Section 3: The Affordable Care Act and Healthcare Utilization among Justice-Involved
3.7 Discussion
Among a national sample of individuals ages 18 to 64 with a history of mental illness and/or SUD, we found that implementation of the ACA was associated with a significant
increase in insurance coverage, a significant decrease in the likelihood of receiving mental health treatment, and no change in the likelihood of receiving SUD treatment among previously
incarcerated respondents compared to those who were not recently incarcerated.
Our findings build on other work that has estimated changes in insurance coverage among vulnerable populations. Research by Sommers et al. found that between 2012 and early 2015, the ACA was associated with an 8 percentage point decline in uninsurance rate among low-income adults.20 Previous work has found that the rate of uninsurance declined 10
percentage points among carceral-involved people with SUD98 and 5.9 percentage points among previously incarcerated men after ACA implementation.3 Our study finds smaller differential gains in insurance coverage (3.3pp) but cannot rule out gains similar in magnitude to prior literature. Although, justice-involved individuals saw gains in health insurance coverage as a result of the ACA, these rates of coverage are still significantly below their peers without recent carceral experience.
Additionally, our results highlight that insurance coverage (i.e., financial access to care) does not translate to real access to care or increased healthcare utilization. This is in line with prior research that finds increases in insurance coverage but no change in receipt of SUD treatment by previously incarcerated people.98 This may indicate that those who needed SUD treatment prior to the ACA were receiving it through other means, resulting in no net increase.
Indeed, this observation has been empirically demonstrated in the context of specialty SUD treatment. There was no net increase in treatment receipt, but there was a shift in payment sources from self-payment and other public sources of funding to Medicaid after the ACA.99
SECTION 4: CONCLUSION AND POLICY IMPLICATIONS Policy Implications
An estimated 6.8 million people are under supervision in the adult correctional system each year.1 If 9% are sexual minorities, this translates to approximately 600,000 sexual minorities who are involved with the justice-system in a given year. This study suggests that policymakers should focus on multiple avenues to address the higher rates of mental illness and SUDs among the justice-involved sexual minority population, beyond traditional treatment. In order to achieve mental health equity among sexual minorities who are criminal-justice involved, policymakers and public health practitioners should target mental illness, inhalants, cocaine, and hallucinogen us disorder. While the present study reveals that treatment rates are much higher for this justice-involved sexual minorities, they continue to have staggeringly high levels of mental illness and SUD, indicating that policymakers should look to other avenues for addressing these conditions. This may come in the form of public health initiatives to identify best practices for treating sexual minorities, ranging from culturally competent clinical interventions to
community-based programs providing psychological resources for addressing mental illness and SUDs. Other avenues to explore are re-entry programs that may provide better outreach at the time of release from correctional facilities to support transition into the general community, providing greater reimbursement for mental health and substance use treatment provided as individuals re-enter the community, and improving educational resources for mental illness and SUDs in correctional facilities.3,7,61
Future studies should evaluate whether there is a difference in mental illness, substance use disorder, and access to treatment among subcategories of sexual and gender minorities such as lesbians or gays, bisexuals, and transgender individuals. Moreover, future research should
analyze how current policies across different states affect sexual minorities and may play a significant role in the prevalence of mental illness, SUDs, and access to treatment. While our current study finds that sexual minorities who have prior justice involvement have higher rates of health insurance than the heterosexual justice-involved counterparts, future research should analyze the primary forms of insurance utilized by this population, and whether policy such as the Affordable Care Act has led to a more recent increase in access to treatment. In addition, examining whether justice-involved populations access mental health and substance use treatment during the time and duration of incarceration, or after re-entry into the community could also aid in policy to support this population.
Ensuring stability and continued access to insurance coverage is a necessary step to increase access to care, but there remains substantial improvement needed as uninsurance remains drastically lower for previously incarcerated people.7,100 The COVID-19 pandemic has emphasized both the critical need for improved access to behavioral health services, as well as the need for tailored and specialized programs to connect people leaving carceral settings to treatment services. One example is the Medicaid Reentry Act that would allow Medicaid to cover services for incarcerated beneficiaries during the 30 days preceding their release.102 Additionally, many states have submitted waiver proposals to the Centers for Medicare and Medicaid Services seeking authority to cover services to people who are leaving incarceration and reentering their communities.102 Other policy mechanisms, such as auto-enrolling individuals 90 days pre-release and suspending instead of terminating Medicaid enrollment in all states, may reduce rates of uninsurance among this population. 103-105
To continue improvement beyond coverage rates, resource coordination across multiple entities, including state Medicaid agencies, jail or prison systems, and mental health and
substance use disorder treatment programs, must occur.67,97 Many potential avenues for change exist, including “inreach” of community providers to carceral settings, warm handoffs from correctional to community providers, greater reimbursement for services provided to people transitioning from correctional settings, prescriptions for medication upon re-entry, and services that address crucial social determinants of health.106,107
Future research should work to gain a stronger understanding of the barriers that result in the lack of healthcare utilization even with increased healthcare coverage for the justice-involved population. To inform policy development, research should identify the prevalence and impact of gaps in Medicaid coverage during reentry and evaluate prospective solutions. Implementing these strategies may represent a feasible opportunity to transform current systems to reduce recidivism and alleviate health inequities.
Barriers to Policy Implementation
While this thesis provides numerous policy recommendations, for policies to contribute to alleviating health inequities, they must be effectively implemented. There are numerous challenges that arise in implementation which include: opposition from key stakeholders, inadequate human or financial resources, lack of clarity on operational guidelines or roles and responsibilities for implementation, conflicts with other existing policies, lack of coordination and collaboration between parties responsible for implementation or lack of motivation or political will.
Specific to health disparities work, there are a few main challenges (1) disparities in health and healthcare are complex and multi-faceted (2) there are uncertain relationships between health outcomes and policies address social determinants of health (3) the causal pathway
between policy and outcome is only apparent in the long-term and even then extremely hard to
measure (4)some policies designed to tackle disparities may inadvertently make problems worse (5) monitoring and measurement mechanisms are often connected with organization
accountability and bureaucracy. Building on this, Purnell et al. recommend addressing health disparities from a multi-tiered approach from patient factors (level 1) family, friends, and social support (level 2), provider and organization factors (level 3) and policy and community factors (level 4) where addressing factors at multiple levels may be more effective that targeting a single level.129 They find that universal policies are important but not sufficient to eliminate disparities where a combination approach targeted for at-risk populations can be more beneficial. Thus, a large challenge to alleviating health inequities lies in coordination and large-scale collaboration in order to create, advocate, and implement changes to the healthcare system.
Conclusion
The findings from this nationally representative sample reports substantial disparities in substance use disorder and mental illness among the justice-involved sexual minorities compared to their justice-involved heterosexual peers; and also reports how these disparities continue to persist even after implementation of the ACA. Public health professionals, the justice system, and policy makers are key stakeholders in addressing incarceration among children, adolescents, and adults and developing and implementing targeted approaches to the adult criminal justice system may be an important step in improving adverse mental health and SUD outcomes. Future studies should continue to focus on vulnerable populations to understand and ameliorate
disparities in behavioral health. This study provides important baseline data for monitoring progress towards achieving health equity for sexual minority and criminal justice-involved populations.
SECTION 5: REFERENCES
1. Kaeble, D., & Cowhig, M. (2016). Correctional Populations in the United States, 2016.
14.
2. Knapp, C. D., Howell, B. A., Wang, E. A., Shlafer, R. J., Hardeman, R. R., &
Winkelman, T. N. A. (2019). Health Insurance Gains After Implementation of the Affordable Care Act Among Individuals Recently on Probation: USA, 2008–2016.
Journal of General Internal Medicine, 34(7), 1086–1088. https://doi.org/10.1007/s11606- 019-04900-3
3. Winkelman, T. N. A., Choi, H., & Davis, M. M. (2017). The Affordable Care Act, Insurance Coverage, and Health Care Utilization of Previously Incarcerated Young Men:
2008–2015. American Journal of Public Health, 107(5), 807–811.
https://doi.org/10.2105/AJPH.2017.303703
4. James DJ , Glaze LE . Mental health problems of prison and jail inmates [Internet].
Washington (DC) : Department of Justice, Bureau of Justice Statistics ; 2006 Sep [cited 2014 Jan 13 ]. Available from: http://www.bjs.gov/content/pub/pdf/mhppji.pdf
5. Cuellar AE, Cheema J. As roughly 700,000 prisoners are released annually, about half will gain health coverage and care under federal laws. Health Aff (Millwood)
2012;31(5):931–938. doi: 10.1377/hlthaff.2011.0501.
6. Fiscella K, Beletsky L, Wakeman SE. The inmate exception and reform of correctional health care. Am J Public Health. 2017;107(3):384-385.
7. Winkelman TN, Chang VW, Binswanger IA. Health, Polysubstance Use, and Criminal Justice Involvement Among Adults With Varying Levels of Opioid Use. JAMA Netw Open. 2018;1(3):e180558. doi:10.1001/jamanetworkopen.2018.0558
8. Some 4.5 percent of U.S. adults identify as LGBT: study | Reuters. (n.d.). Retrieved March 2, 2021, from https://www.reuters.com/article/us-usa-lgbt/some-4-5-percent-of-u- s-adults-identify-as-lgbt-study-idUSKCN1QM2L6
9. Meyer I.H. Minority Stress and Mental Health in Gay Men. J. Health Soc. Behav.
1995;36:38–56. doi: 10.2307/2137286.
10. Lick D.J., Durso L.E., Johnson K.L. Minority Stress and Physical Health among Sexual Minorities. Perspect. Psychol. Sci. 2013;8:521–548. doi: 10.1177/1745691613497965.
11. Hatzenbuehler M.L. How Does Sexual Minority Stigma “get under the Skin”? A Psychological Mediation Framework. Psychol. Bull. 2009;135:707–730. doi:
10.1037/a0016441.
12. Meyer I.H. Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychol. Bull. 2003;129:674–697.
doi: 10.1037/0033-2909.129.5.674.
13. Sexual Orientation and Estimates of Adult Substance Use and Mental Health: Results from the 2015 National Survey on Drug Use and Health. (n.d.). Retrieved February 21, 2021, from https://www.samhsa.gov/data/sites/default/files/NSDUH-SexualOrientation- 2015/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015.htm
14. Meyer, I. H., Flores, A. R., Stemple, L., Romero, A. P., Wilson, B. D. M., & Herman, J.
L. (2017). Incarceration Rates and Traits of Sexual Minorities in the United States:
National Inmate Survey, 2011–2012. American Journal of Public Health, 107(2), 267–
273. https://doi.org/10.2105/AJPH.2016.303576
15. TransgenderPeopleBehindBars.pdf. (n.d.). Retrieved March 2, 2021, from
https://transequality.org/sites/default/files/docs/resources/TransgenderPeopleBehindBars.p df
16. Dahlhamer JM, Galinsky AM, Joestl SS, Ward BW. Barriers to health care among adults identifying as sexual minorities: a US national study. Am J Public Health.
2016;106(6):1116 1122.‐
17. Skopec L, Long SK. Lesbian, gay, and bisexual adults making gains in health insurance and access to care. Health Aff. 2015;34(10):1769 1773.‐
18. National Coalition of Anti Violence Programs. “National Report on Hate Violence against Lesbian, Gay, Bisexual, Transgender, Queer and HIV Affected Communities.”
2014. www.avp.org/storage/documents/2013_mr_ncavp_hvreport.pdf
19. Lipari, R. N. (2019). Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. 114.
20. 2019 Methodological Summary and Definitions | CBHSQ Data. (n.d.). Retrieved April 21, 2021, from https://www.samhsa.gov/data/report/2019-methodological-summary-and- definitions
21. NIMH » Mental Illness. (n.d.). Retrieved April 21, 2021, from https://www.nimh.nih.gov/health/statistics/mental-illness.shtml
22. Some 4.5 percent of U.S. adults identify as LGBT: study | Reuters. (n.d.). Retrieved March 2, 2021, from https://www.reuters.com/article/us-usa-lgbt/some-4-5-percent-of-u- s-adults-identify-as-lgbt-study-idUSKCN1QM2L6
23. The Surgeon General’s Report on Alcohol, Drugs, and Health. (n.d.). 413.
24. Preferred-terms-definitions.pdf. (n.d.). Retrieved April 21, 2021, from
https://addiction.surgeongeneral.gov/sites/default/files/preferred-terms-definitions.pdf 25. Fact-sheet-general.pdf. (n.d.). Retrieved April 21, 2021, from
https://addiction.surgeongeneral.gov/sites/default/files/fact-sheet-general.pdf 26. Mental Health Disparities in Minority Populations | Brook Lane. (n.d.). Retrieved
February 21, 2021, from https://www.brooklane.org/blog/mental-health-disparities- minority-populations
27. Bailey, R. K., Mokonogho, J., & Kumar, A. (2019). Racial and ethnic differences in depression: Current perspectives. Neuropsychiatric Disease and Treatment, 15, 603–609.
https://doi.org/10.2147/NDT.S128584
28. Cummings, J. R., & Druss, B. G. (2011). Racial/Ethnic Differences in Mental Health Service Use among Adolescents with Major Depression. Journal of the American Academy of Child and Adolescent Psychiatry, 50(2), 160–170.
https://doi.org/10.1016/j.jaac.2010.11.004
29. Mental Health Disparities. (n.d.). Prisma Health - Upstate. Retrieved February 21, 2021, from https://www.ghs.org/healthcenter/healthyallyear/minority-health-awareness-
month/mental-health-disparities/
30. thisisloyal.com, L. (n.d) How Many People are Lesbiaa, Gay, Bisexual, and Transgender? Williams Institute. Retrieved February 21, 2021, from
httpes://williamsinstitute.law.ucla.edu/publications/how-many-people-lgbt/
31. LGBT Health Disparities (2013). APA Public Interest Government Relations Office.
Retrieved February 21, 2021 from https://www.apa.org/advocacy/health-disparities/lgbt- health.pdf
32. Su, D., Irwin, J. A., Fisher, C., Ramos, A., Kelley, M., Mendoza, D. A. R., & Coleman, J.
D. (2016). Mental Health Disparities Within the LGBT Population: A Comparison Between Transgender and Nontransgender Individuals. Transgender Health, 1(1), 12–20.
https://doi.org/10.1089/trgh.2015.0001
33. Gonzales, G., & Henning-Smith, C. (2017). Health Disparities by Sexual Orientation:
Results and Implications from the Behavioral Risk Factor Surveillance System. Journal of Community Health, 42(6), 1163–1172. https://doi.org/10.1007/s10900-017-0366-z
34. Sexual Orientation and Estimates of Adult Substance Use and Mental Health: Results from the 2015 National Survey on Drug Use and Health. (n.d.). Retrieved February 21, 2021, from https://www.samhsa.gov/data/sites/default/files/NSDUH-SexualOrientation- 2015/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015.htm
35. Willging, C. E., Salvador, M., & Kano, M. (2006). Brief reports: Unequal treatment:
mental health care for sexual and gender minority groups in a rural state. Psychiatric Services (Washington, D.C.), 57(6), 867–870. https://doi.org/10.1176/ps.2006.57.6.867 36. HORVATH, K. J., IANTAFFI, A., SWINBURNE-ROMINE, R., & BOCKTING, W.
(2014). A Comparison of Mental Health, Substance Use, and Sexual Risk Behaviors Between Rural and Non-Rural Transgender Persons. Journal of Homosexuality, 61(8), 1117–1130. https://doi.org/10.1080/00918369.2014.872502
37. Safer, J. D., Coleman, E., Feldman, J., Garofalo, R., Hembree, W., Radix, A., & Sevelius, J. (2016). Barriers to Health Care for Transgender Individuals. Current Opinion in
Endocrinology, Diabetes, and Obesity, 23(2), 168–171.
https://doi.org/10.1097/MED.0000000000000227
38. Drescher, J. (2015). Out of DSM: Depathologizing Homosexuality. Behavioral Sciences, 5(4), 565–575. https://doi.org/10.3390/bs5040565
39. Explaining the Mental Health Disparity by Sexual Orientation: The Importance of Social Resources—Ning Hsieh, 2014. (n.d.). Retrieved February 21, 2021, from
https://journals.sagepub.com/doi/full/10.1177/2156869314524959
40. Initiative, P. P. (n.d.). Mental Health. Retrieved February 21, 2021, from https://www.prisonpolicy.org/research/mental_health/
41. Carroll, H. (n.d.). Serious Mental Illness Prevalence in Jails and Prisons. Treatment Advocacy Center. Retrieved February 21, 2021, from
https://www.treatmentadvocacycenter.org/evidence-and-research/learn-more-about/3695
42. Prins, S. J. (2014). Prevalence of Mental Illnesses in U.S. State Prisons: A Systematic Review. Psychiatric Services, 65(7), 862–872. https://doi.org/10.1176/appi.ps.201300166 43. Torrey EF, Kennard AD, Eslinger D, et al. More mentally ill persons are in jails and
prisons than hospitals: a survey of the States. Alexandria, VA: National Sheriffs’
Association; May 2010.
44. Mental Illness, Human Rights, and US Prisons. (2009, September 22). Human Rights Watch. https://www.hrw.org/news/2009/09/22/mental-illness-human-rights-and-us- prisons
45. Hills, H., Siegfried, C., & Ickowitz, A. (n.d.). EFFECTIVE PRISON MENTAL HEALTH SERVICES. 93.
46. Ruiz v. Estelle, 503 F. Supp. 1265 (S.D. Tex. 1980). (n.d.). Justia Law. Retrieved February 21, 2021, from https://law.justia.com/cases/federal/district-
courts/FSupp/503/1265/1466998/
47. Interventions for Adults With Serious Mental Illness Who Are Involved With the Criminal Justice System | Effective Health Care Program. (n.d.). Retrieved February 21, 2021, from https://effectivehealthcare.ahrq.gov/products/mental-illness-adults-
prisons/research-protocol
48. Steadman, H. J., Veysey, B. M., & US Department of Justice; National Institute of Justice. (1997). Providing Services for Jail Inmates With Mental Disorders: (491812006- 001) [Data set]. American Psychological Association.
https://doi.org/10.1037/e491812006-001
49. Reingle Gonzalez, J. M., & Connell, N. M. (2014). Mental Health of Prisoners:
Identifying Barriers to Mental Health Treatment and Medication Continuity. American Journal of Public Health, 104(12), 2328–2333. https://doi.org/10.2105/AJPH.2014.302043 50. America’s Largest Mental Hospital Is a Jail—The Atlantic. (n.d.). Retrieved February 21, 2021, from https://www.theatlantic.com/politics/archive/2015/06/americas-largest-mental- hospital-is-a-jail/395012/
51. Lovell, D., Gagliardi, G. J., & Peterson, P. D. (2002). Recidivism and Use of Services Among Persons With Mental Illness After Release From Prison. Psychiatric Services, 53(10), 1290–1296. https://doi.org/10.1176/appi.ps.53.10.1290
52. Health coverage options for incarcerated people. (n.d.). HealthCare.Gov. Retrieved February 21, 2021, from https://www.healthcare.gov/incarcerated-people/
53. Hartwell, S. (2004). Triple Stigma: Persons with Mental Illness and Substance Abuse Problems in the Criminal Justice System. Criminal Justice Policy Review, 15(1), 84–99.
https://doi.org/10.1177/0887403403255064
54. Mulvaney-Day, N., Gibbons, B. J., Alikhan, S., & Karakus, M. (2019). Mental Health Parity and Addiction Equity Act and the Use of Outpatient Behavioral Health Services in the United States, 2005-2016. American journal of public health, 109(S3), S190–S196.
https://doi.org/10.2105/AJPH.2019.305023
55. Hill I, Benatar S, Howell E, Courtot B, Wilkinson M, Hoag SD, Orfield C, Peebles V.
CHIP and Medicaid: Evolving to Meet the Needs of Children. Acad Pediatr. 2015 May- Jun;15(3 Suppl):S19-27. doi: 10.1016/j.acap.2015.02.008. PMID: 25906958.
56. Zuvekas SH, Meyerhoefer CD. State variations in the out-of-pocket spending burden for outpatient mental health treatment. Health Aff (Millwood). 2009 May-Jun;28(3):713-22.
doi: 10.1377/hlthaff.28.3.713. PMID: 19414879.
57. Center for Behavioral Health Statistics and Quality. 2015 National Survey on Drug Use and Health Public Use File Codebook. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2016.
58. Winkelman, T. N. A., Kieffer, E. C., Goold, S. D., Morenoff, J. D., Cross, K., &
Ayanian, J. Z. (2016). Health Insurance Trends and Access to Behavioral Healthcare Among Justice-Involved Individuals—United States, 2008–2014. Journal of General Internal Medicine, 31(12), 1523–1529. https://doi.org/10.1007/s11606-016-3845-5 59. Winkelman, T. N. A., Choi, H., & Davis, M. M. (2017). The Affordable Care Act,
Insurance Coverage, and Health Care Utilization of Previously Incarcerated Young Men:
2008–2015. American Journal of Public Health, 107(5), 807–811.
https://doi.org/10.2105/AJPH.2017.303703
60. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
61. Gonzales G, Henning Smith C. The Affordable Care Act and health insurance coverage ‐ for lesbian, gay, and bisexual adults: analysis of the Behavioral Risk Factor Surveillance System. LGBT Health. 2017;4(1):62 67.‐
62. Blosnich, J. R., Farmer, G. W., Lee, J. G. L., Silenzio, V. M. B., & Bowen, D. J. (2014).
Health Inequalities Among Sexual Minority Adults: Evidence from Ten U.S. States, 2010.
American Journal of Preventive Medicine, 46(4), 337–349.
https://doi.org/10.1016/j.amepre.2013.11.010
63. Gonzales, G., Quinones, N., & Attanasio, L. (2019). Health and Access to Care among Reproductive-Age Women by Sexual Orientation and Pregnancy Status. Women’s Health Issues, 29(1), 8–16. https://doi.org/10.1016/j.whi.2018.10.006
64. Dahlhamer JM, Galinsky AM, Joestl SS, Ward BW. Barriers to health care among adults identifying as sexual minorities: a US national study. Am J Public Health.
2016;106(6):1116 1122.‐
65. Initiative, P. P., & Wagner, W. S. and P. (n.d.). Mass Incarceration: The Whole Pie 2020.
Retrieved March 3, 2021, from https://www.prisonpolicy.org/reports/pie2020.html 66. Marks JS, Turner N. The critical link between health care and jails. Health Aff
(Millwood). 2014 Mar;33(3):443-7. doi: 10.1377/hlthaff.2013.1350. PMID: 24590943.
67. Regenstein M, Rosenbaum S. What the Affordable Care Act means for people with jail stays. Health Aff (Millwood). 2014 Mar;33(3):448-54. doi: 10.1377/hlthaff.2013.1119.
PMID: 24590944.
68. Fazel S, Hayes AJ, Bartellas K, Clerici M, Trestman R. Mental health of prisoners:
prevalence, adverse outcomes, and interventions. Lancet Psychiatry. 2016;3(9):871–881.
doi:https://doi.org/10.1016/S2215-0366(16)30142-0
69. Binswanger IA, Krueger PM, Steiner JF. Prevalence of chronic medical conditions among jail and prison inmates in the USA compared with the general population. J Epidemiol Community Health. 2009;63(11):912–919.
70. 4. Macalino GE, Vlahov D, Sanford-Colby S, et al. Prevalence and incidence of HIV, hepatitis B virus, and hepatitis C virus infections among males in Rhode Island prisons.
Am J Public Health. 2004;94(7):1218–1223.
71. 5. Wilper AP, Woolhandler S, Boyd JW, et al. The health and health care of US prisoners: results of a nationwide survey. Am J Public Health. 2009;99(4):666–672.
72. Wakeman SE, McKinney ME, Rich JD. Filling the gap: the importance of Medicaid continuity for former inmates. J Gen Intern Med. 2009;24(7):860–862.
73. Rich, J. D., Chandler, R., Williams, B. A., Dumont, D., Wang, E. A., Taxman, F. S., Allen, S. A., Clarke, J. G., Greifinger, R. B., Wildeman, C., Osher, F. C., Rosenberg, S., Haney, C., Mauer, M., & Western, B. (2014). How Health Care Reform Can Transform The Health Of Criminal Justice–Involved Individuals. Health Affairs (Project Hope), 33(3), 462–467. https://doi.org/10.1377/hlthaff.2013.1133
74. Wang EA, White MC, Jamison R, Goldenson J, Estes M, Tulsky JP. Discharge planning and continuity of health care: findings from the San Francisco county jail. Am J Public Health. 2008;98(12):2182–2184.
75. Mallik-Kane K, Visher CA. Health and Prisoner Reentry: How Physical, Mental, and Substance Abuse Conditions Shape the Process of Reintegration. Washington, DC: Urban Institute; 2008.
76. Patel, K., Boutwell, A., Brockmann, B. W., & Rich, J. D. (2014). Integrating correctional and community health care for formerly incarcerated people who are eligible for
Medicaid. Health affairs (Project Hope), 33(3), 468–473.
https://doi.org/10.1377/hlthaff.2013.1164