On an icy and snowy Tuesday morning, it took me two hours to get to the Delaney Hall Detention Facility, a halfway house in Newark, New Jersey located next to the Essex County jail on Doremus Street. I was invited by Councilwoman Mary Am Bey of Newark’s West Ward to present information on the Affordable Care Act (ACA) at Delaney Hall, where approximately 1,250 low-level, non-violent offenders begin the process of reintegration back into society.
I agreed to speak with this group, understanding that marginalized populations - including those who were previously incarcerated - are often the last to receive education and information about services that are available to them.
I passed through a rigorous security process at Delaney Hall: I got clearance to bring in my laptop and LCD projector for the PowerPoint presentation, gave up my ID, cell phone and charger, and was escorted by several officers into a large conference room.
The doors opened to a huge group of 300 men transitioning out of the prison system, ranging in age from early twenties to 50+ and including a smattering of veterans. As I set up, you could hear a pin drop. Councilwoman Bey introduced me and I began my psentation to the attentive crowd, making a few initial jokes to break the ice.
To my surprise and delight, the next two and a half hours were filled with jokes, laughter and excellent questions – the time passed quickly! It was no surprise that the majority of those in attendance were African American and Hispanic; both population groups are incarcerated at seven and three times the rate of Whites respectively. Most didn't know anything about the ACA, and by a show of hands, some had never heard of it. Participants even took notes and wrote on the few brochures that I had.
They were polite, friendly, and funny; giving me two standing ovations and telling me “thank you” and “God bless you” out of gratitude for the information. Many stayed behind and asked how they could get this information to their families, girlfriends, wives, brothers, sisters, and the mothers of their children. Many of the men expressed strong interest in information about their children’s eligibility for affordable health insurance under the ACA--especially pediatric dental care for those eligible under private plans.
The word spread quickly about my presentation – before leaving I was approached by others who heard that the presentation was really good and wanted to learn about the ACA. Councilwoman Bey asked me to come back to speak to another group of the same size in January. I am currently working with her to schedule a longer session with this next group. I also plan on bringing navigators with me who would be prepared to enroll on site, particularly for Medicaid.
As I made my way home in the snow, I reflected on the importance of educating re-entry populations about health care. Of the two million Americans who are serving time in prison, sixteen percent have a mental illness and three out of four have substance abuse problems. There is a need for returning citizens to continue treatment for conditions such as substance abuse that may otherwise trigger the same behavior that sent them to prison in the first place and increase recidivism.
Our returning neighbors and community members currently lack access to health care information. A handful of communities in each state receive the majority of returnees from the correctional system, constituting a specific need for health care education among re-entry populations. For example, a recent report by the Re-Entry Policy Council states that15% of neighborhoods in Baltimore receive 56% of the people released from Maryland state prisons.
Many are unaware that they may now meet eligibility requirements for care as a result of Medicaid expansion. Beginning in 2014, Medicaid will cover treatment for mental illness and substance abuse, which will benefit many individuals transitioning out of the prison system.
I invite other advocates to join me in educating our returning community members, leveraging connections with the faith community and elected officials to plan and conduct outreach sessions. It is critical that we continue providing education about the ACA to this population so that they are able to access affordable treatment and re-enter their communities with one less barrier on the road to success.
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Sheila has spent more than two decades representing the healthcare industry throughout North America, Europe and Latin America with a specialty in the health and healthcare of diverse populations. Sheila is Associate Clinical Professor at Stony Brook University School of Social Welfare, Adjunct Professor of Speech and Communications at Queens College and Adjunct Professor at Quinnipiac University in the Physician Assistant program. Sheila has made 50 ACA presentations to faith and community-based organizations, coordinated seven ACA Town Hall Meetings and conducted more than a dozen ACA community workshops in English and Spanish in New York, New Jersey and Washington, DC. A certified Affordable Care Act (ACA) Navigator, Sheila is co-chair of the Cultural and Linguistic Competency Committee of Center for Medicare and Medicaid Services Region II Health Equity Council.