Student-Led Program Coordinates Post-Incarceration Health Care – InventUM
He Miami Med Reentry Care Coordination (MMRCC) The program, started in 2020 by students at the University of Miami Miller School of Medicine, aims to expand its reach in 2023 to people in the community who have been incarcerated and need help establishing health care services.
“MMRCC offers patient navigation services to people returning from incarceration. We help participants with things like finding health insurance, connecting with primary care or other medical, dental or mental health services,” said third-year medical student Julia Telischi, who is one of four students at the Miller School. on the MMRCC executive team. “Then we set some longer-term health goals with them and do regular follow-ups for up to six months, where we meet regularly with the participants, track their progress with their goals, and help fix any issues they may have along the way. navigate the Health Care System.”
The program benefits both the participants and the medical students who help them, according to the founding students, who have since graduated from medical school.
“I believe this project has been the cornerstone of my development as a future provider and leader,” said MMRCC founder and Miller School alumna Erin O’Keefe, MD ’22.
Kyrra Engle, MD ’22, co-founder of MMRCC, said growing the program and helping people transition to potentially healthier lives after incarceration was the most meaningful experience she had in medical school.
“I feel that I have learned as much, if not more, from my participants as I hope they have learned from me,” said Dr. Engle.
Telischi was recruited into MMRCC in her first year of medical school, the program’s pilot year.
“Back then, there were four of us running the program and doing the pilot sailing,” Telischi said. “Today, we are four on our executive team. We had five navigators last year, another four that came in in the summer, and we recruited three more this fall. We are still quite small, but we would like to expand.”
The program matches a person who has been incarcerated with a patient navigator who has been specifically trained for this population. They meet biweekly to set health care goals, which participants take the lead in setting. Navigators, as their titles imply, help participants find their way through the health care system.
According to Telischi, more medical students are badly needed to provide patient navigation services for people returning from incarceration.
“This is a population that is very prevalent in Miami-Dade. If you walk through the wards at Jackson Hospital, you will see at least one patient with a corrections officer outside their door at any given time,” he said. “And I think it’s important to get exposure to different populations in medical school. We focus on long-term relationships. That’s why we don’t have every browser with a ton of patients; we want them to focus on developing a longitudinal relationship with each participant.”
Improving the Well-being of the Vulnerable Population
Providing services like MMRCC is vital to the overall health care landscape, according to Kathryn M. Nowotny, Ph.D., associate professor in the Department of Sociology at the University of Miami College of Arts and Sciences, director of Miami Health and Justice Lab and advisor to the MMRCC faculty.
“People who are incarcerated generally have much higher rates of health problems than people in the community,” Dr. Nowotny said. “The issues we think about most often are mental health and substance use. But they also often have chronic conditions, like high blood pressure and diabetes, that go uncontrolled.”
Ironically, the criminal justice system has become a major healthcare provider in the US, according to Dr. Nowotny.
“We have a poor urban population who are constantly under police surveillance, who have high incarceration rates, who don’t have enough insurance, who live in disinvested neighborhoods. They often only receive care from emergency departments or during periods of incarceration,” Dr. Nowotny said. “Once they’re out of jail, there’s really no system to help them manage their health conditions. They are often uninsured, particularly since the insurance is employment related. Florida currently has more than 1,000 statutes that limit employment and other activities among people who have been incarcerated.”
Helping these individuals gain a healthcare foundation can improve the well-being of this vulnerable population, as well as prepare future physicians to care for a substantial but often overlooked segment of society.
“More than 70 million people have a criminal record; on any given day, two million people are imprisoned; and 50% of Americans have a loved one who has been incarcerated,” Dr. Nowotny said. “But it’s not integrated into our medical training program, so exposing students to working with this population, teaching them about issues related to the criminal justice system: how the criminal justice system affects the health of those who are incarcerated, their families, their communities, it’s incredibly beneficial.”