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Public Health Implications of Prisoner Re-Entry Discussed

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At a Rand Corporation event on Thursday, those who work with prisoners at different stages in the incarceration process talked about the public health implications and challenges prisoners face as they re-enter society in Allegheny County.

The President Judge of Allegheny Court of Common Pleas, the Chief Operating Officer of Allegheny Correctional Health Services, the Director of Allegheny County Probation and a RAND corporation policy researcher spoke candidly to a group of about thirty on Thursday about the challenges they face at every step along the line as they try to meet the health needs of the prison population.

Dana Phillips who runs health services at the jail says that 70 to 75 percent of the men and 90 to 95 percent of the women in Allegheny County jail have or have had a substance abuse problem.

"That's extraordinarily high. It's a huge, huge challenge for us," she said.

She said the people in the acute units are seen daily by psychiatrists but they do not have the staffing to provide the kind of care a person would have gotten at a center specifically geared for that kind of care. For many of the prisoners, she said, the physical and mental health care they receive at the jail is the first time they have had any kind of regular treatment.

There are about 2,500 people in the Allegheny County Jail.

Tom McCaffrey, Director of Allegheny County Probation, says one of the biggest challenges in keeping people sober, medically compliant and law-abiding are the distance in time as to when someone is released and when someone connects with one of the overstretched parole officers in the county.

"We have 29,000 people under supervision with 125 probation officers, so do the math on that one," he said.

The panelists said they have had some success in getting people mental health and substance abuse treatment with programs such as the specialty courts.

One of the implementations of the Affordable Care Act that will take effect in 2014 that all states are planning for now is that eligibility for Medicaid will be expanded to people with incomes less than 133 percent of the federal poverty level. That would ultimately make health care available to many who are re-entering society and would like to continue receiving the health care they were receiving in jail or prison.

Other speakers were Lois M. Davis, a senior policy researcher at RAND whose specialty is public health and public safety, and who recently wrote a paper on the public health implications of prisoner reentry in California, and Judge Donna Jo McDaniel, President Judge of the Fifth Judicial District of Pennsylvania. The panel was moderated by Frederick W. Thieman, president of the Buhl Foundation and former U.S. Attorney.

The attendees were members of the foundation community, those that work with family members of the incarcerated, academics, etc.

Secretary John Wetzel from The Pennsylvania Department of Corrections said the focus has to be on carefully releasing prisoners and tracking their behaviors and having programs in place so that they don't immediately re-offend. "It's all the same taxpayer," he said. "I think the focus has to be on spending money once."

All of the panelists stressed that when a former prisoner is facing mental health and substance abuse challenges in society, it becomes a challenge for all of us.