Center for American Progress

Expanding Access to Basic Reentry Services Will Improve Health, Well-Being, and Public Safety
Report

Expanding Access to Basic Reentry Services Will Improve Health, Well-Being, and Public Safety

Improving access to health care for individuals rejoining their communities after incarceration is a critical strategy for reducing crime, improving community health, and bettering overall public safety.

In this article
A man in a wheelchair is seen receiving a vaccination in a hallway while a security guard watches.
An inmate receives a COVID-19 vaccine at Faribault Prison in Faribault, Minnesota, on January 4, 2021. (Getty/Aaron Lavinsky/Star Tribune)

The current U.S. criminal legal system’s approach to holding people accountable obstructs those returning home from a period of incarceration from accessing basic resources—including health care, employment, education, housing, and food assistance—and is antithetical to breaking the cycle of offending.1 Partly because of systemic failures to connect reentering individuals to necessary resources, nearly three-quarters of people returning from prison are rearrested within five years of release.2 Of these failures, restrictions that limit access to adequate health care services are one of the most influential factors underlying recidivism. And while everyone deserves to be safe in their communities, policymakers have neglected to sufficiently prioritize reentry health care services over more punitive measures, thus failing to create meaningful and lasting safety for individuals and their communities.3

Although those returning to their communities after incarceration can have complex and overlapping needs, access to adequate health care is critical given that this population experiences threats to their physical and mental well-being at a rate disproportionate to that of the general population.4 According to a 2008 Urban Institute report, one-half of men and two-thirds of women who were rearrested after a period of incarceration had a chronic physical ailment such as asthma, diabetes, hepatitis, HIV/AIDS, or cardiovascular disease.5Research has also revealed that mental health disabilities and substance use disorders are staggeringly prevalent in the U.S. prison population: Around half of incarcerated individuals experience co-occurring mental health disabilities and substance use disorders.6

These ailments are often untreated before incarceration. Many people’s first opportunity to access health care resources is when they are incarcerated.7 Once released, individuals are often cut off from the care they received while incarcerated, further destabilizing their lives and increasing their likelihood of reoffending or even death.8 A study examining 14 years of New York State parole data found that each additional year spent in prison resulted in a two-year decrease in lifespan, with death rates peaking two weeks after release, which can be a result of people losing access to medications and treatment they received while incarcerated.9

Connecting formerly incarcerated individuals to services to address health-related social needs immediately upon release is essential to equip them to successfully reintegrate into their communities and prevent recidivism.10 Policymakers can support these efforts by:

  • Expanding Medicaid coverage, including increased funding for community-based services, for returning and incarcerated individuals to make physical and behavioral health services more accessible
  • Supporting the creation of culturally competent community health infrastructure, such as mental health and substance use treatment programs
  • Expanding the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) benefits to support formerly incarcerated individuals
  • Passing automatic record expungement measures at the state and federal levels
Once released, individuals are often cut off from the care they received while incarcerated, further destabilizing their lives and increasing the likelihood of reoffending or even death. Journal of Correctional Health Care, "Journal of Correctional Health Care" (2021).

Addressing the health care and health-related social needs of people returning to their communities should be a part of a comprehensive approach to reentry. When taken together, these measures provide a more restorative way of addressing underlying health issues and reducing recidivism, improving public safety by interrupting cycles of crime.11

Expanding Medicaid access for individuals reentering society is critical for addressing their unique health care needs

The transition from incarceration to reentry poses significant challenges, with access to insurance and affordable health care being key determinants of recidivism rates and subsequent successful reintegration.12 Half of those incarcerated in state prisons are uninsured at the time of their arrest, and one 2008 study found that 78 percent of men and 66 percent of women were still uninsured two to three months after release.13 This is the case despite formerly incarcerated individuals having more significant health care needs than the general population.14 Without insurance, formerly incarcerated individuals forgo needed care or are often forced to seek health care at facilities that are costly and not designed to support long-term or preventive care, such as hospitals or urgent care centers.15 Consequently, treatable medical conditions can worsen into acute crises, such as heart attacks or sepsis resulting from infectious disease, which can lead people to rely on emergency services.16 These stopgap measures are inadequate to support individuals who require sustained care for their ailments over time, and they put substantial strain on health care services.17

Given that many returning individuals have low incomes, a large portion of this population is likely eligible for Medicaid coverage.18 Yet, until recently, federal policy barred incarcerated individuals from eligibility for coverage, even though studies have shown that increasing access to Medicaid—either by maintaining coverage for the duration of incarceration or reinstating coverage just prior to release—decreases the likelihood of repeat offending.19

Both the federal administration and states have started the crucial work of expanding Medicaid access for reentering individuals.20 In 2023, the Biden-Harris administration issued guidance for states interested in using waiver demonstrations under Section 1115 of the Social Security Act to extend Medicaid coverage to eligible incarcerated individuals who are soon to be released.21 The waiver allows states to provide eligible individuals Medicaid coverage for specific services 90 days prior to their release and connects individuals to health care services in the community. These services can include case management, medication-assisted treatment for substance use disorders, and a 30-day supply of prescription medication.

As of October 2024, 11 states have been approved by the Centers for Medicare and Medicaid Services for Section 1115 reentry Medicaid demonstration waivers, with applications from an additional 14 states and Washington, D.C., pending approval.22 While it is still too early to assess the full impact of the federal Medicaid program, results from similar demonstration waivers at the state level show promising results. For example, Massachusetts, while not a reentry demonstration, has used its Section 1115 waiver to create its Flexible Services Program.23 Since the program’s inception in 2018, 93 percent of individuals referred have been connected to community organizations’ support services. Early reports also indicate that program members rely on emergency rooms for care less frequently, intake more nutritional food, and have better housing stability scores than nonmembers. Similar programs specifically for reentering individuals could be set up using the Section 1115 waivers.

In addition to this vital step, Congress should repeal the Medicaid Inmate Exclusion Policy, which would remove the federal prohibition on using Medicaid funds to provide services to incarcerated individuals.24 This would allow incarcerated and formerly incarcerated people to maintain continuity of care before, during, and after incarceration. Removing this exclusion at the federal level is the best way to ensure that all incarcerated and formerly incarcerated people have access to the health care they need.

Supporting the creation of culturally competent community health infrastructure

Community mental health infrastructure

People with mental health disabilities are overpoliced and overincarcerated.25 An estimated 37 percent of those in prisons and jails have a mental illness, compared with 18 percent of the general population.26 Yet carceral settings rarely provide adequate mental health care: An estimated 3 in 5 people with a history of mental health disabilities do not receive quality treatment while incarcerated in prison.27Communities often lack longer-term options to care for these individuals post-release.

Solutions for supporting those with mental health disabilities must be comprehensive, from swiftly and effectively assessing an individual’s needs for mental health support at admission, to providing care while they are incarcerated, to connecting them with community-based services immediately upon release and following up regularly thereafter.28 Mental health services must also be culturally competent, affordable, and easy to enroll in without significant administrative burdens.29

Specifically, post-incarceration care should consist of evidence-based practices such as assertive community treatment, through which patients receive around-the-clock, community-based, wraparound services tailored to each individual.30 These services can include medication and case management, treatment, and job placement assistance. Connecting with formerly incarcerated people who are trained as peer mental health specialists has also been shown to be helpful to those reentering.31 One study conducted in Massachusetts found that compared with the state’s average recidivism rate, reentering individuals who participated in a peer support program were two-and-a-half times less likely to be reincarcerated.32

Congress should support legislation that enables the development, implementation, and expansion of accessible pre- and post-release mental health services, ultimately making communities safer. The Second Chance Reauthorization Act of 2024 would reauthorize the Second Chance Act of 2008, which provides funding for programs geared toward improving reentry for returning individuals, including support for post-incarceration behavioral health programs.33 One important program is the Second Chance Act Crisis Stabilization and Community Reentry Program, which provides funding to state and local governments to support the implementation of clinical and recovery support services for people recently released from correctional facilities and in need of mental health or substance use services.34

Community-based substance use programs

An estimated 58 percent of those in prison have a substance use disorder, compared with 17.3 percent of the general population, and a leading cause of death in the first two weeks post-release for those reentering is drug overdose.35 The death rate for returning individuals are more than 12 times higher than the death rate of the general population, with overdose accounting for nearly one-quarter of all deaths.36

Community-based substance use treatment programs have several advantages over hospital settings, including the ability to:37

  • Adapt treatment to address the root causes of individual substance use
  • Ensure people remain close to their support systems
  • Increase the likelihood that individuals will spend more time in treatment, a key indicator of successful recovery
  • Be cost-effective

Strategies for supporting reentering individuals struggling with substance use disorders include connecting them with medication-assisted treatment programs while incarcerated and in the community after release and removing requirements that they abstain from substance use before being admitted to treatment programs.38 Treatment must also be voluntary. Compulsory treatment programs are not only “less effective in terms of long-term substance use outcomes,” but they are also more harmful; involuntary treatment has been associated with an increase in the risk of nonfatal overdose.39

Removing substance use abstinence requirements for mental health treatment

Mental health treatment programs that require abstinence from substance use for admission create significant barriers to connecting people to critically needed care.40 Many individuals begin using substances because of acute mental health challenges but are turned away when they seek help because they must first be substance-free. The underlying mental health issues motivating the substance use then go untreated. This failure to address comorbid mental health and substance use issues often results in a cycle of addiction and illness.

Additional funding resources could also be used to create and maintain evidence-based, accessible community health programs and rehabilitation centers that would be contiguous with prerelease care. Many local programs that support reentering individuals experiencing an array of mental health, substance use, and behavioral health challenges have seen success.41 For example, in Webb County, Texas, the Border Reentry and Community Integration Program provides substance use treatment for released individuals and has seen fewer arrests, fewer symptoms of depression and anxiety, and increased housing stability among program participants.42

Moreover, creating substance use treatment programs within corrections centers is essential43 to reduce recidivism and save lives. Individuals who participated in substance use treatment programs while in prison and received continued care afterward “were 7 times more likely to be drug free and 3 times less likely to be arrested for criminal behavior” than those who did not.44 Treatment program participants were also more likely to successfully recover from substance use and break cycles of crime and incarceration, thereby improving individual quality of life and reducing the likelihood of rearrest.45

Expanding SNAP and TANF benefits to support formerly incarcerated individuals

Good nutrition is an essential aspect of health and wellness. Yet the challenges of reentry can affect a returning individual’s ability to meet the most basic nutritional needs for themselves and their families. Research shows that returning individuals are more likely to fall below the poverty line and “are twice as likely to experience food insecurity than the general public.”46 SNAP and TANF are valuable social safety net programs that help provide food and financial assistance to individuals in need.47 However, current federal law lets states ban individuals convicted of a drug-related felony from these programs.48

Ending social safety net program restrictions for individuals with a conviction is critical to ensure people returning to their communities are fully supported in meeting their basic nutritional needs. Congress should pass legislation such as the RESTORE Act, which would repeal the SNAP drug felony ban and allow individuals to apply for the program up to 30 days before their release.49

Ending social safety net program restrictions for individuals with a conviction is critical to ensure people returning to their communities are fully supported in meeting their basic nutritional needs in reentry.

Passing automatic record expungement measures at the state and federal levels

For far too many individuals, the collateral consequences of an arrest or conviction record can limit their ability to obtain quality employment opportunities and ultimately limit access to employer-sponsored health insurance. Nearly 60 percent of people under age 65 in the United States receive health insurance coverage through an employer.50 But as many as 90 percent of individuals leaving incarceration do not have health insurance access, in part due to unemployment.51 For these individuals, having a job is not only essential for financial security; it is also a crucial resource to help them access health care and ultimately improve life outcomes that will help break the cycle of reoffending.

Currently, there are no mechanisms available to expunge records at the federal level. And while most states do provide an opportunity to have certain records expunged, the process usually involves an arduous and time-consuming court petition process. Policymakers nationwide—at both the federal and state levels—are working to enact policy measures known as clean slate measures, which automate the expungement process for eligible records and levels the playing field for directly affected job seekers.52

Twelve states have already passed clean slate legislation, including Pennsylvania, which has sealed more than 45 million records through its automated process since the measure was first enacted in 2018.53 The success of clean slate measures has encouraged federal lawmakers to introduce the Clean Slate Act, which would establish the first expungement system for eligible federal drug-related offenses.54 Federal lawmakers are also working to support clean slate measures at the state level through the Fresh Start Act.55 This measure would create a federal grant program to support states working to implement their own automatic record clearance measures.

Conclusion

Addressing the basic health needs of individuals reentering their communities would improve public safety. Reentering people are often denied access to health care, mental health support, and substance use treatment—all services that would support them in successfully rebuilding their lives and break cycles of offending. Public safety solutions for people coming home from incarceration should be designed to address underlying health issues during the reentry process, focusing on rehabilitation and providing second chances, all of which promote safer communities.

Endnotes

  1. Marina Zhavoronkova and others, “How To Improve Employment Outcomes for Young Adults Leaving Incarceration” (Washington: Center for American Progress, 2023), available at https://www.americanprogress.org/article/how-to-improve-employment-outcomes-for-young-adults-leaving-incarceration/; Justin Dorazio, “Strengthening Access to Housing for People with Criminal Records Is Key to Successful Reentry,” Center for American Progress, April 17, 2023, available at https://www.americanprogress.org/article/strengthening-access-to-housing-for-people-with-criminal-records-is-key-to-successful-reentry/; Jenny Landon and Alexi Jones, “Food insecurity is rising, and incarceration puts families at risk,” Prison Policy Initiative, February 10, 2021, available at https://www.prisonpolicy.org/blog/2021/02/10/food-insecurity/.
  2. Nancy La Vigne and Ernesto Lopez, “Recidivism Rates: What You Need to Know,” Council on Criminal Justice, available at https://counciloncj.org/recidivism_report/(last accessed October 2024).
  3. Lindsey McLendon, Rachael Eisenberg, and Nick Wilson, “Improving Public Safety Through Better Accountability and Prevention” (Washington: Center for American Progress, 2024), available at https://www.americanprogress.org/article/improving-public-safety-through-better-accountability-and-prevention/.
  4. NPR, “Signed Out Of Prison But Not Signed Up For Health Insurance,” December 6, 2016, available at https://www.npr.org/sections/health-shots/2016/12/06/504443879/signed-out-of-prison-but-not-signed-up-for-health-insurance; Ebony N. Russ and others, “Prison And Jail Reentry And Health,” Health Affairs, October 28, 2021, available at https://www.healthaffairs.org/content/briefs/prison-and-jail-reentry-and-health.
  5. Kamala Mallik-Kane and Christy A. Visher, “Health and Prisoner Reentry: How Physical, Mental, and Substance Abuse Conditions Shape the Process of Reintegration” (Washington: Urban Institute, 2008), available at https://www.urban.org/sites/default/files/publication/31491/411617-Health-and-Prisoner-Reentry.PDF; Ingrid A. Binswanger and others, “Release from Prison — A High Risk of Death for Former Inmates,” New England Journal of Medicine 356 (2) (2007): 157–165, available at https://www.nejm.org/doi/full/10.1056/nejmsa064115.
  6. Gergő Baranyi and others, “The prevalence of comorbid serious mental illnesses and substance use disorders in prison populations: a systematic review and meta-analysis,” Lancet Public Health 7 (6) (2022): e557–e568, available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178214/.
  7. Prison Fellowship, “Helping Former Prisoners Get Medical Care,” available at https://www.prisonfellowship.org/resources/training-resources/reentry-ministry/on-going-ministry/helping-ex-prisoners-get-medical-care/ (last accessed October 2024).
  8. Esther Galletta and others, “Societal Reentry of Prison Inmates With Mental Illness: Obstacles, Programs, and Best Practices,” Journal of Correctional Health Care 27 (1) (2021): 58–65, available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9041384/.
  9. Evelyn J. Patterson, “The Dose-Response of Time Served in Prison on Mortality: New York State, 1989-2003,” American Journal of Public Health 103 (2013): 523–528, available at https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2012.301148; Beth Schwartzapfel, “Why Some States are Trying to Get People Medicaid Before They Leave Prison,” The Marshall Project, June 8, 2024, available at https://www.themarshallproject.org/2024/06/08/medicaid-reentry-waivers-prison-jail.
  10. Elizabeth Hinton, “A Look at Recent Medicaid Guidance to Address Social Determinants of Health and Health-Related Social Needs,” KFF, February 22, 2023, available at https://www.kff.org/policy-watch/a-look-at-recent-medicaid-guidance-to-address-social-determinants-of-health-and-health-related-social-needs/#:~:text=Health%2Drelated%20social%20needs%20(HRSN,%2C%20work%2C%20and%20age).
  11. Nathan W. Link, Jeffrey T. Ward, and Richard Stansfield, “Consequences of mental and physical health for reentry and recidivism: Toward a health-based model of desistance,” Criminology 57 (3) (2019): 544­–573, available at https://onlinelibrary.wiley.com/doi/full/10.1111/1745-9125.12213.
  12. Michael Friedrich, “How Bolstering Health Care for People Reentering Communities Improves Safety,” Arnold Ventures, March 5, 2024, available at https://www.arnoldventures.org/stories/how-bolstering-health-care-for-people-reentering-communities-improves-community-safety.
  13. Prison Policy Initiative, “New report, Chronic Punishment, reveals the unmet health needs of people in state prisons,” June 22, 2024, available at https://www.prisonpolicy.org/blog/2022/06/22/chronic-punishment/#:~:text=exacerbated%20behind%20bars.-,Half%20(50%25),-of%20people%20in; Elaine Mitchell Albertson and others, “Eliminating Gaps in Medicaid Coverage During Reentry After Incarceration,” American Journal of Public Health 110 (3) (2020): 317–321, available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7002937/#:~:text=One%20pre%2DACA%20study%20of,eight%20to%2010%20months%20later.
  14. Ibid.
  15. Mallik-Kane and Visher, “Health and Prisoner Reentry: How Physical, Mental, and Substance Abuse Conditions Shape the Process of Reintegration,” p. 14.
  16. Joseph W. Frank and others, “Increased hospital and emergency department utilization by individuals with recent criminal justice involvement: results of a national survey,” Journal of General Internal Medicine 29 (9) (2014): 1226–1233, available at https://pubmed.ncbi.nlm.nih.gov/24817280/.
  17. Schwartzapfel, “Why Some States are Trying to Get People Medicaid Before They Leave Prison”; Tyler D. Harvey and others, “Cost savings of a primary care program for individuals recently released from prison: a propensity-matched study,” BMC Health Services Research 22 (585) (2022), available at https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-07985-5.
  18. Natasha Camhi, Dan Mistak, and Vikki Wachino, “Medicaid’s Evolving Role in Advancing the Health of People Involved in the Justice System” (New York: The Commonwealth Fund, 2020), available at https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/medicaid-role-health-people-involved-justice-system.
  19. National Association of Counties, “Reinstate Federal Health Care Benefits for Non-Convicted Juctice-Involved (sic) Individuals,” available at https://www.sheriffs.org/sites/default/files/NACo%20Medicaid%20and%20Jails%20One-Pager_wNSA.pdf (last accessed October 2024); Erkmen G. Aslim and others, “The Effect of Public Health Insurance on Criminal Recidivism,” Journal of Policy Analysis and Management 41 (1) (2022): 45–91, available at https://onlinelibrary.wiley.com/doi/epdf/10.1002/pam.22345.
  20. Lore Joplin and others, “Implementing the Medicaid Reentry Waiver in California” (South Easton, MA: Justice System Partners; Washington: The Health and Reentry Project; and San Francisco: Safety and Justice Challenge, 2024), available at https://safetyandjusticechallenge.org/wp-content/uploads/2024/10/ImplementingTheMedicaidReentryWaiverInCalifornia.pdf.
  21. Daniel Tsai, “Opportunities to Test Transition-Related Strategies to Support Community Reentry and Improve Care Transitions for Individuals Who Are Incarcerated,” Centers for Medicare and Medicaid Services, April 17, 2023, available at https://www.medicaid.gov/federal-policy-guidance/downloads/smd23003.pdf; Social Security Administration, “Compilation Of The Social Security Laws: Demonstration Projects,” available at https://www.ssa.gov/OP_Home/ssact/title11/1115.htm (last accessed October 2024); Nada Hassanein, “Many states are eager to extend Medicaid to people soon to be released from prison,” Stateline, May 2, 2024, available at https://stateline.org/2024/05/02/many-states-are-eager-to-extend-medicaid-to-people-soon-to-be-released-from-prison/.
  22. KFF, “Section 1115 Eligibility Changes – Expanded Eligibility Groups – Justice-Involved,” available at https://datawrapper.dwcdn.net/HhnNo/64/, in “Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State,” October 15, 2024, available at https://www.kff.org/medicaid/issue-brief/medicaid-waiver-tracker-approved-and-pending-section-1115-waivers-by-state/.
  23. David Raths, “CMS Medicaid Waiver Allows Massachusetts to Expand Coverage to Incarcerated,” Healthcare Innovation, May 1, 2024, available at https://www.hcinnovationgroup.com/policy-value-based-care/medicare-medicaid/news/55036234/cms-medicaid-waiver-allows-massachusetts-to-expand-coverage-to-incarcerated; Noah Tong, “Massachusetts 1115 waiver success can translate to New York: experts,” Fierce Healthcare, February 21, 2024, available at https://www.fiercehealthcare.com/payers/massachusetts-1115-waiver-success-can-translate-new-york-experts.
  24. National Alliance on Mental Illness, “Medicaid Coverage for People Who are Incarcerated,” available at https://www.nami.org/Advocacy/Policy-Priorities/Improving-Health/Medicaid-Coverage-for-People-Who-are-Incarcerated/ (last accessed October 2024).
  25. Mia Ives-Rublee and Christina Stafford, “Long-Term Solutions to the Overincarceration of People With Mental Health Disabilities” (Washington: Center for American Progress, 2024), available at https://www.americanprogress.org/article/long-term-solutions-to-the-overincarceration-of-people-with-mental-health-disabilities/.
  26. Substance Abuse and Mental Health Services Administration, “About Criminal and Juvenile Justice,” available at https://www.samhsa.gov/criminal-juvenile-justice/about#:~:text=a%20mental%20illness.-,However,-%2C%20an%20estimated%2044 (last accessed October 2024).
  27. National Alliance on Mental Illness, “Medicaid Coverage for People Who are Incarcerated.”
  28. Ives-Rublee and Stafford, “Long-Term Solutions to the Overincarceration of People With Mental Health Disabilities”; Brian Holoyda, ”Reentry Considerations for Inmates With Mental Illness,” Psychiatric Services 75 (8) (2024): 725–725, available at https://psychiatryonline.org/doi/10.1176/appi.ps.24075012.
  29. Justin Schweitzer and others, “How Dehumanizing Administrative Burdens Harm Disabled People” (Washington: Center for American Progress, 2022), available at https://www.americanprogress.org/article/how-dehumanizing-administrative-burdens-harm-disabled-people/.
  30. Galletta and others, “Societal Reentry of Prison Inmates With Mental Illness: Obstacles, Programs, and Best Practices”; Substance Abuse and Mental Health Service Administration, “Assertive Community Treatment (ACT) Evidence-Based Practices (EBP) KIT,” available at https://store.samhsa.gov/product/assertive-community-treatment-act-evidence-based-practices-ebp-kit/sma08-4344 (last accessed October 2024).
  31. Charlotte Huff, “The formerly incarcerated are helping newly released prisoners cope with life after prison,” Monitor on Psychology 53 (7) ( 2022): 52, available at https://www.apa.org/monitor/2022/10/life-after-prison.
  32. Justeen Hyde and others, “Enhancing community integration after incarceration: findings from a prospective study of an intensive peer support intervention for veterans with an historical comparison group,” Health & Justice 10 (33) (2022), available at https://link.springer.com/article/10.1186/s40352-022-00195-5#Sec16.
  33. Second Chance Reauthorization Act of 2024, S. 4477, 118th Cong., 2nd sess. (June 6, 2024), available at https://www.congress.gov/bill/118th-congress/senate-bill/4477/text?s=1&r=2&q=%7B%22search%22%3A%22second+chance+reauthorization+act%22%7D.
  34. Bureau of Justice Assistance, “Second Chance Act Crisis Stabilization and Community Reentry (CSCR) Program,” available at https://csgjusticecenter.org/wp-content/uploads/2023/01/BJA-Fact-Sheet_CSCR_508.pdf (last accessed October 2024).
  35. Substance Abuse and Mental Health Services Administration, “About Criminal and Juvenile Justice”; Substance Abuse and Mental Health Services Administration, “HHS, SAMHSA Release 2022 National Survey on Drug Use and Health Data,” Press release, November 13, 2023, available at https://www.samhsa.gov/newsroom/press-announcements/20231113/hhs-samhsa-release-2022-nsduh-data#:~:text=the%20past%20year.-,In%202022,-%2C%2048.7%20million%20people; Binswanger and others, “Release from Prison – A High Risk of Death for Former Inmates.”
  36. Binswanger and others, “Release from Prison – A High Risk of Death for Former Inmates.”
  37. Wellspring Center for Prevention, “What Are Community-Based Prevention Programs?”, July 23, 2024, available at https://wellspringprevention.org/blog/what-are-community-based-prevention-programs/#:~:text=One%20of%20the%20main%20benefits,and%20investment%20in%20their%20success; Pinnacle Treatment Centers, “Going Local: The Advantages of Community-Based Treatment,” available at https://pinnacletreatment.com/blog/going-local-the-advantages-of-community-based-treatment/ (last accessed October 2024); Fresh Coast Alliance, “What are the benefits of community-based substance use disorder treatments?”, available at https://www.freshcoastalliance.org/blog/what-are-the-benefits-of-community-based-substance-use-disorder-treatments (last accessed October 2024).
  38. Trinh Q. Truong and others, “Tackling the Opioid Crisis Requires a Whole-of-Government, Society-Wide Approach” (Washington: Center for American Progress, 2023), available at https://www.americanprogress.org/article/tackling-the-opioid-crisis-requires-a-whole-of-government-society-wide-approach/#:~:text=the%20opioid%20epidemic.-,Expand,-access%20to%20evidence; Galletta and others, “Societal Reentry of Prison Inmates With Mental Illness: Obstacles, Programs, and Best Practices.”
  39. Leo Beletsky, Elisabeth J. Ryan, and Wendy E. Parmet, “Involuntary treatment for substance use disorder: A misguided response to the opioid crisis,” Harvard Health Blog, January 28, 2018, available at https://www.health.harvard.edu/blog/involuntary-treatment-sud-misguided-response-2018012413180; Claudia Rafful and others, “Increased non-fatal overdose risk associated with involuntary drug treatment in a longitudinal study with people who inject drugs,” Addiction 113 (6) (2018): 1056–1063, available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938130/.
  40. Simon Bratt, “For people with mental illness, drugs and alcohol can be a key survival strategy. I’ve learned they shouldn’t have to ‘get clean’ to get treatment,” The Conversation, March 26, 2024, available at https://theconversation.com/for-people-with-mental-illness-drugs-and-alcohol-can-be-a-key-survival-strategy-ive-learned-they-shouldnt-have-to-get-clean-to-get-treatment-225827.
  41. Substance Abuse and Mental Health Services Administration, “Best Practices for Successful Reentry From Criminal Justice Settings for People Living With Mental Health Conditions and/or Substance Use Disorders” (Rockville, MD: 2023), available at https://store.samhsa.gov/sites/default/files/pep23-06-06-001.pdf.
  42. Serving Children and Adults in Need, “Border Reentry and Community Integration Program: Webb county,” available at https://www.scan-inc.org/orp.html (last accessed October 2024); U.S. Department of Health and Human Services Tracking Accountability in Government Grants System, “Award Information: Border Reentry and Community Integration Program,” available at https://taggs.hhs.gov/Detail/AwardDetail?arg_AwardNum=H79TI080915&arg_ProgOfficeCode=147#:~:text=HIDE%20AWARD%20ABSTRACT-,Serving,-Children%20and%20Adults (last accessed October 2024); Substance Abuse and Mental Health Services Administration, “Best Practices for Successful Reentry From Criminal Justice Settings for People Living With Mental Health Conditions and/or Substance Use Disorders,” p. 40.
  43. Truong and others, “Tackling the Opioid Crisis Requires a Whole-of-Government, Society-Wide Approach.”
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Authors

Anuja Gore

Project Associate

Akua Amaning

Director, Criminal Justice Reform

Team

Criminal Justice Reform

We focus on developing policies to shrink the justice system’s footprint, improve public health and safety, and promote equity and accountability.

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