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Sentara program helps recently incarcerated individuals stay out of prison

Left to right: Manager of Behavioral Health Erin Martin, Riverside Regional Jail Case Manager Ricky P. Weeks, Sr., and Justice Care Coordination Supervisor Martina Taylor stand outside the Riverside Regional Jail.
Sentara Justice Care Coordinator program staff at Riverside Regional Jail.jpeg
As a corrections officer, Martina Taylor watched people cycle in and out of correctional facilities. Many needed treatment for mental health and substance use issues, but they weren’t getting it.

Taylor became a therapist because she wanted to help. Then, when she read about a new Justice Care Coordinator role at Sentara Health Plans, she thought the position was a better way to break the cycle of incarceration. She applied.

Now Taylor helps recently incarcerated Sentara Health Plans members in Virginia access resources for behavioral health, a term that encompasses mental health and substance use issues. She also connects them to housing and employment opportunities.

The goal? To help them stay healthy and out of prison.

“A lot of times, when these members have behavioral health diagnoses, they don’t get the help that they need,” said Taylor, citing the stigma faced by people with criminal records. “We are trying to make sure they have the resources they need to not reoffend.”

Since launching at the end of 2022, the program has engaged more than 3,000 Sentara Health Plans members, according to Erin Martin, manager of behavioral health, who oversees the program. Currently there are three full-time staff members, including Taylor, who was recently promoted to care coordination supervisor.

The results have been positive. For example, from 2023 to 2024, the program saw an 80% increase in the utilization of opioid treatments by engaged members with opioid use disorders.

“Our Justice Care Coordination program provides impactful outreach to a specialized and highly vulnerable population,” said Martin. “We’re here to help these individuals so they get the treatment they need to have fulfilled lives.”

Recently incarcerated individuals suffer from high rates of mental health and substance use disorders. About 80% of individuals released from prison in the U.S. have a chronic medical, substance use, or mental health condition.

Helping members be successful

As a care coordinator and now supervisor, Taylor visits resource fairs and works with probation and parole officers across Virginia. To conduct outreach, program staff also phone Sentara Health Plans members who are newly released from prison.

“There are a lot of members who are skeptical at first,” said Taylor, adding that they typically warm up once staff explain their role. Most often, members need services for behavioral healthcare. Staff also provide information on other healthcare services available to them.

The most rewarding part of the job is helping members be “successful,” said Taylor.
For example, one Sentara Health Plans member had been incarcerated for substance use and had lost custody of all four of her children. With Taylor’s assistance, she started a substance use program and found a job at a gas station. Now she is working toward gaining custody of her children.

“I’m proud of the fact that she’s acknowledging she has made some missteps and is working toward improving her life,” Taylor said.

Responding to community need

Sentara established the Justice Care Coordinator program after then-Virginia Governor Ralph Northam authorized the early release of inmates during the Covid-19 pandemic. Many were released with little to no resources, according to Martin.

“Over the last three years, the program has grown and developed based on need,” Martin said.

Sentara Health Plans members served by the program must be on probation or parole, or they must have been released from a correctional facility in the last six months. 

Staff have cultivated relationships with probation and parole officers, as well as correctional facilities. They have built a database of housing and employment resources.

The impact has been community wide, Martin said.

“This is a person, not just someone who has broken the law,” Martin said. “And when you lead one person toward recovery and positivity, it impacts individuals throughout the community.”