the Miami Med Re-Admission Care Coordination (MMRCC) The program, started in 2020 by students of 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 provides patient navigation services to people returning from prison. We help participants with things like finding health insurance, connecting with primary care or other medical, dental, or health services,” said Julia Teleci, a third-year medical student who is one of four Miller students on the executive team at MMRCC. mental. “Then we set some long-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 on their goals, and help troubleshoot any issues they may be having as they navigate the health care system.”
The program benefits both the participants and the medical students they help, according to the students’ founders, who have since graduated from medical school.
“I believe this project has been a cornerstone of my development as a provider and future leader,” said MMRCC founder and former Miller School student Erin O’Keefe, MD ’22.
Kyrra Engle, MD ’22, co-founder of MMRCC, said developing the program and helping people transition to healthier lives after prison was the most important experience she had in medical school.
“I feel as if I learned as much, if not more, from the participants as I hope they learned from me,” said Dr. Engel.
Telischi was recruited to MMRCC in her first year of medical school, the program’s pilot year.
“At the time, there were four of us running the program and doing the experimental navigation,” said Teleshi. “Today, there are four of us on our executive team. We had five Mariners last year, four more came in the summer, and we’ve recruited three more this fall. We’re still very young, but we’d like to expand.”
The program pairs an individual who has been incarcerated with a patient navigator who has been trained specifically for this population. They meet every two weeks to set healthcare goals, which participants take the lead in setting. Navigators, as their titles suggest, help participants find their ways through the health care system.
There is an urgent need to tap more medical students to provide patient transportation services to people returning from prison, according to Telischi.
“That’s a large population in Miami-Dade. If you walk into the wards of Jackson Hospital, you’ll see at least one patient with a corrections officer outside their door at any given time,” she said. “And I think it’s important to learn about different populations in medical school. We focus on long-term relationships. That’s why we don’t have every navigator with a large number of patients. We want them to focus on developing a longitudinal relationship with each participant.”
Improving the well-being of vulnerable populations
Providing services like MMRCC is vital to the big picture of health care, according to Catherine M. Justice Lab, and faculty advisor at MMRCC.
“People who are incarcerated generally have much higher rates of health conditions than people in the community,” said Dr. Nowotny. “The things we think about the most are mental health issues and substance abuse. But they often also have chronic conditions, like high blood pressure and diabetes that go untreated.”
Ironically, the criminal justice system has become an important healthcare provider in the United States, according to Dr. Novotny.
“We have poor urban residents who are constantly monitored by the police, have high rates of incarceration, that is, are uninsured, and live in underinvested neighborhoods. They often only receive care from emergency departments or during periods of incarceration,” said Dr. Nowotny once. “Not being incarcerated, there is no system in place to help them manage their health conditions. They often go without insurance, especially because insurance is tied to employment. Florida currently has over 1,000 laws that restrict employment and other activities among incarcerated people.”
Helping these people access health care can improve the well-being of this vulnerable population, as well as prepare future physicians to care for an often overlooked but significant segment of society.
more than 70 million people have a criminal record; On any given day, two million people are imprisoned; “Fifty percent of Americans have had a loved one who has been incarcerated,” Dr. Novotny said. “But it is not an integral part of our medical training program, so having students be exposed to working with this population, teaching them about issues related to the criminal justice system — how the criminal justice system affects the health of incarcerated persons, their families, and their communities — is incredibly beneficial.”