Ensuring adequate health care for justice-involved individuals is a critical responsibility of corrections systems. This is especially true regarding those within the justice system who have mental health and/or substance abuse disorder needs—a group that makes up 65 percent of the total justice-involved population and faces higher risk of victimization, recidivism, and suicide. Unfortunately, providing care to these individuals is often derailed by a number of broken elements within the justice system.
One of Pioneer’s 2016 Better Government Competition finalists, from Richard A. Sheola of Beacon Health Options, offers valuable commentary on this issue. As Sheola notes in his proposal, a central problem with delivery of care to justice-involved individuals is the problematic fragmentation between local and state agencies, probation and parole offices, and, to an even greater extent, corrections departments and Medicaid agencies. This leads to a system that lacks interaction and information sharing, disrupting what should be an effective collaborative dynamic. Sheola identifies three main problems facing incarcerated individuals with mental health and/or substance abuse disorders: an unplanned disconnect with servicing providers and community agencies; inadequate behavioral health services; and failure to reconnect with community agencies upon release.
To improve delivery of care, Beacon Health Options has developed a unique web-based tool, Jail DataLink, which enables users to look up corrections records for individuals in custody and match these detainees’ information to Medicaid eligibility data, including medical history and prescription information. In this way, the comparative tool gives agencies that service corrections populations the ability to better identify these individuals’ medical needs – including those resulting from mental health and substance abuse issues – and ensure appropriate treatment. The program has already had enormous impact in Maryland, where DataLink has been partnering with the state’s Department of Health and Mental Hygiene, Behavioral Health Administration, Department of Public Safety and Correctional Services (DPSCS), and the Mental Health Criminal Justice Partnership.
This information is also shared with the groups that coordinate care for detainees upon their release. These Core Service Agencies (CSA’s) receive daily updates from DataLink with data from DPSCS on detainees, in addition to information on patients’ psychiatric histories, to optimize treatment. All changes in patients’ medical needs, including any diagnostic or medication change, are updated in the system daily. As the proposal notes, this routine maintenance of information facilitates “proactive discharge planning and follow-up care,” while also ensuring more seamless community reintegration and consistency in follow-up care.
The introduction of this new data-driven system has enormous potential to reduce recidivism. As the proposal notes, preliminary data already indicates a 30 percent drop in recidivism among individuals who have mental health and substance abuse issues, largely due to the improved coordination of care made possible through the data tool. Over just the past year, DataLink has achieved a 37.8 percent match rate, matching 54,579 individuals receiving care through Maryland’s Public Behavioral Health System to more than 144,000 records processed. These numbers signal an impactful future for the program.
While Beacon Health Options has made access to care during incarceration and post-release a central focus for its program, the group is also working on ways to identify and divert individuals with mental health and substance abuse disorders to appropriate care before incarceration. In collaboration with drug and mental health courts, Beacon plans to leverage its DataLink system to provide information in advance of trial. All detainees with mental health and substance abuse problems would be identified before court proceedings in a way that would alert judges of an individual’s condition, enabling a more informed judgment to divert detainees to community care when appropriate.
Datalink’s partnership with Maryland’s state agencies and unique system for information-sharing among them provide a valuable lesson on the utility of these platforms in delivering healthcare in corrections. As other states deal with historically high prison populations and try to determine optimal systems to provide care to detainees, they would be prudent to consider options that have shown promise in Maryland through exchange of data for better identification of treatment needs.