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Enhanced discharge planning during COVID-19 crisis

Dear Solicitor General,

We write to express concerns about limited access to healthcare for people who are currently incarcerated, have recently been released from correctional facilities, or are otherwise involved with justice.

Canada is a signatory to United Nations declarations committing to the provision of adequate health services for imprisoned people, without discrimination. During the ongoing COVID-19 pandemic, healthcare access for people held in correctional facilities and those recently discharged has not been equitable to mainstream populations. On the contrary, health risks to these vulnerable populations have been elevated. We urge the ministry to close these gaps to care.

Community led healthcare organizations provide primary care to people involved with justice across the province. Our organizations are acutely aware that incarcerated people are at elevated risk of harms linked to COVID-19 due to overcrowded conditions in correctional facilities that make close contact inevitable. Incarcerated people do not have “on demand” access to prevention resources in the same way that mainstream populations do. These factors increase susceptibility to COVID-19. In light of these contextual factors, community led health organizations have welcomed recent actions to accelerate release for eligible individuals. For the safety of these populations and the wider population of Ontario, a core component of this COVID-19 response must be to provide adequate supports and comprehensive healthcare for recently released individuals.

Our organizations are concerned about inadequate discharge planning protocols currently in place. Despite the elevated risk to COVID-19 exposure, the province has not released a strategy for corrections and incarcerated populations under the COVID-19 Action plan for vulnerable populations. Reports indicate that over 1000 people have been released from correctional facilities in the midst of the ongoing pandemic. Recently released people are susceptible to poor health outcomes. Without tailored interventions, many remain disconnected from primary healthcare and disconnected from vital social service supports. Evidence shows that many people leaving correctional facilities in Ontario are at higher risk of poverty, homelessness and poor health. COVID-19 exacerbates these concerns. The lack of clear transition plans and comprehensive discharge strategies puts vulnerable people at risk. These outcomes are entirely preventable.

We can help. Our sectors have the expertise and the capacity to eliminate these gaps. Community Health Centres (CHCs) and Aboriginal Health Access Centres (AHACs) have made a list of primary healthcare facilities in close proximity to correctional facilities available to the Solicitor General’s office. These healthcare facilities are prepared to establish formal linkages with facilities in close proximity. Social service organizations, (convening as the Correctional Reform Coalition), have offered the province support in developing robust and nimble discharge plans that decrease social isolation and vulnerability for individuals leaving corrections. We urge the province to invite stakeholders from these sectors to the table to develop comprehensive discharge protocols. 

The province can act swiftly to support these populations by:

  1. Developing linkages to healthcare through community led primary healthcare organizations. CHCs and AHACs are well positioned to support recently released populations. They already support communities experiencing high levels of marginalization and are well suited to respond to the complex needs of individuals recently discharged from corrections.
  2. Developing pandemic discharge strategies in collaboration with social services organizations. The province must include sector leaders in the development of guidelines, case management protocols and discharge policies that will ensure linkages to social services.
  3. Mandating pandemic discharge protocols for remanded populations that match protocols used in discharge planning for the release of individuals who have been sentenced. The presence of protocols for one group which are not required for the other creates inequities in care.
  4. Releasing data on the proportion of sentenced and remanded individuals released to inform sector discharge planning. We urge the province to report transparently about COVID-19 to effectively address this crisis.
  5. Formalizing links to community and social service organizations supporting discharged individuals.
  6. Expanding temporary hold on identification document renewal for recently discharged populations during COVID-19 and eliminate requirements for valid I.D to access health and social services.
  7. Addressing factors contributing to mass staff walkouts in facilities by prioritizing access to PPE and hazard pay to these essential workers. The province must ensure that facilities remain well-staffed and able to provide comprehensive care.

This is an exceptional crisis requiring responses that surpass the ordinary. Our sectors are prepared to support the province in developing supportive programs for marginalized population groups.

Adrianna Tetley, CEO, Alliance for Healthier Communities

Friday, May 29, 2020