Equal Justice Initiative launches clinic to provide care for formerly incarcerated Alabamians

The Equal Justice Initiative clinics reception area, where patients are greeted and snacks are offered, is seen Monday. / Alabama Reflector Photo by Alander Rocha

The Equal Justice Initiative has opened a free clinic in Montgomery providing primary care to Alabamians released from jail or prison.

The nonprofit, known for its legal assistance to incarcerated people over the past three decades, opened the clinic earlier this year. It also plans to send a mobile clinic around the state this month as part of its expanded efforts to combat poverty in Alabama.

Dr. Margaret Hayden, one of two full-time primary care physicians at the clinic, said many of its patients suffer from high blood pressure, diabetes and high cholesterol. There is also a prevalence of mental health issues, like post-traumatic stress disorder.

"People often have childhood trauma, and they spend time in jail or in prison, which are traumatizing settings for many, so a lot of PTSD, anxiety and depression," she said.

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A large portion of the cases the clinic treats involves hepatitis C. While the illness affects about 1% of the U.S. population, up to 50% of the patients who come to the clinic have or have had the disease, Hayden said.

Hepatitis C, which is triggered by the hepatitis C virus, is an infection that primarily affects the liver, according to the Centers for Disease Control and Prevention. The transmission of hepatitis C occurs through contact with blood of an infected individual. Today, the majority of hepatitis C cases stem from the sharing of needles or other paraphernalia used for drug preparation and injection.

The treatment for hepatitis C is simple once the disease is diagnosed, Hayden said. It typically involves taking a pill for just eight weeks.

The clinic offers wrap-around, integrated services meant to address different aspects of health. The clinic has an on-site lab that processes blood work in about 15 minutes, and Laquarria Nevins, the clinic's social worker, works with patients to help them get back on their feet, such as helping them apply for a driver's license or Social Security card.

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"Most people just don't have those items," Nevins said.

Many of the clinic's patients have been incarcerated so long that those items have been lost or family members who they left things with have passed away, so the clinic is getting the former inmates to a "place to where they can get a life start to some type of normality," Nevins said.

Appointments usually take longer than a typical doctor visit. Ryan Pratt, the clinic's registered nurse, said he likes to take a patient-centered approach and lets the patient lead the conversation.

"You go into a hospital, and nurses ask 80 pages of invasive questions that would just never be appropriate given the population we serve. We let them discuss what they want to talk about," Pratt said.

Dr. Sangay Kishore, the other full-time physician at the clinic, said he thinks access to health care is related to public safety, and it's much more than just taking prescriptions. The first couple of weeks after being released are the most dangerous health-wise, Kishore said.

People may be exposed to homelessness and addiction, he said, and providing health care interventions can disrupt what he called a "vicious spiral." Because of this, Kishore feels the clinic can show the state that providing basic primary care can reduce recidivism.

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"Other states have shown that when you expand access to health care — mental health services, addiction, basic primary care — you reduce recidivism. We care a lot about that in the state. We should be thinking about expanding access to health care to improve safety," he said.

Read more at AlabamaReflector.com.