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National Commission on Correctional Health Care Position Statement

Increasingly, experts are recognizing that correctional health care is a vital part of public health in American communities (Glaser and Greifinger, 1993). Those who are behind bars suffer from a number of maladies mental illness, homelessness, substance abuse, violent behavior, Human Immunodeficiency Virus (HIV), sexually transmitted diseases (STDs), tuberculosisat a rate higher than that reported for the general population. Significantly, most of these people will return to their communities so that, to the extent their maladies can be treated, they will return healthier and pose less of a risk to the public health of the community (Bell, 1992). As a vital component of the community public health program, the financing of correctional health care is a responsibility that all in society must share. In the free world, private (i.e., health insurance and out-of-pocket expenditures) and public (i.e., Medicare and Medicaid) programs pay for this health care. The health care provided to those in jail or prison, however, is not included in these expenditures. Those who are incarcerated lose eligibility for private or public health insurance entitlement benefits even though they may have been eligible prior to arrest. Upon arrest, detention, conviction and sentencing, the burden or providing health care falls upon counties (i.e., jails) and the states (i.e., prisons). An ever increasing number of Americans, including a high proportion of minorities and an increasing number of women and juveniles, are presently behind bars. Others, including the mentally ill and the homeless, are behind bars because there are no other alternatives available in our communities. Most return to these communities after relatively short periods of incarceration.