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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. With the ongoing implementation of the Patient Protection and Affordable Care Act (ACA), COCHS now reserves its home page to highlight recent developments impacting public health and public safety. For those seeking more information about COCHS, please visit our About Us page.

  • The Future of the Safety Net:
    Federal Legislation and Behavioral Health Financing

    COCHS General Counsel Dan Mistak looks at the Excellence Act as the newest way states can incorporate value-based purchasing into their health care delivery system and meet the needs of those who have often been left out of our health care system. Read more...

  • CMS Guidance on Justice Involved Individuals Eligibility for Medicaid
    Steven Rosenberg, President of COCHS, comments on CMS's State Health Director letter that clarifies the conditions under which a justice-involved individual is deemed an “inmate of a public institution” and thus ineligible for federal financial participation (FFP) for Medicaid-covered services. Read more...
  • The Affordable Care Act and the Excellence Act: An Evolving Terrain to Meet the Needs of the Neediest
    In Cornerstone, the magazine of the National Legal Aid & Defender Association, Dan Mistak, COCHS' general counsel, explains how two tectonic shifts in the health care world have poised legal aid lawyers and defenders to better advocate for community solutions to client needs: the Medicaid expansion under the Affordable Care Act (ACA) and Section 223 of the Protecting Access to Medicare Act (otherwise known as the “Excellence Act”). Read more...
  • When the Old Sheriff Leaves Town
    Former COCHS board member, Mike Ashe retires as sheriff of Hampden County, Massachusetts. Sheriff Ashe brought community health providers into his jail because he understood that inmates were temporarily displaced community members and continuity of care was important for their successful re-entry. This model was the impetus for the creation of COCHS by the Robert Wood Johnson Foundation in 2006. Read more...
  • New HIE Funding Opportunities for Corrections:
    Health Information Technology’s Role in Reducing Mass Incarceration

    The Centers for Medicare and Medicaid Services (CMS) on February 29, 2016 released a Dear State Medicaid Director letter which expanded the list of providers that could participate in the 90 percent federal matching funds (90/10) on state activities to promote health information exchange (HIE). The new expanded list included correctional health providers. This addition is a recognition that coordinating care of individuals cycling through the criminal justice is an important contribution in assisting eligible Medicaid providers in the community to meet EHR Incentive objectives of Meaningful Use

    To coincide with this announcement, COCHS is disseminating a new issue paper by COCHS CIO Ben Butler, New HIE Funding Opportunities for Corrections: Health Information Technology’s Role in Reducing Mass Incarceration. In this paper, Ben outlines the potential of HIE to vastly improve connectivity between community and correctional healthcare and possibly help reduce mass incarceration. Read more...

  • The Present and Future of Correctional Health and Mental Health Care
    In the current issue of Correctional Mental Health Report, Steve Rosenberg, the president of COCHS, writes about how our behavioral health care systems and correctional systems must be re-engineered to more appropriately respond to the needs of offenders suffering from behavioral health disorders. Read more...

  • Health Reform and The Excellence Act and Criminal Justice Reform: Opportunities and Intersections
    On December 8th, 2015 in Washington DC.,COCHS and the National Council for Behavioral Health held a conference: The Excellence Act and Criminal Justice Reform: Opportunities and Intersections. At this conference, experts from public safety, health care, philanthropy, and government addressed issues related to the implementation of the Excellence Act. Senator Debbie Stabenow (D-MI), Co-Sponsor of the Excellence Act gave the welcoming address. Roy Austin, Deputy Assistant to the President for the Office of Urban Affairs, Justice and Opportunity gave the keynote speech. To view a recording of the conference click here...

  • Community Supervision and Community Health: ACA and Changing Landscape of Community Supervision
    In the Fall 2015 issue of Perspectives, The Journal of the Probation and Parole Association, Dan Mistak, COCHS’ general counsel, explores how the Patient Protection and Affordable Care Act (ACA) is changing community supervision. This change will integrate public safety goals with the goals of public health . Read more (Dan’s article starts on page 50)…

  • Addressing the Disparate Impact of the Federal Response to the Opioid Epidemic
    In this paper, Dan Mistak, general counsel of COCHS, describes the history of federal financial participation (FFP) prohibitions on providing health care for individuals in public institutions and CMS’ current re-consideration of old FFP exclusions on funding for Institutions for Mental Disease ("IMD") in the face of the opioid abuse crisis. He also points out how removing prohibitions for IMDs, while retaining the ban on funding for certain types of inmate health care will exacerbate disparate racial impacts. This paper urges CMS to reconsider the “Inmate Exception” in the same way it reconsidered its IMD exception in order to ensure that everyone affected by the opioid epidemic receives treatment and to avoid the implicit devaluation of young, poor people of color. In order to create a fairer criminal justice system, we must ensure that everyone affected by the opioid epidemic is treated rather than incarcerated. Read more...

    In order to create a fairer criminal justice system, we must ensure that everyone affected by the opioid epidemic is treated rather than incarcerated. Please send Victoria Wachino, Director of Medicaid and CHIP Services, an email urging her to consider a waiver for the inmate exception: click here to send email.

  • New York Times: Prosecutors and Safety
    In a letter to the editor of The New York Times, Keith Barton (COCHS) and David LaBahn (Assn. of Prosecuting Attorneys) respond to a Sept. 29 column by David Brooks headlined The Prison Problem which suggested that district attorneys are overly aggressive in their prosecutions and, further, that prosecutors have misaligned incentives because they “tend not to have to worry about the financial costs of what they do.” Barton and LaBahn write “this portrait ignores the connections that prosecutors across the country have formed with community groups to address public safety.” The letter continues: Collaborations between prosecutors and community groups are yielding important results. Together, we can divert people away from jails, improve access to health care and address the root causes that lead to criminal behavior. Read more...
  • State Medicaid Eligibility Policies for Individuals Moving Into and Out of Incarceration
    An issue brief from The Henry J. Kaiser Family Foundation explaining Medicaid eligibility for justice involved populations. Read more...
  • No Escaping Medical Copayments, Even in Prison
    In an article from the Pew Charitable Trust, the president of COCHS, Steve Rosenberg states that charging inmates a copayment for medical services is counter to one of the chief ambitions of health reform under the Affordable Care Act: preventive care, which can forestall worsening medical conditions and costlier treatments in the long run. Read more...
  • Disparities in Mental Health Referral and Diagnosis in the New York City Jail Mental Health Service
    Research shows that significant health disparities exist for incarcerated persons of color, including the occurrence of infection, violence, and mortality. Because persons with mental illness have longer lengths of stay than others, they now represent approximately 38% of persons in jail. In New York City, both non-White and young patients appear to be less likely to enter the jail mental health system and more likely to enter solitary confinement than their White and older counterparts. Read more...
  • Predictive Analytics in Health Care and Criminal Justice: Three Case Studies
    In this issue paper, Ben Butler, COCHS' CIO, examines three case studies where predictive analytics are being used to assist health care providers along with criminal justice professionals in reducing incarceration, improving health, and maintaining public safety. Read more...

  • Medicaid Coverage for Jail Inmate's Inpatient Hospitalization
    In Sheriff Magazine, Steve Rosenberg, president of COCHS discusses the Department of Health and Human Services' guidance letter of 1997 that outlines the circumstances under which Medicaid could pay for health insurance when an inmate becomes a patient in a medical institution. The ACA's Medicaid expansion means that a significant number of inmates are likely to be eligible. Read more...

  • Consumer Rights Come to Jail: How the Affordable Care Act Changes the Rights of Individuals Pending Disposition
    The ACA has expanded affordability of, and access to, health care and granted rights and responsibilities specifically to individuals in jail pending disposition. It is only a matter of time before correctional settings must incorporate the consumer-based insurance mechanisms and assurances established by the ACA. Recognition of serious, widespread deficiencies in the physical and mental health care services provided in jail underscores the urgency of this need. Read more...