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BOH Agenda 102319
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BOH Agenda 102319
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11/4/2019 8:51:15 AM
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BOCC
Date
10/23/2019
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Regular Meeting
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Agenda
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Leading To Health <br />After prison:Community health worker Tommy Green drivesabout100milesaweekvisiting <br />clients scattered around Orange County, North Carolina, and helping them cope with life after <br />prison. He has the use of three offices but does much of his work in his car. <br />doi:10.1377/hlthaff.2019.01163 <br />After Prison, Healthy <br />Lives Built On Access To <br />Care And Community <br />A North Carolina program helps recently released inmates connect to <br />health care, social services, and support. <br />BY ROB WATERS <br />J ustin Jones got hooked on <br />prescription painkillers after <br />he flipped his truck as a teen- <br />ager, put his head through <br />thewindshield,andfractured <br />his wrist and sternum. When doctors <br />would no longer write prescriptions for <br />him, he began buying—and selling— <br />drugs on the streets of Durham and <br />Hillsborough, North Carolina. His first <br />arrests came before he turned twenty. <br />At first, he used prescription pills like <br />the Oxycodone he knew, but when they <br />were too scarce or expensive, he turned <br />toheroin.Athispeak,Jonessaysmatter- <br />of-factly, he was consuming about <br />$2,000worthofheroinadayandselling <br />ittofeedhisaddiction.He’slostcountof <br />how many times he’s been in and out of <br />prison but guesses that it’s more than <br />fifteen. <br />Jones, who is now thirty-two, tells me <br />allthisinthespaciouslivingroomofhis <br />parents’home on the wooded outskirts <br />of Hillsborough. A buck’s head adorns <br />the living room wall; an American flag <br />flapsfromthetidyfrontporch.Acursive <br />tattoo of the family’s name decorates <br />Jones’s left forearm. <br />Eachtimehewasreleased,Jonessays, <br />the same thing happened: He’d try to <br />stop but would be using again within <br />two weeks.“I would try to do better, <br />but I didn’t have a stable system, I didn’t <br />have insurance,”he says.Without insur- <br />ance, his access to doctors or treatment <br />programs was greatly limited. (North <br />Carolina is one of fourteen states that <br />have opted not to expand eligibility <br />for Medicaid to low-income adults who <br />aren’t disabled.) <br />He almost resumed the pattern after <br />his last release, in December 2018.“I <br />startedhangingaroundthesamepeople <br />and doing the wrong things,”he recalls. <br />“Then I said,‘Well, I need to stop this.’” <br />His probation officer put him in touch <br />with another former inmate, a commu- <br />nity health worker named Tommy <br />Green, who brought me to the Joneses’ <br />home in July 2019 and introduced me to <br />his client. <br />Green has been out of prison since <br />2015, and he started working last year <br />fortheFormerlyIncarceratedTransition <br />(FIT)Program,whichhelpspeoplecom- <br />ingoutofprisongetaccesstohealthand <br />social services. Green called Jones a few <br />times,“but I blew him off, thinking I <br />didn’t need the program,”Jones recalls. <br />“But then I saw I was going downhill, <br />and I was like,‘Damn, I need to do <br />something.’” <br />He had another motivation, too: sur- <br />vival. Jones says that in the six months <br />since he was released, ten friends, most <br />of them recently released inmates, have <br />1616 Health Affairs October 2019 38:10 Photograph by Rob Waters <br />
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