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Health Care Revamped At L.A. County Jails

By Kaiser Health News  
   March 08, 2018

Part of the plan is to make clinics inside the jails more like ones on the outside.

This article first appeared March 08, 2018 on Kaiser Health News.

By Anna Gorman

Michael Callahan, an outgoing 43-year-old carpenter, landed in a Los Angeles County jail last September because of what he said were “bad decisions and selling drugs.”

He had uncontrolled diabetes and high blood pressure when he arrived, but his health was the last thing on his mind. Consumed by a meth addiction, he hadn’t taken his medications for months. “When I got here, I was a wreck,” said Callahan, who is stocky and covered in tattoos. “My legs were so swollen that if I bumped them they would break open.”

By January, however, his diabetes was improving and his blood pressure had dropped. Now, he takes his medications daily and sees a doctor every two months. Even as he counts the days until his release this summer, Callahan knows he is getting much-needed medical care. “I’m where I need to be, not where I want to be,” he said.

Callahan’s situation is counterintuitive: He may end up leaving jail healthier than when he arrived. Officials at the Los Angeles County Department of Health Services hope to see more cases like his as they embark on an ambitious effort to improve health care for jail inmates. Their project follows decades of complaints, lawsuits and reports of poor medical and mental health care at the Los Angeles County jails, which together house about 18,000 inmates on any given day.

The county’s overhaul is designed to raise the quality of health care behind bars and better equip inmates to manage their health after they are released. But the challenges are enormous — the population is disproportionately sick, and the jails weren’t designed to be medical facilities.

The innovative effort at one of the nation’s biggest jail systems is based on a logical premise: Inmates don’t stay in jail for long — the average stay is just 60 days — so it’s a crucial opportunity to diagnose and begin treating their diseases.

“People are there for just a blip in time, days, weeks, months … and they’re returning back to the community,” said Mark Ghaly, director of community health for the county Department of Health Services. “What happens in the jail matters.”

The county health agency took over medical care in the jails from the Los Angeles County Sheriff’s Department in 2015 and started revamping the system in earnest last year.

Kaiser Health News is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.

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