Cover -- Title Page -- Copyright -- Preface -- Contents -- Figures -- Tables -- Summary -- Acknowledgments -- Abbreviations -- Chapter One: Introduction -- Background -- Health Care Needs of Returning Prisoners Are High -- The Size and Composition of California's Prison Population Are Changing -- Recent Policy Changes Will Influence How California Approaches Meeting the Health Care Needs of the Reentry Population -- Study Objective and Scope -- Study Limitations -- Organization of This Report -- Chapter Two: What Do We Know About Prisoners' Health Care Needs and the Capacity of the Safety Net to Meet the Needs of the Reentry Population? -- Introduction -- What Are the Health Care Needs of the Reentry Population? -- Where Do Prisoners Go Upon Release from Prison? -- Concentration and Distribution of Parolees Within California -- What Are the Demographic Characteristics of Parolees and of the Socioeconomic Areas in Which They Locate? -- Results of Analysis of Demographic Characteristics of California Parolees -- Results of Analysis of Demographic and Socioeconomic Characteristics of Areas in Which Parolees Locate -- What Does the Health Care Safety Net Look Like for Parolees in Four Focus Counties? -- Conceptual Framework -- Analysis of Geographic Distribution of Health Care Facilities in Los Angeles County -- Analysis of Accessibility of Reentry Population to Health Care Safety-Net Facilities in Four Counties -- Discussion -- Chapter Three: Understanding the Challenges of Reentry: Ex-Prisoner Focus Group Results -- Introduction -- Approach -- Key Findings from the Focus Groups -- How Ex-Prisoners Think About Their Health Care Needs -- Views About Access to Substance Abuse Treatment Programs in Prison -- Views About Access to and Quality of Health Care in Prison -- Experiences in Having Care Transitioned to Community Providers.

Interest in Preventive Care -- Prerelease Planning -- Parole and Community Team (PACT) Meetings -- Where the Focus Group Participants Sought Care and Other Services on Release -- Views About Cultural Competence -- The Importance of Family -- The Experience of Being Released -- Discussion -- Chapter Four: Understanding the Challenges of Dealing with Released Prisoners: Provider Interview Results -- Introduction -- Literature on Ex-Prisoners' Access to Insurance and Health Care Reform -- Ex-Prisoners' Access to Health Insurance -- Safety-Net Health Care Resources in California -- Potential Impact of Health Care Reform in Improving Ex-Prisoners' Access to Health Care -- Provider Interviews: Approach -- Provider Interviews: Results -- From the Provider's Perspective, the Reentry Population Has a Wide Range of Treatment Needs -- Lack of Medications and Medical Records Can Affect Continuity of Care -- Individuals May Be Reluctant to Seek Help from Parole -- Low Levels of Health Insurance and Lack of Finances Limit Treatment Options -- Challenge of Linking Individuals to Mental Health Treatment -- Communication Problems on Both the Individual and Provider Sides -- Difficulties in Navigating Health Care and Social Services Systems -- Uncertainty Among Safety-Net Providers About How to Access Reentry Population -- Impact of Budget Cuts on Providers -- Providers' Recommendations for Improving Access to Services for the Reentry Population -- Discussion -- Chapter Five: The Impact of Incarceration on Families: Key Findings -- Introduction -- Literature on the Impact of Incarceration on Children and Families -- Impact of Individual-Level Effects of Parental Incarceration -- The Impact of Child Welfare Laws and Other Legislation -- What Is Known About Programs to Help Children and Incarcerated Parents -- Family Caregiver Focus Group: Approach.

Family Caregivers Focus Group: Results -- The Challenges Incarcerated Parents Face Upon Release -- The Suddenness of Being Thrust into a Caregiver Role -- The Degree to Which the Children Want to Have Contact with Their Parents -- Children's Support Needs -- Caregivers' Support Needs -- Discussion -- Chapter Six: Conclusions and Recommendations -- California at a Crossroads -- An Historic Opportunity to Improve Access to Health Care for the Reentry Population -- What Can California Do to Prepare? -- Develop Informed Estimates About the Percentage of the Medicaid Expansion Population That the Reentry/Criminal Justice Population Will Represent -- Develop Medicaid Enrollment Strategies -- Leverage the Experience of Other States That Have Previously Expanded Coverage to Childless Adults Under Medicaid -- Develop Health Homes for the Reentry/Criminal Justice Population -- Develop Care/Case Management Systems That Can Account for Special Populations' Needs, Including the Reentry/Criminal Justice Population -- Assess Workforce-Development Strategies for Alcohol, Drug, and Mental Health Treatment -- Consider Developing Electronic Medical Records -- Consider Expanding Prerelease Planning Efforts -- Undertake a Comprehensive Assessment of California's New Public Safety Realignment Plan to Inform Future Policy Refinements -- What Can Counties and Providers Do to Prepare? -- Develop County-Level Estimates to Inform Planning for Rehabilitative Services and for Increased Demand for Mental Health and Alcohol Care and Drug Treatment -- Convene All Relevant Stakeholders for Planning and Coordination of Services -- Assess Local Capacity to Meet New Demands for Health Care -- Develop "Welcome Home" Guidebooks Tailored to Individual Counties, Particularly for Counties and Communities with High Rates of Return -- Train Providers on Cultural Competence.

Consider the Role of Patient Navigators -- Address the Needs of Families and Those That Care for Children of Incarcerated Parents -- Final Thoughts -- Appendixes -- A. Methodology -- B. Protocols -- References.