The proposal to expand Medicaid in Ohio will help provide much-needed mental and physical health care to people coming out of our jails and prisons. How does that affect the average Ohioan? We would like to make the case from the perspective of three groups dedicated to developing programs and services that keep criminal offenders from being incarcerated again and again.
OhioLink Corrections & Treatment, Inc., is composed of three nonprofit agencies: Alvis House in Columbus, Oriana House in Akron and Talbert House in Cincinnati. We provide community corrections programs, job and education services, and substance abuse and mental health treatment services.
As professionals in the field, we are well aware that more than 96 percent of all incarcerated offenders will return to the community. According to the Ohio Department of Rehabilitation and Correction, 21 percent of male prisoners and 38 percent of the women have a history of mental illness, and 85 percent of men and 79 percent of women have a history of substance abuse. Untreated, they are likely to reoffend and end up back in the corrections system. This vicious cycle is not only unsafe for the public, but also expensive to taxpayers and a waste of human talent and productivity.
If Medicaid is expanded in Ohio to serve low-income childless adults, many released offenders would qualify for mental and physical health treatment. Currently, offenders who are incarcerated or are in halfway-house settings have most of their medical treatments paid by government agencies. Once they are released, there is nothing to ensure continuity of care for these individuals. Many of them do as thousands of others without health coverage do, which is to seek expensive medical attention at hospital emergency rooms with no ability to pay for such treatment. All other Ohioans with insurance end up paying more for services, to cover the cost of those who cannot pay.
There is even a more compelling reason to provide Medicaid services to this particular segment of the population. According to studies done in the state of Washington, treatment for chemical dependency saved an average of $2,500 per person per year in medical costs. In addition, rates of rearrest were 21 percent to 33 percent lower in three groups treated for chemical dependency than in those not receiving treatment. This saved jails, courts and law enforcement $5,000 to $10,000 per person. It also reduced crime and increased public safety.
Substance abuse and mental-health counseling is a big part of what our agencies do for the people we serve. An expanded Medicaid program would help cover the costs of clinicians in our agencies. This would free up dollars that our agencies could use to strengthen work force development, behavioral treatment and all other programs that have been proved to reduce recidivism.
Health plays a big part in the ability of people released from incarceration to keep on the straight and narrow. That is especially true for those with mental illness. Prisoners as a group also tend to be less healthy physically than the general population. Most suffer from at least one chronic health condition, such as asthma, diabetes, hypertension, hepatitis and HIV/AIDS. Individuals with a history of incarceration are four times to six times more likely to have HIV/AIDS and 17 times more likely to have tuberculosis than the general population.
About 80 percent of prisoners with these conditions have not received treatment before incarceration, and almost all receive no treatment after release because they are uninsured. It is unacceptable to deny people access to health care for treatable chronic conditions. Moreover, it is a danger to the community to have untreated communicable diseases on the street.
It is far more costly in terms of dollars and public safety to release prisoners without the care they need to fully function in society. We have the tools to stop this cycle of re-incarceration.
In the past couple of years, Ohio’s Medicaid system has been much improved. Care is better coordinated to give patients comprehensive and integrated mental and physical treatment. We urge the Ohio General Assembly to support Gov. Kasich in expanding Medicaid. The $23.8 billion in additional federal funds through 2019 will help community-based corrections services such as ours make Ohio a healthier and safer state.
Robinson is the president and chief executive of Alvis in Columbus. Lawrence is the president and chief executive of Oriana House in Akron. Tilow is the president and chief executive of Talbert House in Cincinnati.