Earlier this month, Arapahoe County Colorado Commissioner Nancy Sharpe joined fellow county leaders from across the country for an advocacy day on Capitol Hill. The meeting of the National Association of Counties (NACo) and National Sheriffs’ Association (NSA) joint task force, from October 8-10, was part of an effort to reduce jail inmate recidivism via continuity of health care services.
Commissioner Sharpe is the co-chair of the task force, which is comprised of NACo and NSA members representing law enforcement, judges, prosecutors, public defenders, behavioral health and veterans’ services. The group was set up earlier this year to explore the impacts of the national mental and behavioral health crisis and the Medicaid Inmate Exclusion Policy (MIEP), which strips federal health and veterans’ benefits from individuals upon admission to jail – not upon conviction – which forces counties to incur the costs of inmate health care and leads to increased recidivism.
Task force members shared stories and promising practices on pre-trial jail populations, jail health care, services provided and recommendations for how local governments can work with law enforcement to ensure better health outcomes in the local justice system, reduce recidivism and build community capacity to support a continuum of care. Commissioner Sharpe used her time in Washington to update staff members of Colorado’s Rep. Ken Buck and Senator Cory Gardner about the task force’s work and the situation at home.
“In Arapahoe County, we are currently dealing with the many ramifications of having an outdated and overcrowded detention center,” Sharpe said. “The MIEP interrupts the continuity of care of pre-trial inmates, adds substantial additional cost to the county and increases the possibility of recidivism among those affected by the policy.”
“Stripping federal health benefits from those jailed but not convicted and who are presumed innocent is a violation of their constitutional rights and places an enormous financial burden on counties and local taxpayers,” said NACo Executive Director Matthew Chase. “By providing access to health care benefits to those most in need, counties can help break the cycle of recidivism exacerbated by untreated physical and mental illnesses and substance use disorders.”
Members of the task force are exploring the impacts of existing federal policies on recidivism and health outcomes of local jail inmates. The primary focus is on those individuals suffering from mental health, substance abuse and/or other chronic health illnesses.
An issue plaguing sheriffs and their jails throughout the United States is that of the increasing number of inmates with substance abuse, mental illness, and co-occurring disorders. Due to a lack of community resources, jails have become the de-facto mental health hospitals and treatment facilities and have assumed the liability as well. Across the nation, there is growing reliance on local jails to serve as “one-stop” treatment centers for these afflictions. Under current law, those who can afford bail keep their health care. But those who are unable to pay – and who are most susceptible to illness – face a gap in coverage. Research shows that these gaps in lead to higher rates of recidivism resulting in over-incarceration.
The double standard created by MIEP is putting undue strain on our local judicial, law enforcement, public safety and human services systems and leading to increased health care costs and poorer health outcomes. Having access to federal health benefits for non-convicted individuals would allow for improved coordination of care, while decreasing short-term costs to local taxpayers and long-term costs to the federal government.
The suspension of federal benefits for pre-trial detainees doesn’t just trigger constitutional challenges; it also unjustly increases the fiscal impact on the sheriffs and counties that must pay for necessary medical and mental health care, that but for the pre-trial inmates’ incarceration, the federal government would normally cover. These monies, if reinstated, would increase the sheriffs’ ability to provide additional programming and resources to the inmates and allow for a smoother transition back into the community for inmates without a lapse in benefits and medical care. These inequities must stop. A change must happen.
Read more about the need to reinstate federal health care benefits for non-convicted justice-involved individuals here.