Examining the effects of carceral exposure on health services use: Implications for policy and service coordination

Research Project Description

There is a clear and urgent need to improve coordination between justice, health care, and social services systems to ensure that people being released from incarceration access appropriate support. This need is likely greatest in Louisiana, which led the world in per capita incarceration until reforms enacted in 2017. Spearheaded by lead organization VOTE, reforms led to an initial release of 3000 people, and shortened parole eligibility generated a steady uptick in monthly releases. Simultaneously, the state expanded Medicaid and implemented pre-release enrollment programming. Louisiana allocated the savings from the population reduction to support re-entry services, but there is limited information about how FIPs use Medicaid services or how social services organizations health care providers are coordinating services for this growing special population. We will conduct a community-engaged mixed-methods study that will allow for multi-directional input from various health and social service providers and have implications for improving service coordination in a state facing gross health inequities. Our project includes an environmental scan of health care and transitional services delivery in Louisiana’s jails and prisons; qualitative interviews with stakeholders (currently and formerly incarcerated people, correctional health care staff, community-based health care providers, social services agency staff, and Medicaid managed care organization case managers staff; and a quantitative analysis of Medicaid claims data to test the hypothesis that use of health services differs among Medicaid enrollees based on history of incarceration.