2011
  • Kirjastus: RAND
  • ISBN-10: 0833059149
  • ISBN-13: 9780833059147
Teised raamatud teemal:
"The past few decades have witnessed a significant increase in the number of ex-prisoners returning to communities nationwide. Often overlooked are this population's physical and social-behavioral health concerns and, consequently, the role that health care plays in influencing the success of reintegration. The prison population is disproportionately sicker than the U.S. population in general, with substantially higher rates of infectious diseases, serious mental illness, and substance abuse disorders - trends that are mirrored in California. To address the related public health challenges, it is necessary to better understand the health care needs of these former inmates and the capacity of the health care safety net in the communities to which they return. The first phase of this study used a variety of approaches to assess the health care needs of California prisoners upon their release, the geographic distribution of state prisoners who return to local communities, and the health care services that are available in these communities. A statewide analysis of data from a survey of inmates, geocoded corrections data on California parolees and cluster analysis, and a focused analysis of the four counties in which nearly one-third of California parolees reside (Alameda, Kern, Los Angeles, and San Diego) provide policymakers with a picture of communities' capacity to meet the needs of parolees and other underserved populations." --From publisher description.

Preface iii
Figures
xiii
Tables
xv
Summary xvii
Acknowledgments xxxvii
Abbreviations xxxix
Chapter One Introduction
1(12)
Background
2(7)
Health Care Needs of Returning Prisoners Are High
2(2)
The Size and Composition of California's Prison Population Are Changing
4(1)
Recent Policy Changes Will Influence How California Approaches Meeting the Health Care Needs of the Reentry Population
5(4)
Study Objective and Scope
9(2)
Study Limitations
11(1)
Organization of This Report
12(1)
Chapter Two What Do We Know About Prisoners' Health Care Needs and the Capacity of the Safety Net to Meet the Needs of the Reentry Population?
13(36)
Introduction
13(1)
What Are the Health Care Needs of the Reentry Population?
14(5)
Where Do Prisoners Go Upon Release from Prison?
19(7)
Concentration and Distribution of Parolees Within California
19(7)
What Are the Demographic Characteristics of Parolees and of the Socioeconomic Areas in Which They Locate?
26(5)
Results of Analysis of Demographic Characteristics of California Parolees
27(2)
Results of Analysis of Demographic and Socioeconomic Characteristics of Areas in Which Parolees Locate
29(2)
What Does the Health Care Safety Net Look Like for Parolees in Four Focus Counties?
31(14)
Conceptual Framework
31(3)
Analysis of Geographic Distribution of Health Care Facilities in Los Angeles County
34(6)
Analysis of Accessibility of Reentry Population to Health Care Safety-Net Facilities in Four Counties
40(5)
Discussion
45(4)
Chapter Three Understanding the Challenges of Reentry: Ex-Prisoner Focus Group Results
49(36)
Introduction
49(1)
Approach
49(4)
Key Findings from the Focus Groups
53(32)
How Ex-Prisoners Think About Their Health Care Needs
53(3)
Views About Access to Substance Abuse Treatment Programs in Prison
56(3)
Views About Access to and Quality of Health Care in Prison
59(4)
Experiences in Having Care Transitioned to Community Providers
63(1)
Interest in Preventive Care
64(1)
Prerelease Planning
64(2)
Parole and Community Team (PACT) Meetings
66(2)
Where the Focus Group Participants Sought Care and Other Services on Release
68(3)
Views About Cultural Competence
71(2)
The Importance of Family
73(2)
The Experience of Being Released
75(2)
Discussion
77(8)
Chapter Four Understanding the Challenges of Dealing with Released Prisoners: Provider Interview Results
85(32)
Introduction
85(1)
Literature on Ex-Prisoners' Access to Insurance and Health Care Reform
86(10)
Ex-Prisoners' Access to Health Insurance
87(1)
Safety-Net Health Care Resources in California
88(4)
Potential Impact of Health Care Reform in Improving Ex-Prisoners' Access to Health Care
92(4)
Provider Interviews: Approach
96(1)
Provider Interviews: Results
97(14)
From the Provider's Perspective, the Reentry Population Has a Wide Range of Treatment Needs
97(2)
Lack of Medications and Medical Records Can Affect Continuity of Care
99(2)
Individuals May Be Reluctant to Seek Help from Parole
101(1)
Low Levels of Health Insurance and Lack of Finances Limit Treatment Options
102(2)
Challenge of Linking Individuals to Mental Health Treatment
104(1)
Communication Problems on Both the Individual and Provider Sides
105(1)
Difficulties in Navigating Health Care and Social Services Systems
106(1)
Uncertainty Among Safety-Net Providers About How to Access Reentry Population
107(1)
Impact of Budget Cuts on Providers
108(2)
Providers' Recommendations for Improving Access to Services for the Reentry Population
110(1)
Discussion
111(6)
Chapter Five The Impact of Incarceration on Families: Key Findings
117(26)
Introduction
117(1)
Literature on the Impact of Incarceration on Children and Families
118(7)
Impact of Individual-Level Effects of Parental Incarceration
118(3)
The Impact of Child Welfare Laws and Other Legislation
121(2)
What Is Known About Programs to Help Children and Incarcerated Parents
123(2)
Family Caregiver Focus Group: Approach
125(3)
Family Caregivers Focus Group: Results
128(10)
The Challenges Incarcerated Parents Face Upon Release
128(1)
The Suddenness of Being Thrust into a Caregiver Role
129(1)
The Degree to Which the Children Want to Have Contact with Their Parents
130(3)
Children's Support Needs
133(3)
Caregivers' Support Needs
136(2)
Discussion
138(5)
Chapter Six Conclusions and Recommendations
143(30)
California at a Crossroads
143(8)
An Historic Opportunity to Improve Access to Health Care for the Reentry Population
147(4)
What Can California Do to Prepare?
151(11)
Develop Informed Estimates About the Percentage of the Medicaid Expansion Population That the Reentry/Criminal Justice Population Will Represent
152(1)
Develop Medicaid Enrollment Strategies
152(1)
Leverage the Experience of Other States That Have Previously Expanded Coverage to Childless Adults Under Medicaid
153(1)
Develop Health Homes for the Reentry/Criminal Justice Population
154(2)
Develop Care/Case Management Systems That Can Account for Special Populations' Needs, Including the Reentry/Criminal Justice Population
156(1)
Assess Workforce-Development Strategies for Alcohol, Drug, and Mental Health Treatment
157(1)
Consider Developing Electronic Medical Records
158(1)
Consider Expanding Prerelease Planning Efforts
159(2)
Undertake a Comprehensive Assessment of California's New Public Safety Realignment Plan to Inform Future Policy Refinements
161(1)
What Can Counties and Providers Do to Prepare?
162(8)
Develop County-Level Estimates to Inform Planning for Rehabilitative Services and for Increased Demand for Mental Health and Alcohol Care and Drug Treatment
163(1)
Convene All Relevant Stakeholders for Planning and Coordination of Services
164(1)
Assess Local Capacity to Meet New Demands for Health Care
165(1)
Develop "Welcome Home" Guidebooks Tailored to Individual Counties, Particularly for Counties and Communities with High Rates of Return
166(1)
Train Providers on Cultural Competence
167(1)
Consider the Role of Patient Navigators
168(1)
Address the Needs of Families and Those That Care for Children of Incarcerated Parents
169(1)
Final Thoughts
170(3)
APPENDIXES
A Methodology
173(8)
B Protocols
181(16)
References 197