System Innovation in California: The Impact of MHSA
Offender Reentry And Elderly Health
1. Offender Reentry and Elderly Health Multnomah Department of Community Justice Supervisor: Charlene Rhyne By Jessica Robb
2. Why is the process of Reentry important? Nearly 2.2 million men and women are incarcerated in prisons and jails in the US; the rough equivalent of one out of every 136 US residents (Williams, N.H.,2007) The 50+ are the fastest growing population in prison, increasing 3x faster than the general population (Reimer, G. 2008) 95% of incarcerated individuals will eventually be released back into the community (Williams, N.H.,2007)
3. Cost/Benefit Numbers Approximately 2 out of every 3 people released from prison in the US are re-arrested within 3 years of their release. (Langan, PA & Levin, DJ, 2002) Economics of care: >50 = $60,000/yr. <50 = $21,000 (Reimer, G.2008) The average cost of nursing home care would be around 25K/yr/per person. (Regan, JJ, Alderson, A, Regan, WM, 2002)
4. Emphasis of Work Evaluate the reentry program in Multnomah County with regard to an “elderly” offender population over the age of 50 Develop framework to measure unmet health needs of elderly offenders in Multnomah County Recommend best practices from current reentry literature
5. Literature Review Recent focus on evidence-based practices with regard to offender reentry Paucity of literature regarding reentry EBPs and specific population outcomes Nexus of community health and community justice perspectives Reentry policies vary from state to state
6. Best Practices report State/county/national programs: No measurement/evaluation tools Success of reentry determined by access to the following: housing, employment/income, community/family connections, healthcare, and reduced recidivism* Collateral consequences of a conviction In Oregon, benefits reinstated once released, but may take time *Recidivism: relapse into criminal behavior
9. Significance of work Elderly population previously not looked at Knowledge of local policy hurdles that prevent population from access to services Survey tools assess reentry program from various angles: client perspective, service perspective, and health outcomes
10. Implications for career Networking through various agencies Negotiate policies at city, county, state, and federal levels Research Emphasis in continual improvement Tool design IRB application exposure
11. Implications for career Look at issues through a public health lens Ask questions and develop working relationships Focus on health disparities in vulnerable populations Discussion for appropriate resource allocation
12. References Langan, PA & Levin, DJ (2002) National Recidivism study of released prisoners: recidivism of prisoners released in 1994. US Department of Justice, Bureau of Justice Statistics, NCJ 193427 Reimer, G. (2008) The graying of the US prisoner population Journal of correctional health care 14(3): 202-208 Regan, J.J., Alderson, A, Regan, W.M., (2003) Psychiatric disorders in aging prisoners, Clinical Gerontologist 26(1):117-124 Williams, N.H. (2007) Prison health and the health of the public: Ties that bind. Journal of correctional health care 13(2):80-92
Notas del editor
I worked with Charlene Rhyne in quality systems management and evaluation services, as well as with LivJenssen who is the manager of the Transition Services Unit
I chose this project primarily because I wanted to explore the dichotomy between criminal justice program policies and the health impact on specific populations.
There are discrepancies regarding the age of “elders” within the context of incarceration. Some say 55, some 60. For my purposes, I defined it as over the age of 50. Studies have consistently shown that incarceration ages an individual.
Even though there is paucity of evaluation data, experts state re entry success is facilitated by housing, employment, and access to healthcareMultnomahCounty: TSU prioritizes high needs. TAB program for SS benefits, apply for food stamps before released. Medicaid is now suspended and reinstated post-incarcerationCollateral consequences: basically what continues to affect someone with a criminal history.
My logic model specifically catering to elderly offenders in Multnomah County
Client DCJ Satisfaction Survey: To assess elderly offenders’ experiences with the Department of Community JusticeStaff Satisfaction Survey: To assess staff satisfaction within the Department of Community JusticeClient Healthcare Assessment: To assess an elderly offender’s access to healthcare resourcesAgency Questionnaire: To assess the comprehensiveness of a reentry program. Aimed at an agency director or someone with the knowledge to complete.
Reentry programs deal have multiple stakeholders involved: law enforcement, community corrections, housing authorities, mental health services, faith based organizations, community advocacy groups, community leaders, and state legislators are some examples**There is very little known about this population and contributions are needed and will be valued**There are current assessment, satisfaction forms but there is a compelling need to customize them for this population**conducting interdisciplinary team projects on a decade long basis between and among community justice, police, and community health researchers will help to decrease the stigmatization, transfer best practices, and build interest in multiyear funding.**non management of these populations in producing higher level costs in unplanned care, homelessness, and recidivism**this area of interest touches upon many areas of collateral study: chronic disease, function, infectious disease, and self care.
One of the ongoing themes was resource allocation and “deserving” and “undeserving” populations. This is a population that is often viewed as “undeserving,” and accessing resources for these individuals can often be hindered by this designation. It is important to realize that 95% of incarcerated individuals will return to the community, and their successful reentry is tied to the health and safety of the community. And elders are not a homogenous group by any means; they reflect different life experiences, backgrounds, ethnicities, sexual orientations, and gender.
