Thursday, April 17, 2014

The DOJ selling ObamaCare and expanding on it

Posted by Cotoblogzz

Rancho Santa Margarita, CA-  earlier this month at a conference hosted by the Community Oriented Correctional Health Services and the journal Health Affairs, Associate Attorney General Tony West  took the opportunity to speak with a distinguished group of policymakers, researchers and health care and criminal justice professionals about the implications of ObamaCare for those under correctional supervision.

Mr. West argued that ObamaCare, provides " ..  an opportunity born of necessity, as leaders across the political spectrum seek ways to better align our criminal justice investments with outcomes that actually make us safer. "

He went on to state that:
"At the Department of Justice, we understand that public health and public safety often walk hand-in-hand; that the public policy investments we make yield the greatest returns when they reflect the importance of that connection; and that key to making our communities safer is reducing recidivism by improving reentry, which in turn means focusing on the physical and mental health of incarcerated and formerly incarcerated individuals. "
Reducing recidivism is a noble goal.  So is  improving reentry.  So is aligning the "criminal justice investments" to measurable outcomes.  I argue that a focus by the DOJ in better reentry using ObamaCare is not the best investment in criminal justice investment, quite the contrary.  The focus should be on making sure the prisoner pays back his or her debt to society.  Currently, a good number of prisoners view prison life as Club Med and a much better option that having to work for a living:  Room and board, including entertainment paid for by the investment in criminal justice. Comprehensive prison reform, which is what we advocate, also requires a consistent, fair, sentencing guidelines.

Mr. West rightly points out that:
We know that the incarcerated population carries substantially higher rates of medical, psychiatric and substance abuse problems than the general population.  Rates of communicable diseases are higher among inmates; an estimated 39 to 43 percent suffer from one or more chronic health conditions; and men and women in this population suffer three times the rate of mental illness and four times the rate of substance abuse problems as compared to the general public.

But his conclusion that the solution is ObamaCare is flawed:
" The Affordable Care Act, primarily through its Medicaid expansion provisions and parity for mental health and substance abuse treatment, provides us with this unique opportunity to reduce recidivism while improving public health.  Access to these benefits can be a critical factor in the success or failure of incarcerated persons upon their release." 
This is the nanny state at its best.  The prisoner is treated as zombie with absolutely no responsibility for his or her actions.

Mr. West adds:

Much of the work being done by the Federal Interagency Reentry Council, which is chaired by the Attorney General, focuses on reducing the collateral consequences of incarceration and increasing access to employment, treatment and civic participation.  With our Reentry Council partners at the Department of Health and Human Services, we are jointly supporting a three-year pilot project to test the efficacy of enrolling prison and jail inmates in Medicaid prior to release, and we’re tracking usage, employment and recidivism outcomes along the way.

At the Department of Justice, we will require halfway houses in the federal system—known as residential reentry centers (RRCs)—to offer standardized treatment to prisoners with mental health and substance abuse issues.  Once fully-implemented, these services will be available to the approximately 30,000 inmates who are released through halfway houses each year, helping to promote consistency and continuity of care between federal prisons and community-based facilities.

And goes on to argue that we must do more:

  • We must make it standard practice to assess the health care needs of individuals as soon as they come into the criminal justice system, being thoughtful about our options and basing decisions on individual needs.  
  • We should be willing to consider detention alternatives such as drug and mental health courts, and we should make health care enrollment part of the intake and discharge processes for all inmates. 
  • We must develop partnerships between correctional facilities and community health programs to promote information exchange and ensure continuity of care. 
  • And we must target our actions to those who need services the most.  The Affordable Care Act gives us the chance to provide those with the highest risks and the greatest needs access to quality health care in a way that promotes public health and safety while strengthening community and respecting individual dignity.

Everything Mr. West suggests and that the DOJ is doing on the surface, seem reasonable.

For a complete text of Mr. West remarks:

I argue that this akin to trying to push a string:  it is using tax payer money to make the prison population even more dependent, while avoiding,personal responsibility. When most of the prison population see jail time as a better alternative than holding an honest job in order to eat, you know the focus on better reentry is. mop,Ethel's misplaced.

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