Achieving Racial Equity in Health Care & Criminal Justice Reform Campaign

A multi-state initiative envisioning a system of mass decarceration where health care is provided to all and people are no longer criminalized for conditions related to their health. 

 
 
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Campaign Lens

 
 

Inequities in the health and criminal justice systems are often rooted in racial discrimination. Reforms must therefore address these pervasive biases or risk tackling consequences rather than root causes of inequity. For example, new research has suggested that contrary to their intent, ban-the-box laws which limit employers’ access to criminal record reports may be leading more employers to dismiss resumes with “African American sounding names.”

Today, the new interest in establishing opioid courts may favor treatment for the generally, though far from exclusively, white population that society sees as victims of opioid addiction. These policies once again marginalize and discriminate against Black and Latino people with substance use disorders, who have for decades been disproportionately jailed instead of diverted to treatment. LAC will therefore work with communities to promote criminal justice and health reform through a racial justice lens.

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Campaign Tactics

 
 

unite

Bring together health, criminal justice and racial justice advocates in states across the country, particularly as the opportunity for meaningful reform shifts markedly away from Washington D.C. to state and local jurisdictions where advocates are increasingly energized to create change.

LISTEN

Listen to and amplify the concerns of directly-affected individuals by providing safe spaces to discuss the conceptual prism that links discrimination, poor health care infrastructure and mass incarceration.

Help

Help cross-sector advocates in these communities pursue reforms that work to end racial disparities in the criminal justice and healthcare systems and emphasize treatment over punishment to improve public safety. 

AMPLIFY

Promote local and state advocacy by communicating ideas with national and federal policymakers and stakeholders.   

EDUCATE

Educate the public by promoting a vision for change that shifts the answer from punishment and incarceration to treatment and rehabilitation through legislative and programmatic reforms. 

 
 
 

Project Goals and Objectives

 
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1. Increase access to health care and encourage diversion from punishment to treatment by:

  • Increasing access to preventive care that can keep people out of the criminal justice system;

  • Increasing treatment access for the conditions most often coinciding with criminal justice involvement--substance use disorders and mental health, HIV/AIDS, Hepatitis C, etc.;

  • Increasing diversion to treatment at all phases of the criminal justice system—pre-arrest, pre-trial, pre-adjudication, community reentry, parole and other post-release, etc.

  • Training for police departments on why/how to divert individuals to treatment.

2. EASE COMMUNITY REENTRY FOR PEOPLE WITH CRIMINAL RECORDS SO THEY BECOME OR REMAIN HEALTHY AND ARE ABLE TO FULLY PARTICIPATE IN SOCIETY, PARTICULARLY BY:

  • Linking individuals to coordinated health care, especially substance use disorder and mental health care, immediately upon community reentry from the criminal justice system;

  • Increasing opportunities for engagement associated with better health and less involvement in the criminal justice system, by:

    • Enhancing civil rights protections to prevent discrimination in employment, housing, education, and other necessities of life against people with criminal histories,

    • Increasing employer accountability and willingness to hire people with criminal records and,

    • Promoting enfranchisement policies.

 
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Project Policy and Practice Levers


LAC’s work since 1973 has helped establish policy levers listed below, through which advocates can pursue our shared goals and objectives.

Insurance Enrollment and Health Care Linkages for the Justice Involved

Since 2010, 32 states and the District of Columbia have expanded Medicaid under the Affordable Care Act (ACA) to millions of low-income non-parenting adults. Because that expansion made a large percentage of the criminal justice population eligible for Medicaid, several states and local jurisdictions have begun to enroll and connect them to health care. In large part, as LAC learned by working with New York State on one of the most ambitious of these projects and by providing technical assistance to hundreds of jurisdictions through a U.S. Bureau of Justice Assistance project, cities and states have been motivated by promised savings to their criminal justice budgets. New York, with whom LAC worked most closely, is now enrolling approximately 500 people in Medicaid each month before they leave state prisons and linking approximately 1,000 of these individuals each year to coordinated care through Medicaid-funded health homes. LAC can help advocates push more states to adopt this paradigm-shifting model to promote better health, lower recidivism and create long-term savings in the health and criminal justice systems.


Reentry Reforms

In 1973 an LAC board member wrote what is still the most progressive and expansive law barring employment discrimination based solely on an individual’s criminal record (NYS Corrections Law Art. 23A). LAC can help advocates in other states and jurisdictions: 1) build upon reform movements like Ban-the-Box to enact more comprehensive anti-discrimination laws like New York’s, which will not just delay the opportunity for discrimination but ban it altogether; 2) push for similar laws to cover discrimination in housing, where most landlords can still simply bar any individual with a criminal justice history no matter how old or unrelated to the housing opportunity; and 3) promote expanded sealing (as LAC did in the run-up to New York’s 2017 new law) and expungement legislation that eliminates public records of conviction. In more progressive states, it may even be time to advocate for an end to virtually all collateral consequences, meaning that once a person serves their time or pays other penalties, there are NO other repercussions to a criminal record.


Parity Implementation and Enforcement

Sixty-five to 85% percent of people in our nation’s criminal justice system have a substance use and/or mental disorder. Adequate treatment could lessen or end that involvement altogether. To increase access to treatment, in 2009 LAC and its allies successfully advocated for the Mental Health Parity and Addiction Equity Act (Parity Act) which, together with the ACA, mandate that most insurers, including Medicaid, provide coverage for substance use disorder and mental health treatment that is no less comprehensive or more expensive than that which they provide for other chronic conditions like diabetes or heart disease. Since passage of the law, however, treatment rates have not increased as expected, mainly because the Parity Law is not being adequately enforced. LAC can help local advocates work to change that through their own advocacy or as part of LAC’s parity enforcement campaign, Parityat10.


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What Happens Next? 

As more and more communities grapple with the question: “What happens next?” the door to groundbreaking and systemic reform is now open.  

Not only have policy levers been put in place, local advocates are increasingly fighting for change. Newer groups like Black Lives Matter are taking the lead in pointing to the pervasive racial injustice that underpins the American criminal justice system.

Success on a systemic scale, however, will require reforming our health care system, particularly the points at which it intersects with criminal justice, and eliminating other discriminatory barriers. 

LAC brings a deep understanding of health care and criminal justice policies and practices and how to move these large, complex sectors toward coordinated and fundamental change. The No Health = No Justice Campaign brings these forces together to create radical reform and build a bridge to the civil rights that far too many communities have been systematically denied.