NAVIGATING HEALTH SYSTEMS
This role doesn’t fully click into action until your friend is released. So get situated, educate yourself, reach out to your friend, and make a timeline together.
During your friend’s full first month of getting plugged back into the land of the living is when this role requires a good amount of focused time and energy navigating multiple systems: health insurance, mental health, drug treatment classes, primary healthcare.
You’ll see how many calls, appointments, forms, insurances, evaluations are needed and why so many reentering folks get overwhelmed and end up violating their release requirements and neglecting their own health. These systems become “stones” – big barriers to reentry.
This is where you come in! You are the gift God has sent to walk with your friend through these systems—their wholeness and health is important to God and to us.
That said, medical issues and mental health in particular can be sensitive and personal topics. We are here to help make appointments, give rides, pass time in the waiting room, be an encouragement. If your releasing friend wants your presence and support during their appointment, feel free to accompany them. Alternately, respect their privacy if they prefer to see a provider alone.
HEALTH INSURANCE
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In Washington State, thankfully almost everyone releasing from prison with no income qualifies for free health insurance (called AppleHealth). Ask your incarcerated friend if they can apply for this before release – many prison facilities offer help with this.
If not, this is your first stop their first week out: The DSHS Office (dshs.wa.gov). This is a standard, essential first visit when getting back on your feet. Find the local office, head over there together, take a number, wait, and share some stories as you sit in the lobby.
Go with your friend when their number is called. Make sure they ask for and leave with:
Health insurance set up and card in hand
Any cash and/or food benefits available
If available, a voucher for DOL (Dept of Licensing) ID/License costs
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In Illinois, thankfully almost everyone releasing from prison with no income qualifies for free health insurance through Medicaid. The resource guide Mapping Your Future has great suggestions for how to get organized when it comes to healthcare—even before release (see pages 19-22).
Some things to start on before release are:
Physical exam
Requesting copies of medical records
Signing up for Medicaid
Scheduling doctor appointments for after release
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TDCJ offers healthcare coverage for releasing folks, and local jurisdictions also have resources. In Austin, for example, folks can apply for a MAP card which gives them access to care at all Community Care Clinics.
Ask your incarcerated friend if they can apply for coverage before release, as this is offered in many facilities.
If not, this will be your first stop their first week out: The DSHS Office (dshs.texas.gov). This is a standard, essential first visit when getting back on your feet. Find the local office, head over there together, take a number, wait, and share some stories as you sit in the lobby.
Go with your friend when their number is called. Make sure they ask for and leave with:
Health insurance set up and card in hand
Any cash and/or food benefits available
If available, a voucher for ID/License costs
MENTAL HEALTH
This is just a brief overview of addressing mental health needs. Hopefully the upcoming modules, Mental Health and Trauma & Healing, will start rich conversations between your team and your friend about the important realities so many of us face.
Medications
Ask your friend if they have any mental health meds (prescriptions) that they are taking while inside prison. Make note of this. So many folks are released from prison with only 30 days’ worth of their prescription, and if they don’t establish mental healthcare that first month, the meds run out and there’s no way to get a refill quickly.
We’ve seen many folks relapse into their old addictions in their second month out of prison, only to later find out they’d run out of their mental health meds. This invisible issue deserves our attention ahead of time! The first month is overwhelming, and no one else in their life is helping them connect with mental healthcare on the outside.
Some releasing friends have told us, “I don’t want to be on those meds. They’re just trying to sedate me in there.” Maybe so. We often counter with: “That may be true, but your brain is gonna go on a bender if you go off the meds cold turkey. Out here, mental healthcare isn’t trying to numb you like prison does. Let’s get you a new evaluation and the care you deserve, so you don’t struggle more than you have to!”
Mental Health Evaluation
This part is often required—by probation, anyway.
Look up a local mental health agency (there are usually a couple options for low-income clients). Sit down together and call to set up an evaluation as soon as you can. Put it in both of your calendars. Go together (give them a ride). They might get recommended weekly meetings with a therapist, or regular support groups or classes. Are they excited? Great! Do they seem bummed? Encourage them that it’s OK. This is part of healing—and sometimes a required part of staying out of prison!
PRIMARY CARE
Please be aware: some mental health agencies don’t prescribe medications. If this is the case, your friend will need to get set up with primary care right away so their doctor can prescribe the meds they need. You can ensure the mental health agency’s evaluation makes it to the primary care doctor so that everyone’s on the same page.
Most folks leaving prison have never had regular medical care or a primary care provider. Getting one may take some time sitting down making calls together: phone around to local doctors’ offices that you (or your team) trust, and find one that takes your friend's health insurance. Schedule an initial appointment.
This first appointment is where your friend can bring in any prescriptions to be refilled or adjusted AND bring up any other health concerns. Get a full physical! Invite them to see this not as another inspection or requirement, but treating their bodies to the same care as a good car: getting a full checkup and all the repair they deserve!
If you’ve raised kids, you’ve done this before. Sadly, too many children grow up without parents offering them this kind of attentive care and concern. You are part of a deep redemption taking place, showing them their bodies are worth caring for.
CHEMICAL DEPENDENCY
This is one of the most common requirements from prison probation: go get a drug evaluation, and go to classes or groups. Ask your friend if this will be required as part of their probation. If so, remind them you’ll help them every step of the way.
Most cities have both a mental health agency and a drug treatment (“chemical dependency”) agency (sometimes they’re in the same office, often called “Behavioral Health”).
Do the same thing you did for mental health and primary care: sit down together, call the agency, and set up an evaluation. Mark your calendars. Go together.
If the evaluation recommends several weeks of classes or appointments, that’s a normal part of reentry. All of these appointments—on top of the court dates and the steps required to get a driver’s license–are why we fundraise as a congregation to help pay early rent costs: so our friend can focus on all this reentry work as their full-time job for the first month or two!
You can help your friend by reminding them that all these appointments are normal, worth it, and necessary. You’re here to help with rides, encouragement, and coordinating their (increasingly full) calendar.
To review, these are the four basic health systems to navigate with your friend:
Health insurance (DSHS)
Mental health (agency)
Primary care (find a doctor)
Chemical dependency (agency)
Most of this will come together in a storm of appointments and rides over the first couple months . You have the mental and emotional capacity to keep track of these four systems – you’ve likely navigated them for yourself. But for someone undergoing the difficult transition out of prison, it can be overwhelming. Your presence, doing it together, is a miracle.
All these small steps equal something much bigger – Celebrate what you’re accomplishing together! Take a deep breath. Relax. Go out to lunch.
It can feel like burdensome social work, but in our years of doing this, we’ve found the greatest conversations, trust-building, laughter, and vulnerability happen when going to these appointments together. Your team will learn more about this in the Accompaniment Through the System module in a few months. Just remember: this work is the front lines of deeper relationship and ministry.
ONGOING RESURRECTION & REPAIR
As time goes on, months after your friend releases, they may become aware of more repair their bodies need after years of neglect on the streets and in prison.
Willy had broken bones in his hand from an old injury and it had not healed well in prison. His team helped him make the calls, get x-rays, coordinate with Labor & Industries for some coverage, and schedule the surgery. They even made a post-op Meal Train for him, allowing the church to come around their beloved community member as he healed.
Roxanne was clean and sober, graduating from a recovery home and working—but she was shy about smiling. Years of meth use had taken a toll on her teeth. For her, resurrection meant working with her health providers—and her team —to get new teeth through her dental insurance! Now her smile is a reminder not only of her ongoing recovery, but the people who’ve supported her through it.
At this point in the journey, it’s not uncommon for members of the larger church congregation to join in and help your releasing friend. As the Health Systems Lead, you will be the point person in coordinating with these new players. Have fun!