OGDEN — A decades-old federal law that strips many pretrial detainees of health insurance is being blamed for worsening some of the biggest problems afflicting today’s jails.
Veterans and people covered by Medicaid, Medicare or other federal health programs lose those benefits under Social Security Act Section 1905 when they go behind bars.
The exclusion does not differentiate between a convicted inmate and one held awaiting trial.
As a result, inmates suffering from substance addictions or mental health problems are more likely to reoffend when they are released because they have lost coverage for treatment services, say advocates of legislation to remove the exclusion.
It has become a priority issue for the National Association of Counties and the National Sheriffs’ Association, because modern jails are swamped with unprecedented numbers of people with substance use and mental health problems.
The rationale for severing coverage apparently stemmed from a desire to avoid duplication of coverage, because county jails are constitutionally obligated to provide heath care to inmates.
But it can take inmates up to 90 days to restore federal coverage once released from jail, which leaves them prone to returning to jail quickly because they are unable to continue treatment.
“That means 90 days of no treatment for substance abuse, mental health issues or chronic pain,” said Paul Guequierre, spokesman for the counties group. “This often leads to problems that put them back in jail.”
The exclusion is “quite antiquated,” said Blaire Bryant, associate director of health legislation for the counties group.
“It’s just something that is frankly unfair and unconstitutional,” Bryant said.
Detainees would benefit from uninterrupted coordination of care, getting help to beat addictions and treat mental conditions, the counties group says. That would lessen recidivism, thereby shaving jail and law enforcement costs and improving public safety.
“That would be a good thing,” said Lt. Joshua Marigoni, the Weber County Sheriff Office‘s corrections spokesman.
The sheriff’s office this year started a “bridging the gap” program that helps inmates receive substance use and mental health treatment while still behind bars and also works with them after release to gain treatment, housing and employment.
The counties group meanwhile is promoting a national effort, the Stepping Up Together Initiative, to reduce the number of people jailed with mental illnesses.
More than 500 counties nationwide are participating, including Salt Lake and Sevier in Utah, said the group’s associate program director for justice, Nastassia Walsh.
The idea is to pool research, innovation and best practices so county jails as a whole can improve how they deal with mental health problems among offenders, Walsh said.
“Every county does it a little bit differently,” Walsh said. “We are looking at it across the spectrum. ... Traditionally there has not been a lot of partnering.”
Issues include training of law enforcement personnel on screening arrestees and identifying mental problems; developing alternatives to incarceration; keeping released inmates in treatment; and modifying probation and parole practices.
Not coincidentally, suicide is the leading cause of death in Utah jails.
“It is something we hear from our sheriffs,” Walsh said — many inmates suffering from mental health conditions enter incarceration in crisis and are at a high risk of suicide.