Improving access to health care has been a recurring theme in American philanthropy for decades. The passage of the Affordable Care Act gave health-focused foundations a new opportunity to tackle health care, and in California, a state law allowing private groups to fund Medi-Cal outreach and enrollment has given local foundations a new avenue to reach their organizational objectives.
With more uninsured residents than any other state in the U.S., California’s foundations have stepped up in a big way to guide the millions of low-income families and individuals through the process of obtaining health insurance. The California Endowment (TCE), a longtime leader in the health care equity space, has poured tens of millions of dollars into public education efforts to boost enrollment and train competent ACA advisors through their Health4All campaign.
TCE has been very vocal and active in its work. If you live in California, as I do, you’ve undoubtedly seen a billboard or commercial telling you that “Health Happens Here”—they were literally everywhere. But one program that TCE has been funding along with several of its peers in the California health care space may have slipped under your radar.
According to Californians for Safety and Justice (CSJ), a project of the Tides Center working with Californians to replace prison and justice system waste, prior to the passage of the ACA, nine out of 10—that’s right, 90 percent—of incarcerated individuals in California jails lacked access to health insurance. And the abysmal system of health care delivery in California jails didn’t offer much in the way of an alternative.
Building on the recent expansion of Medi-Cal, which extended eligibility for public health insurance to all adults with incomes up to 138 percent of the federal poverty line, the California Endowment and the California Wellness Foundation (CWF) have teamed up with CSJ under the banner of their Health Matters project to launch a statewide outreach campaign alerting people coming out of jail or prison, or who are on probation or parole, about their right to health insurance.
Some might find this effort hard to swallow. When you think of populations most deserving of access to health care, prisoners are not likely to top your list. But when you consider that there are nearly a quarter of a million people currently incarcerated in California, and that the prison population has been aging dramatically, with the share of prisoners age 50 and older growing from 4 percent to 21 percent between 1990 and 2013, this effort seems particularly poignant.
Furthermore, according to the Public Policy Institute of California (PPIC):
Rates of infectious diseases (such as tuberculosis and hepatitis) and chronic conditions (such as hypertension and asthma) are higher among incarcerated individuals compared to the general population.
While health care equity is at the core of this effort, Health Matters is also tackling issues of public safety. A large percentage of the individuals that cycle in and out of the justice system suffer from chronic health problems, including mental illness and addiction disorders. In fact, statistics suggest that local jail inmates are more likely to have mental health problems than even state and federal prisoners are. These unresolved health problems contribute to recidivism, prison overcrowding and high costs in the justice system—a bill footed by you, my fellow California taxpayer.
As you can imagine, reaching individuals cycling in and out of prison, who have unstable home and work lives, is far from an easy undertaking. Luckily for CSJ, TCE has mastered the art of reaching inaccessible communities over the years, and thanks to over $1 million in combined contributions from TCE and CWF, the campaign will feature:
- More than 100 bus shelter ads running throughout Los Angeles County in English and Spanish
- A texting tool to help people determine eligibility
- Approximately 2,000 posters in English and Spanish that are going out to probation and sheriff department partners across California
- An animated video that will run on closed-circuit TVs in jails, prisons, probation offices and reentry facilities, and via online channels across the state