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Kuster: Incarcerated population should keep Medicaid coverage

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Ninety percent of women serving time at New Hampshire State Prison are dealing with addiction, officials say.

While incarcerated, they have access to medication, peer support and other recovery programs.

Yet since inmates lose Medicaid coverage while they are in prison, when they are released, it takes 30 or 60 days to regain insurance – a vulnerable window of time for most people in recovery.

“People are at very high risk right upon their discharge,” Congresswoman Annie Kuster said. “Many of the deaths are happening from overdoses, people coming out, losing hope and getting back into drug use.”

Many women using drugs are also dealing with co-occurring trauma and mental health issues, the congresswoman said. Those factors, without support, commonly lead to recidivism.

Kuster is proposing two pieces of federal legislation she believes will help incarcerated populations struggling with substance abuse – one that will provide grant money for recovery services, and another that will enable people who are incarcerated to keep their Medicaid coverage. She said she hopes it will help people attain long-term recovery, by easing the transition from incarceration back into their everyday lives, which will help keep them from reoffending.

“I’m not suggesting that we should let people break into somebody’s home to steal medication, I’m not suggesting that we should let them sell drugs to other people … but I am suggesting that the ‘war on drugs’ for 50 years and that focus without the focus on mental health treatment, the underlying trauma and the long term recovery (is not working),” Kuster said.

Department of Corrections Commissioner Helen Hanks told Kuster during a visit to the women’s prison in Concord that the prison is always looking for more ways to support those in recovery.

“We invest all this time during incarceration to treatment, but what happens when they leave our institution?” Hanks said. “We want access to insurance and access to those people who know how to navigate the systems to deal with the recourse of their substance use, whether that’s continued treatment for Hepatitis C, or other things, reconnecting to families and helping be the conduit for their success.”

Using the State Opioid Response grant from the New Hampshire Department of Health and Human Services, the Department of Corrections is already starting to expand its use of medicine in the state’s prisons to assist inmates who are trying to overcome opioid and alcohol use.

The grant also provides funding for two additional re-entry care coordinators who will work with male inmates diagnosed with substance use disorders at each stage of their release.

The women’s prison has been working with grant-funded re-entry coordinator, Chelsea Jones, for the last two years, and officials say her work is helping inmates. Jones works on substance abuse case management, her job is to set up a strong support system with physicians and recovery coaches for inmates when they leave.

“The idea is, if they have those connections and if they have that substance abuse treatment already set up for them, and they have that primary care physician already set up to continue mental health medication or any medication, that is one less thing they have to worry about when they get out, it’s one less thing that is overwhelming to them,” Jones said.

Jones services are available to help people transitioning back into the community for up to a year after they are released.

Kuster said she believes its also important to employ resources at the border to stop the flow of drugs coming into the country. But she thinks getting to the root of the demand for drugs will also make a big impact on curbing the opioid epidemic – and save taxpayer money.

“At the end of the day it’s very expensive to lock people up for crimes related to substance use disorder and then not get treatment and then come out and repeat crimes and have this very high rate of recidivism,” she said.

“I’ve heard the expression that, the organ you need to solve the problem is the organ that’s ill. People are making very poor decisions and for these people that has led to criminal justice involvement.”