Facilitating Outreach &
Enrollment for the JusticeInvolved Populations
David Young, Community Health Specialist, MSU
dyoung@montana.edu
Jen Gross, Field Operations Manager, Planned
Parenthood of Montana
jen.gross@ppmontana.org
Introductions
Questionnaire
Learning Objectives
• To provide an overview of the Montana
correctional system
• To define the justice-involved populations
• To share results of two health-focused
projects in a county jail
• To provide an example of putting theory into
practice
• To discuss challenges for the future
Justice-Involved Populations
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Inmates in jails & prisons
Residents of prerelease centers
Residents of treatments centers
Returning citizens on probation or parole
Definitions
• Parole – The supervised release into a community
of an inmate prior to the completion of a
sentence, as a result of a decision by the state
Board of Pardons and Parole, and subject to
conditions imposed by the board.
• Probation – The court’s release of an offender,
subject to supervision by the department and
under direction of the court. Juvenile probation is
supervised by the Montana Supreme Court.
Top 10 Adult Conviction Offenses
FY 2010 ‐ 2014
Males
1 Felony DUI
2 Possession of drugs
3 Criminal endangerment
4 Theft
5 Burglary
6 Distribution of drugs
7 Partner/family member assault
8 Assault with a weapon
9 Possession & intent to distribute
10 Criminal mischief
Females
1 Possession of drugs
2 Theft
3 Criminal endangerment
4 Distribution of drugs
5 Felony DUI
6 Issuing a bad check
7 Fraudulently obtaining drugs
8 Forgery
9 Burglary
10 Possession with intent to distribute
OMIS Data Extracted 8/6/2014From: MT DOC 2015 Biennial Report.
Health-Related Projects
Inmates Have High Incidence of
Chronic Health Conditions
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Asthma
Hypertension
Tuberculosis
Diabetes
Hepatitis
HIV/AIDS
Substance Abuse & Mental Health Issues
NRC Publications 2013 & 2014
Two-Part Project*
• Part I – Improving Health Literacy and Personal
Health Management of Inmates
October 1, 2011 – August 31, 2012
• Part II – Promoting Health Insurance and
Enrollment Literacy with Inmates
October 1, 2013 – August 30, 2014
*Express Outreach Awards, National Network of Libraries of Medicine
(NNLM) Pacific Northwest Region (PNR), University of WA, Seattle, WA
Administrative Core Team - HIL
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Jackie Keery, PD, Program Director, GCDC
Dave Young, Co-PD, MSU
Erin Hamilton, MSU Student Intern
Katie Liebenstein, MSU SCOPE Student Intern
Morgan Bennett, AmeriCorps*VISTA volunteer
Cody Warner, Department of Sociology &
Anthropology, MSU
• Clarann Weinert, College of Nursing, MSU
Collaborators/Partners
• Gallatin County Detention Center
• Montana State University (Extension, College
of Nursing, Dept of Soc & Anthro & Library)
• Gallatin City-County Health Department
• Community Health Partners
• Gallatin Mental Health Center
• Bozeman Public Library
• Gallatin County Reentry Task Force
Overall Goal
to engage, educate and prepare inmates to
enroll in health insurance coverage under
the ACA upon release from the Gallatin
County Detention Center (GCDC)
This workshop on health insurance coverage and the Affordable Care Act will
run two hours per day, Monday through Friday, for one week.
By the year 2014 nearly all Americans will be required to have
health insurance or pay a penalty.
The Affordable Care Act
will affect everyone. Attend
this workshop and find out
how it affects you and your
family.
Things you will learn:
•How to get started
•How to review health insurance plans
•How to choose the best plan
•How to enroll in the health insurance marketplace
This project is a collaborative effort between the Gallatin County Detention Center and Montana State University
Interventions
• Nine Handouts
• Three Instructor-Led Workshops
– Four Teaching/Learning Modules (PPTs & videos)
• Staying Healthy – Health Literacy & Health Insurance
Literacy
• Affordable Care Act & Your Health
• Financial Literacy & Health
• Making a Smart Choice – Plan Selection
• Two Self-Directed Study Sessions
Workshop Format
Day
Time
Activity
Monday
9:00am – 11:00am
Introduction, Consent Forms, Q1, Module #1
Tuesday
2:00pm – 4:00pm
Self-directed study in Computer Lab
Wednesday
9:00am – 11:00am
Modules #2 & #3
Thursday
2:00pm – 4:00pm
Self-directed study in Computer Lab
Friday
9:00am – 11:00am
Module #4, Q2, Receive Grad Certificate
Resources - NACo
Resources - NACo
1. Questions & Answers: The Affordable Care
Act and County Jails – October 2014
2. Health Coverage and County Jails: Inpatient
Exception – November 2014
3. Health Coverage and County Jails: Suspension
vs. Termination – December 2014
4. Questions and Answers: The Affordable Care
Act and County Jails – May 2015
Resources - CMS
1. Ten ways jails can help make connections
to new health insurance opportunities.
2. Ten ways corrections systems can help
link returning offenders to health
insurance.
3. Ten ways court systems can help link
returning offenders to health insurance.
4. Ten ways probation & parole officers can
help link people to new health insurance
opportunities.
Lesson’s Learned
• Health-based instruction with inmates must
include
– Health literacy
– Numeric/financial literacy
– Health insurance literacy
• Adequate health insurance for inmates is
dependent upon
– Medicaid expansion
– Medicaid suspension/termination upon arrest
Connecting the Dots
Putting Theory into Practice
Targeting Justice-Involved Individuals
In Billings:
• Alpha House (Sept 2014)
– 27 presentations
– 195 individuals educated
• Passages (March 2015)
– 22 presentations
– 140 individuals educated
• Montana Women’s Prison
(August 2015)
– 2 presentations
– 12 individuals educated
– 54 staff educated
Getting Started: Tactics
Tactic #1
Leverage existing partnerships
Ask yourself these questions:
• Who do I already work with?
• If I don’t have existing
relationships within justiceinvolved organizations, who do
I know who does?
• What is my angle?
• How do I help potential &
current partners understand
the value?
Getting Started: Tactics
Tactict #2
Program layering
• Planned Parenthood Health
Care Providers
• Planned Parenthood
Outreach Educators
• Planned Parenthood
Advocates
Efficient Use of Resources =
More Bang for Your Buck
Getting Started: Tactics
Tactic #3
Education for staff
• MT DOC Clinical Services
Division
– 54 staff educated
• Alpha House
– 12 staff educated
• MT Women’s Prison
Opportunities:
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Staff meetings
One-on-ones
Stakeholder meetings
Presentations
Challenges
• Medicaid coverage gap & lack of income
• Prerelease not defined by CMS for the
purposes of the ACA
• Unable to preemptively submit applications
for Marketplace coverage (before release)
• Stress of reintegration to society
• Mandated vs. self-motivated enrollment
Lessons Learned
• The time is right – DOC mandate
• Follow up is key for justice-involved
populations
• Moving from education to action – help others
discover their own self-interest
• Track O/E work within justice-involved
populations – be specific
Looking Ahead
Where to Start?
• Determine what facility or facilities are is in
your county/community working with
offenders
• Contact your local Sheriffs Office/Department
• Contact your local jail administrator
• Contact your local Probation & Parole Office
• Establish partnerships with county health
office and nearest community health center