The Health and Health Needs of People under Community Supervision

Americans under community supervision experience high rates of chronic disease, mental illness, and substance use disorders but have poor access to high-quality preventive care and treatment. Pervasive barriers to healthcare and health insurance reinforce poor health, as do restrictions to evidence-based addiction treatment. We propose that community supervision agencies transfer management of the health of supervised individuals to an expanded community-based healthcare system and that they abandon practices at odds with the science of addiction medicine (e.g. prohibitions on medications to treat addiction, and revocation of community release for addiction relapse). Further, we argue that correctional systems should prioritize health of those under supervision by standardizing health-related protocols, including basic needs resources in discharge planning, and leveraging the skills of individuals with lived experiences in the correctional system. If implemented, the success of our recommendations would require expansion of community-based primary care, mental health, and addiction treatment centers.