The CDC reports that 48% of adult ER patients choose to go to emergency services, knowing that they are not sick enough to be admitted, because their doctor’s offices are closed. Even more end up at the ER because they wait to take care of their health problems until the problem worsens.
For a number of formerly incarcerated individuals, the ER seems like the only logical place to go in a time of medical distress.
While behind bars, approximately 40% of inmates are diagnosed with a chronic illness. This covers anything from asthma to high blood pressure, depression, and even cancer. In jail, inmates have access to the medical care they need. Some jails, especially the big ones and maximum security prisons, have entire medical wings to treat the inmates. There, they have their medications handed to them by a nurse, and are also guaranteed a place to sleep and food to eat.
But since many of these inmates are homeless or do not have a permanent address when they get out, they are unable to apply for health insurance or receive any documents. For most, the best medical attention and care they can afford to receive is when they are behind bars.
“When they come home from prison, they have to learn to use the pharmacy, learn to get a refill, learn to make their appointments…” lists Dr. Emily Wang, a primary care doctor with the Yale University School of Medicine. “…On top of trying to get housing, get employed, [and] figure out where to get food for the day.”
Having health insurance isn’t a cure-all, however. There are very few systems in place that allow formerly incarcerated people to learn how to handle their health once they’ve been released. Ex-inmates are often unaware how the health system works and avoid seeking care on their own.
Normally preventable illnesses and conditions often go untreated once a person is released from prison, and the only care provided is prompted by a trip to the emergency room.
Since these conditions are significantly worse, they are much more expensive to treat, and these costs are often picked up by hospitals and taxpayer dollars.
Dr. Wang and her colleagues have worked to help provide resources for these people. They work at the Transitions Clinic Network. Funded by private donors and grants, the center has 14 locations in the U.S. and Puerto Rico. The patients who seek help at the Transitions Clinic can qualify for Medicaid based on income, and the clinics are reimbursed.
One Transitions patient, Joe McFadden, recounted firsthand how the system failed him once before.
After his release, McFadden’s leg had swollen significantly. He went to the emergency room only to find that he had a potentially life-threatening blood clot.
“I thought I had pulled a muscle. It took me like a week to go in because I didn’t know the symptoms of having blood clots,” said McFadden, who’d very rarely visited a doctor before the incident.
Now, McFadden reports to the clinic’s New Haven branch for follow-up care. In addition, the clinic has helped him find a substance abuse recovery program as well as a place for him and his two children to live.
Before his release, McFadden had served 40 days in solitary confinement. His sentence ended just two weeks later.
“You’re just locked up like an animal,” said McFadden. “It’s not easy, coming home from being incarcerated to a world where you’re being discriminated against.”
Thanks to the Transitions Clinic Network, McFadden and many others are being treated not just as patients, but as people, with dignity and respect.