Removing barriers to care for Justice-Involved members

Michelle Fei is Justice Liason for United Healthcare Community Plan of Hawai’i.

People who are or have been incarcerated experience significant physical and behavioral health care needs. Compared to the general population, incarcerated people experience higher rates of chronic diseases, and over half of prison and jail inmates report having a mental health disorder.^1,2,3 People who are incarcerated often have limited access to health care services, which can result in them leaving jail and prison with unaddressed chronic health problems and worsened symptoms of mental illness. These challenges can persist following release: for example, the risk of death by drug overdose is sharply increased in the first two weeks immediately following release.⁴

Ensuring access to care for individuals involved with the criminal justice system is key to reducing recidivism and improving health outcomes. The UnitedHealthcare Community Plan of Hawai‘i is dedicated to addressing these issues and removing barriers to care through our Community Transitions Program for the Justice-Involved.

In 2022, we established our Community Transitions Program to help our members reenter society from incarceration in jail, prison, and the Hawai‘i State Hospital. Our Program offerings have since expanded to serve members with open criminal cases who are currently still in the community. We also provide support to members whose previous justice involvement may affect their ability to access housing, employment, and other social and economic opportunities.

Through the Community Transitions Program, any member transitioning out of incarceration – up to six months post-release – can receive health coordination services tailored to their needs. We take a whole-person approach across the continuum of care to work with each member to support their transition by understanding their needs and providing connections to health care and social services.

We have also established bidirectional referral programs with key community and government agencies. These partners identify members who may benefit from health coordination. In turn, we refer our justice-involved members to resources that can aid in their transition and integration back into the community, including housing and employment services that our members often acutely need.

Over the past year, the Program has served 180 people across O‘ahu, Maui, Kaua‘i, and the Big Island. In the months since the Program’s onset, we are already seeing promising results:

• Among those transitioning out of jail, prison, and the Hawai‘i State Hospital, the Program has resulted in a 59% decrease in out-patient costs and 100% decrease in ER visits (based on a rate calculated per thousand members).
• Those who have open criminal cases and are still in the community have shown a 25% decrease in per-member per-month costs and 65% decrease in ER visits.
• Those with past justice involvement have demonstrated a 67% decrease in per-member per-month costs and 95% decrease in ER visits.

By helping justice-involved members navigate health care and social resources, we can work to reduce costs and improve health outcomes.