Director of the Health Integration Project
Avoiding legal trouble is much easier if ex-offenders can avoid homelessness and have access to health care, particularly mental health counseling and medication. Recent guidance from the Department of Housing and Urban Development (HUD) and the Center for Medicaid and CHIP Services (CMCS) aims to improve access to housing and health insurance for ex-offenders. The guidance sets the right goals; now it’s up to states and localities to enforce and implement the guidance to achieve its purpose.
People leaving jail and prison are three to six times likelier than others to suffer from mental illness, studies show, and 20 percent of ex-offenders with mental illness become homeless. Also, people who were homeless after jail or prison stays are seven times likelier to re-offend during the first month of release. Lowering barriers to housing and health care can therefore lower recidivism rates.
In both private-market rentals and publicly assisted housing, landlords’ rental and lease-renewal policies often restrict access for people with criminal histories. African Americans and Hispanics are incarcerated at nearly 3 and 1.3 times the rate of the general population, respectively; when housing practices based on criminal history have this type of disparate impact on racial and ethnic minority groups, they violate the Fair Housing Act. HUD’s guidance provides important information to identify potentially discriminatory policies.
HUD guidelines explain that housing providers:
As for health coverage, we recently explained the CMCS guidance and the importance of connecting people to Medicaid before they leave jail or prison. Medicaid coverage is an important first step so they can continue the treatment they began while incarcerated, which often stabilizes their symptoms.
Medicaid and the treatment it covers go hand in hand with housing. If a person leaving incarceration ends up in a homeless shelter, his or her odds of staying on medication and accessing counseling are poor. Similarly, people who can’t get their mental health medication likely won’t stay housed. States and communities need to fully implement and enforce both of these federal policy clarifications to help people avoid homelessness, stabilize their health, and build new lives.