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Halfway to Health

Transitional Inmates Lack Health Care

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ERRIN JACOBS IS ADDICTED to methamphetamines. He wants to be in a treatment program. The trouble is, he is finishing his jail sentence at a halfway house and, like hundreds of other inmates transitioning out of prison and jails in the state, he is stuck in a bureaucratic blind spot. Currently, Jacobs resides at a Multnomah County Restitution Center--essentially, a halfway house. As such, the prison system refuses to provide health care unless he returns full-time to jail and, at the same, the state refuses to put him on their health plan because he is, technically, still an inmate."I'm supposed to be doing a drug and alcohol treatment program at De Paul," said Jacobs, "but since I'm here (at the restitution center) it's impossible." He continued, "treatment is nowhere in my future without the Oregon Health Plan."

Funded by federal Medicaid dollars, the OHP is designed to provide medical care for poor residents in the state, a category into which Jacobs otherwise qualifies.

In May, Jacobs left Inverness Jail in NE Portland and entered into the Restitution Center. Although strictly run by correctional officers, Jacobs prefers living at the Restitution Center. He has a social pass to visit relatives and can leave to search for a job. These centers, according to inmates and correctional officers, help smooth the transition out of prison.

Yet, whatever their health problem--schizophrenia, drug addiction, appendicitis--hundreds of men and women in Oregon each year will not receive treatment from the OHP as they move through halfway houses.

"If we have someone here with diabetes, and they have no way to get insulin, they're going back to jail," says Carolyn Clark, the lead corrections counselor at the Restitution Center. "That's the really sad part," she adds.

Corrections officers like Clark argue that the state should tighten its interpretation of the word "inmate" to only people living full-time in jail or prison. They have written letters and made phone calls and testified at agency hearings to the Oregon Health Board and Adult and Family Services to change their policy.

But Steve St. Cloud, OHP medical program analyst for Adult and Family Services, says the rules are simply lined up with federal rules that prohibit inmates from receiving Medicaid funds. "I don't believe we're going to be allowed to expand coverage," he explained. "In fact," he continued, "the federal government is going to tighten restrictions."

Even so, although corrections officials would not say where or who, they claim that certain OHP staff members approve coverage for people like Jacobs. Some knowingly bend or break the rules, they claim; others seem to simply not be aware of the nuances of who is an inmate. Beyond the immediate threats to an inmates' health, Jacobs adds that there are important reasons to extend coverage to inmates who no longer are incarcerated. "If the Oregon Health Plan was made available to people who are in the situation I'm in," he said, referring to his drug addiction, "they would get treatment and cut down on crime."

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