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Community Oriented Correctional Health Services

Community Oriented Correctional Health Services (COCHS) is the national leader in promoting health care connectivity between jails and the communities in which they reside. COCHS reserves its home page to highlight developments impacting public health and public safety. For those seeking more information about COCHS, please visit our About Us page.

  • How America’s Health-Care System Makes Mass Incarceration Worse
    The prohibitive costs of America’s for-profit health-care system are well documented. Even in 2016, after the major provisions of the Affordable Care Act had taken effect and the national uninsured rate was down to 8.8 percent, a historical low, nearly 30 million people still lacked coverage, a disproportionate share of them black or Latino. But among the less-appreciated features of America’s system is how it supplements our more explicitly punitive institutions. Nowhere is this more evident than in Alabama. Sheriffs in 15 of its 67 counties of Alabama had issued so-called “medical bonds” to jail inmates — meaning they’d released sick detainees from custody when they needed medical treatment in order to avoid paying their medical bills, often saddling them with debt that, by law, the county would’ve been responsible for. This is not merely an indictment of Alabama’s jails and the barely checked power of county sheriffs. It’s an indictment of a health-care system that lends itself so seamlessly to immiserating the lives of the miserable.

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  • A visit with my (incarcerated) mother
    In an opinion piece for The Hill, COCHS' Homer Venters writes that one of the hidden consequences of mass incarceration is its impact on families as they are separated from loved ones. When family members aren’t able to visit prisoners, community ties are broken and recidivism increases. Even when visitation happens, visitors are often forced to undergo harassment and humiliation as they navigate the visitation process. The impact of these practices falls disproportionately on women, both as incarcerated people struggling to see their families and as the ones most likely to visit jail and prison.
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  • How many people in your state go to local jails every year?
    County and city jails have been called “mass incarceration’s front door,” but campaigns to reform or close jails often don’t receive the attention they deserve. Why? Because the traditional way we measure the impact of jails – the average daily population – significantly understates the number of people directly affected by these local facilities. To close this gap in the data and making the impact of jails clearer,a new national report Arrest, Release, Repeat, is able to estimate the number of people in every state who go to local jails each year.
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  • The Private Option
    Most people held in jails haven’t been convicted, and as of the end of 2017, black people were jailed at a rate of more than three times that of white people. Their charges, too, are often minor: traffic offenses, marijuana possession, petty theft. Put another way, every day, thousands of legally innocent people are stopped, searched, cuffed, booked, examined, locked up, and upended from their routines, families, homes, and jobs—all without their own medical supplies and prescriptions. But the correctional health-care industry depends on them. In a financial disclosure to investors, one publicly traded company listed reduced sentences, decriminalization, and relaxed enforcement among its top business risks.
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  • Death and politics roil a Georgia jail
    Reuter's report on COCHS' role as the health care monitor in the Chatham County Detention Center (Savannah, Georgia). COCHS reported widespread problems in the mental health care provided to suicidal inmates. In those reports, COCHS warned that the infirmary’s cells were dangerous for suicidal inmates. COCHS urged the health care vendor, CorrectHealth, to craft policies for dealing with mentally ill inmates. As the suicides mounted, the sheriff pushed back against the monitor’s scrutiny and COCHS was forced out of the jail. The Chatham County Detention Center’s troubles offer a look into the challenges American communities face in holding accountable the private companies, like CorrectHealth, that have been entrusted with managing healthcare services at a growing number of jails and prisons.
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  • Policymakers, provide adequate health care in prisons and detention centers
    In an opinion piece for CNN, Homer Venters, COCHS Health Justice Fellow, and Katherine C. McKenzie write, since President Donald Trump has taken office, 24 individuals have died in ICE custody, according to federal data analyzed by NBC News. This includes six migrant children who have died in less than a year. One of the migrants was a 16-year-old Guatemalan boy who died while being held in custody by US Customs and Border Protection. He was diagnosed with the flu. He was found unresponsive at the Weslaco Border Patrol Station in Texas, although his cause of death is still unknown. This is not a surprise when we consider the conditions in US jails and detention centers. Facilities are often bleak, over-crowded and under-resourced, while those held in custody are frequently separated from their loved ones. Insufficient or negligent medical care is a violation of human rights, according to the World Health Organization. But basic human rights should be afforded to all. And, in the case of prisoners, "a deliberate indifference to serious medical needs" violates the Eighth Amendment's prohibition against cruel and unusual punishment.
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  • How Connecting Justice-Involved Individuals to Medicaid Can Help Address the Opioid Epidemic
    Vicki Wachino the former director of the Center for Medicaid and CHIP Services at the Center for Medicare & Medicaid Services from 2015 to 2017 writes for the Kaiser Family Foundation how providing treatment to people with addiction who are involved with the criminal justice system can help address the epidemic of opioid use disorder (OUD) and increasing rates of overdose in the U.S. Many people with OUD and other substance use disorders (SUD) are involved with the criminal justice system. The period that immediately follows incarceration poses extremely high health risks for them. The ACA Medicaid expansion provided new opportunities to connect individuals leaving incarceration to coverage and services that can mitigate these risks and help people successfully transition into the community with services to support recovery and treatment.
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  • Getting serious about preventable deaths and injuries behind bars
    In an opinion piece for The Hill, Dr. Homer Venters, COCHS Health Justice Fellow and the former chief medical officer at New York's Rikers Island, discusses the health risks of populations cycling through our criminal justice system. These health risks include death, injury and sexual abuse. Many who die commit suicide, which is the leading cause of death in America’s county jails. The use of solitary confinement, whether in name or practice, as the primary response to mental health and substance use issues behind bars is an important contributor to these preventable deaths. Other drivers of preventable death include denial of care for chronic disease, lack of treatment for substance use and outright physical abuse.
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  • HR 6: The Opioid Bundle
    On October 24, 2018, the President Trump signed HR 6 also known as the Opioid Bundle, which signifies a major leap forward in ensuring that our health care system reflects the reality that incarcerated individuals are members of our community and deserve to be treated as such. HR 6 contains several sections that could stop the disparate impact of the opioid crisis and fundamentally change the criminal justice system. Contained within this law is the Medicaid Reentry Act found in Section 5031 et seq. These sections require Health and Human Services to create a stakeholder group to develop best practices to allow for Medicaid dollars to pay for care 30 days before release. Unlocking funding sources for this crucial time will create a unified payer for services received on both sides of the wall and allow for continuity of care unlike the which we have never seen for justice-involved individuals. Read more...
  • Jail-Based Medication-Assisted Treatment:
    Promising Practices, Guidelines and Resources for The Field

    Jails have become a revolving door for individuals struggling with mental health and
    substance use disorders. The following guidelines introduce what has been learned from the sheriff s’ and jail administrators’ innovative use of MAT, describing the essential components of these programs and analyzing the latest research on how these programs are best implemented, as well as the medications approved for opioid use disorders.
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