Can we actually get HIPAA-compliant data sharing between jail health and community providers?

Yes — with the right BAA structure and a FHIR R4 transport layer. The jail health operation is a covered entity or business associate. The community CBHC or FQHC is a covered entity. HealthcareCheck acts as the business associate processor under executed BAAs with both. FHIR R4 Bundles move from carceral clinical record to community provider under treatment authorization — that's a HIPAA-permitted disclosure. The subprocessor chain (Vertex AI under Google Cloud BAA, AWS RDS with pgcrypto encryption at rest, AWS SES under AWS BAA) is published and weekly-verified on our HIPAA gate. No PHI moves outside BAA-covered infrastructure. The technical safeguards under 45 CFR 164.312 map one-to-one to platform controls. The answer is yes — and the BAA list is public so your own compliance team can verify before you sign.

How do we handle someone leaving on a Friday afternoon when our CBHC partner is closed?

The 30-day pre-release window exists so Friday releases don't become Monday deaths. HealthcareCheck schedules the community intake appointment before release day — not at the door. The MAT bridge prescription is confirmed dispensed before the person leaves. The community pharmacy is notified by FHIR R4 MedicationRequest or fax confirmation before close of business Thursday. The CBHC intake is scheduled for the Monday or Tuesday immediately following release, not the next available opening three weeks out. If the release is accelerated — early release on time served, bond posted — the system fires a same-day emergency re-routing task to the on-call care coordinator. The Friday afternoon problem is a scheduling problem, not an infrastructure problem. The infrastructure closes it if you're using it 30 days out.

We don't prescribe MAT inside the jail. Does that block the continuity workflow?

No. The continuity workflow works from wherever the person's MAT status sits: (a) if the person was on MAT at the time of incarceration and was taken off, HealthcareCheck documents the prior regimen and routes the reinstatement referral to a community prescriber pre-release; (b) if the person never received MAT but has an OUD diagnosis, the workflow flags the OUD, routes a MAT intake referral to a community prescriber, and schedules an appointment within 72 hours of release; (c) if the jail does offer MAT (buprenorphine in-jail programs are expanding under DOJ and SAMHSA guidance), the platform tracks the current dose and routes the continuation prescription to a community prescriber with dose confirmation. The jail not offering MAT is the most common case. The platform is built for that case, not around it. What matters is that the community prescriber appointment exists before the person leaves — not that the jail was doing the prescribing.

Will parole and probation officers actually use a clinical dashboard?

The dashboard is designed to be used by someone who does not have clinical training and does not want clinical training. The officer sees green, yellow, or red — treatment engaged, appointment pending, appointment missed. That's it. No diagnoses visible. No medications visible. No progress notes visible. PHI is visible only to the clinician. The supervision signal (engaged/not engaged) is visible to the officer. When the signal drops to yellow or red, both the officer and the CBHC clinician receive a same-day alert and the response is documented in a shared thread. Officers who have used co-response and integrated supervision models report that clinical visibility reduces the number of violation filings they write — because they now have an alternative response when they see a clinical crisis. The Skeem 2011 meta-analysis documents 20–30% reductions in technical violations across multiple integrated supervision models. Officers file fewer violations when they have somewhere to route the person besides jail.

BAA execution path for a correctional facility?

Mutual BAA executed on day one — with the jail, prison, or re-entry program as the covered entity or business associate, depending on their HIPAA status. The subprocessor chain is published: Google Cloud (Vertex AI) under the Google Cloud BAA with no-training settings enforced at the project level; AWS (compute, RDS PostgreSQL with pgcrypto encryption at rest, SES for transactional email) under the existing AWS BAA; CloudWatch and S3 for log retention under that same AWS BAA. The 45 CFR 164.312 technical safeguards map one-to-one to platform controls and are re-verified on the weekly HIPAA gate every Wednesday. No subprocessor is added without a signed BAA. The BAA list is publicly maintained on the compliance page. Your own general counsel can review the chain without scheduling a vendor call. Most correctional health general counsels do not trust verbally stated compliance positions — we don't ask you to. Read the list. Ask us about any gap. That's the conversation.

Re-entry is the highest-mortality medical handoff in US healthcare. We close it before release day.

Opioid OD risk in the first two weeks post-release is 12–129× the general population. Medicaid suspended at booking. MAT cut on release. Mental-health meds out. HealthcareCheck links the carceral clinical record to a community care team before the door opens — not after the call comes in.

Configure your tenant — 30-min discovery, 48-hour deploy See the 48-hour deploy walkthrough →

HealthcareCheck is patient-navigation infrastructure for correctional health programs and re-entry coordinators. The platform links jail and prison clinical records to community CBHCs, FQHC care teams, MAT prescribers, and housing coordinators before release day — not after the overdose. It manages Medicaid pre-release reinstatement workflow, buprenorphine and methadone continuity contracts with community prescribers, Hep C and HIV treatment routing, mental-health medication bridge supply, and SDOH housing referrals structured against the first week post-release. FHIR R4 native, executed BAA chain, white-label tenant on a jail or re-entry program subdomain in 48 hours. Built by Matthew Sexton, LCSW — fourteen years across thirteen clinical settings, including forensic ACT — because the handoff keeps killing people and nobody tracks it.

Where the pathway breaks — and how we close it

Jail and prison health records live in carceral EHRs that are invisible to the community care system. On release, a person walks out with no record transfer, no medication list, and no clinical summary reaching the CBHC or FQHC that is supposed to pick up care. The community provider starts from zero.

Zerodocumented structured clinical-record transfer from carceral to community EHR in most US jurisdictions at baseline — no interoperability standard exists across correctional and community FHIR endpoints^cite

Cost when unaddressed: A community care team starting from zero does not prescribe MAT on day one, does not continue psychiatric medications, and does not have a Hep C or HIV status. The gap between release and first documented community contact is where the deaths cluster.

HealthcareCheck generates a structured pre-release patient roster — medication list, active diagnoses, MAT status, Hep C and HIV status, mental-health care needs, SDOH flags — shared as a FHIR R4 Bundle with the assigned community CBHC or FQHC 30 days before release. The community care team can schedule the intake appointment, request the MAT bridge prescription, and assign a case manager before the person walks out.

30 dayspre-release window for community care planning when a structured roster transfer is in place — compared to zero-day walk-out-and-hope-for-the-best baseline^cite

Before0 dayscommunity care team lead time at baseline (no record transfer, walk-out)^cite

After30 dayscommunity care team lead time with pre-release FHIR R4 roster transfer — intake appointment + MAT bridge + case manager assigned before release^cite

Impact on jail-as-island clinical recordMethodology →

Most states suspend — and many terminate — Medicaid coverage at arrest or booking. Coverage does not automatically reinstate on release. The person leaves jail with no insurance, no primary care, and no way to pay for a MAT prescription or psychiatric medication that afternoon.

43 statesstates that suspend rather than terminate Medicaid at incarceration (suspension is the better policy — termination requires full re-enrollment on release, adding weeks to coverage gap)^cite

Cost when unaddressed: A coverage gap on release day means no covered pharmacy for MAT, no covered psychiatrist for medication management, and no covered ER as a last resort. The gap is not administrative inconvenience. It is a clinical risk window measured in days.

HealthcareCheck triggers a Medicaid reinstatement task 30–45 days before the projected release date. The workflow documents the suspension status, flags the state-specific reinstatement pathway, and creates a task assigned to the re-entry coordinator with deadline tracking. On release day, the person leaves with active coverage rather than a stack of forms to mail.

Day-one coverageMedicaid active on release day when pre-release reinstatement workflow is completed 30–45 days before release — eliminating the post-release enrollment gap that averages 3–8 weeks in states that require re-enrollment^cite

Before3–8 weeksaverage post-release Medicaid coverage gap in re-enrollment states when no pre-release reinstatement workflow is in place^cite

AfterDay-oneMedicaid active on release when pre-release reinstatement task completes 30–45 days before release^cite

Impact on medicaid suspension at bookingMethodology →

Medication-assisted treatment with buprenorphine or methadone is the gold standard for opioid use disorder. Most jails and prisons do not offer MAT, and many that do cannot hand off an active prescription to a community prescriber on release day. The result: a person leaves with an opioid use disorder, no MAT, and a dramatically reduced opioid tolerance — exactly when overdose risk peaks.

12–129×elevated opioid overdose mortality risk in the first two weeks post-release compared to the general population (Binswanger 2007 NEJM; subsequent replications including Merrall 2010 and Forsyth 2011)^cite

Cost when unaddressed: MAT is the one intervention with consistent evidence for reducing post-release opioid OD mortality. Discontinuing it at release day is not a policy gap. It is a choice to let people die.

HealthcareCheck pre-identifies a MAT prescriber in the person's home ZIP code 30 days before release, sends a FHIR R4 referral with the current MAT regimen and dose, schedules a continuity appointment within 72 hours of release, and provides a documented bridge prescription for the transition window. The hand-off is tracked to closure — appointment confirmed, prescription filled, no gap.

Up to 75% reductionin post-release opioid-overdose mortality among people receiving MAT in the pre-release and peri-release period vs. no MAT (Marsden 2017 Lancet; Kinner 2012 pooled analysis)^cite

Before12–129×opioid OD mortality risk in first 2 weeks post-release without MAT continuity (Binswanger 2007 NEJM)^cite

AfterUp to −75%reduction in post-release opioid OD mortality with pre-release + peri-release MAT continuity (Marsden 2017 Lancet)^cite

Impact on mat discontinuation at releaseMethodology →

Carceral populations carry hepatitis C virus prevalence rates 9–26× the general population and HIV prevalence 5× the general population. Most jails do not screen universally, and most that do cannot complete a treatment course within the incarceration window or link to a continuation of care on release.

9–26×HCV seroprevalence in incarcerated populations compared to the general population (Trubnikov 2014 AHRQ systematic review; CDC 2020 correctional health data)^cite

Cost when unaddressed: An untreated HCV case leaving jail re-enters the community as an active transmission risk and as a person whose cirrhosis and cancer trajectory is now accelerating. The treatment exists. The routing does not.

HealthcareCheck captures a universal HCV and HIV screening flag at booking (or at clinical intake), routes a positive result to a treatment task with a 30-day clinical review window, links the person to a community Hep C or HIV care provider pre-release, and tracks the handoff to a documented community appointment within 14 days of release.

85–97%HCV sustained virologic response (SVR) rates with 8–12 weeks of direct-acting antiviral treatment — the cure exists and works at high rates when treatment is initiated and continued (AASLD/IDSA 2023 HCV guidance; Falade-Nwulia 2018 NEJM for simplified treatment)^cite

BeforeScreen-and-loseHCV positive at booking; no treatment course completed; no community linkage at release^cite

After85–97% SVRHCV cure rate with DAA course initiated in jail + community provider handoff tracking to 14-day post-release appointment (AASLD/IDSA 2023)^cite

Impact on hep c and hiv undertreatment in carceral settingsMethodology →

People on psychiatric medications — antipsychotics, mood stabilizers, antidepressants, benzodiazepine tapers — leave jail with whatever is in their pocket from the last jail-pharmacy fill. There is no bridge prescription to a community pharmacy, no psychiatric appointment within the first week, and no mechanism to flag the community CBHC that this person is at risk for psychiatric decompensation without medications.

3–7 daysmedian time to psychiatric decompensation after psychotropic medication discontinuation for people with serious mental illness who lose access to medication — community data; correctional setting literature documents even shorter windows given medication-adherence disruption during incarceration^cite

Cost when unaddressed: Psychiatric decompensation in the first week post-release leads to emergency psychiatric holds, criminal justice re-contact, and the revolving-door cycle that costs the system more than prevention ever would. The 30-day bridge prescription costs the jail pharmacy less than one ED visit.

HealthcareCheck generates a 30-day medication bridge task 14 days before release — flagging the active psychiatric medication list, the community pharmacy in the person's home ZIP code, and the assigned CBHC or community mental health center that will manage ongoing prescriptions. The bridge supply is confirmed dispensed before release. The community pharmacy is notified via fax or FHIR R4 MedicationRequest. The CBHC intake appointment is scheduled within 7 days of release.

−25 to −40%reduction in 90-day psychiatric re-hospitalization and criminal justice re-contact among people with serious mental illness who receive bridged medication supply + same-week community mental health intake (Baillargeon 2010 Am J Public Health; Osher 2012 SAMHSA re-entry framework review)^cite

BeforeDay-of-release cutoffpsychiatric medication supply ends at jail discharge; no bridge, no community pharmacy linkage, no CBHC appointment within 7 days^cite

After30-day bridge + 7-day intake30-day medication bridge confirmed dispensed before release + CBHC intake within 7 days → −25 to −40% psychiatric re-hospitalization at 90 days (Baillargeon 2010)^cite

Impact on mental-health medication interruption on release dayMethodology →

Housing instability in the first seven days post-release is one of the strongest predictors of recidivism, psychiatric re-hospitalization, and overdose death. Re-entry programs route housing referrals by phone. There is no structured referral, no acknowledgment, no documented placement, and no flag to the clinical team that the housing plan collapsed.

−49%reduction in recidivism at 18 months among people receiving stable housing as part of structured re-entry vs. standard re-entry without housing placement (Fontaine 2012 Urban Institute; consistent across multiple re-entry housing studies)^cite

Cost when unaddressed: A person who exits jail on Friday to a shelter waitlist is back in the system by Monday. Recidivism is not a character defect. It is a housing and resource gap with a predictable timeline.

HealthcareCheck captures a housing plan flag 30 days before release — confirmed placement, shelter with open bed, transitional housing, family address — and routes an SDOH housing referral to a community partner with a documented response deadline. Placement is tracked to confirmation. If placement collapses, the case manager receives a same-day alert and a secondary referral is triggered. Clinical team is notified when housing is unstable.

−49%recidivism reduction at 18 months with stable housing placement vs. standard re-entry (Fontaine 2012 Urban Institute)^cite

BeforeVerbal-only planhousing referral by phone; no structured placement confirmation; recidivism rate at 18mo baseline^cite

After−49% recidivismstructured housing placement tracked to confirmation → 49% recidivism reduction at 18 months (Fontaine 2012 Urban Institute)^cite

Impact on housing in the first week post-releaseMethodology →

Parole and probation officers supervise hundreds of people with serious mental illness, active substance-use disorders, and unmedicated psychiatric conditions. They have no clinical visibility into mental-health status, active prescriptions, or treatment engagement. They are making supervision decisions — violation filings, revocation recommendations — with no clinical input.

20%estimated prevalence of serious mental illness among people under community corrections supervision — three to five times the general population prevalence (Skeem 2011 Psychological Science in the Public Interest; SAMHSA 2018 national survey data)^cite

Cost when unaddressed: A parole violation that ends a mental-health treatment engagement costs more than the treatment. The officer files a violation because they have no clinical signal. The jail costs $250/day. The treatment was $40/session.

HealthcareCheck creates a shared supervision dashboard that gives parole and probation officers a clinical-status flag — treatment engaged, medication current, appointment kept — without PHI. The officer sees green/yellow/red. The CBHC clinician sees the full chart. When status drops to yellow or red, both receive a same-day alert. Clinical and supervision responses are documented in the same thread. Violation filings reflect clinical reality.

−20 to −30%reduction in technical parole violations among people with serious mental illness enrolled in Mental Health Court or co-response supervision models that include clinical visibility (Skeem 2011 meta-analysis; Lamberti 2016 review of forensic-ACT + community supervision integration)^cite

BeforeClinical-blindparole/probation supervision with no clinical status visibility; violation rate for SMI population at baseline (20% SMI prevalence under supervision)^cite

After−20 to −30%technical parole violations reduced with integrated clinical-supervision routing and co-response alerting (Skeem 2011 meta-analysis)^cite

Impact on parole and probation case management blind to mental healthMethodology →

Methodology

How we measure

A "completed re-entry handoff" is the unit of work. HealthcareCheck counts a re-entry transition as closed when all of the following are documented against a single person's pre-release record within the 30-day pre-release window and the 14-day post-release window: (a) a community care provider (CBHC, FQHC, MAT prescriber, or HIV/Hep C specialist) is named and has received a FHIR R4 Bundle or MedicationRequest referral with clinical summary; (b) an intake appointment is scheduled or a prescription is confirmed filled before or within 72 hours of release; (c) housing placement status is documented (confirmed address, shelter bed with acknowledgment, or clinical alert if unstable); (d) Medicaid reinstatement task is completed with coverage-active confirmation before release day; (e) for MAT: bridge prescription dispensed before release + 72-hour community MAT appointment confirmed; (f) for psychiatric medication: 30-day bridge supply confirmed dispensed + CBHC intake within 7 days of release. Handoffs that fail any of these steps within the defined windows are reported as open and excluded from the closed-handoff numerator. Re-entry OD mortality risk reduction is cited per the Binswanger 2007 NEJM and Marsden 2017 Lancet primary literature — not extrapolated. Recidivism outcomes are cited per Fontaine 2012 Urban Institute. SMI supervision outcomes per Skeem 2011 meta-analysis. All before/after metrics are sourced from primary peer-reviewed literature; HealthcareCheck does not generate proprietary outcome claims.

What counts

FHIR R4 Bundle or MedicationRequest referral sent to named community provider
Intake appointment or prescription confirmed within 72 hours of release
Housing placement documented (confirmed address or shelter bed with acknowledgment)
Medicaid reinstatement confirmed active before release day
MAT bridge prescription dispensed + 72-hour community MAT appointment confirmed
Psychiatric medication 30-day bridge confirmed dispensed + CBHC intake within 7 days
HCV or HIV status flagged and community specialist appointment confirmed within 14 days

What doesn't count

Referrals made by phone without a FHIR R4 or documented structured referral record
Handoffs without confirmed community provider intake or prescription fill
Housing plans without documented placement confirmation or secondary referral on collapse
Medicaid reinstatement tasks not completed before release day
MAT gaps exceeding 72 hours post-release without documented bridge supply
Psychiatric medication gaps exceeding 7 days post-release without bridge or CBHC contact

Sources:binswanger-2007-nejm-postrelease-mortality, marsden-2017-lancet-mat-prison-release, reentry-health-transitions-2019, medicaid-incarceration-suspension-policy-2023, hcv-correctional-prevalence-cdc-2020, aasld-idsa-hcv-treatment-guidelines-2023, psychotropic-discontinuation-reentry-2018, baillargeon-2010-smi-reentry-outcomes, fontaine-2012-urban-institute-reentry-housing, skeem-2011-mental-illness-community-corrections, hl7-fhir-r4-2019, hhs-2013-omnibus-rule-baa-requirements

How we compare

Sourced from primary citations — not vendor marketing claims.

	UsHealthcareCheck	vsIn-house jail EHR (paper or fragmented)	vsCorrectional-health vendor module	vsNothing — manual re-entry coordinator
Pre-release community handoff (30-day window)	FHIR R4 roster transfer 30 days pre-release; appointment scheduled before release day	No structured outbound transfer; discharge summary on paper at door	Outbound referrals by fax or phone; no acknowledgment tracking	Coordinator calls CBHC; no structured record; no appointment confirmation
MAT continuity^cite	Community prescriber identified + 72-hour appointment + bridge prescription dispensed before release	Jail EHR documents inpatient medications; no community prescriber handoff	Vendor tracks jail-side MAT; community linkage limited or out of scope	Coordinator makes calls; no documented prescription confirmation
Medicaid reinstatement workflow^cite	Pre-release reinstatement task triggered 30–45 days before release; coverage-active confirmed	Discharge planner aware of issue; reinstatement paperwork at door	Not in scope for most correctional EHR products	Coordinator aware; no structured task tracking; gaps common
HCV and HIV treatment routing^cite	Universal screening flag at booking; positive result routed to community specialist; 14-day post-release appointment tracked	EHR captures screening results; community linkage on discharge planner initiative only	Some modules include screening; community linkage not standard	Screening result on paper; community specialist routing informal
Psychiatric medication bridge^cite	30-day bridge confirmed dispensed + CBHC intake within 7 days; community pharmacy notified	Jail pharmacy fills last prescription; community pharmacy not notified; no bridge task	Medication reconciliation documented; community pharmacy notification not standard	Coordinator aware; pharmacy call informal; no documented confirmation
FHIR R4 data portability^cite	Every clinical artifact in FHIR R4; portable to any receiving community EHR on release	Proprietary carceral EHR formats; interoperability with community FHIR endpoints rare	FHIR support varies by vendor; correctional-to-community interoperability not standard	No electronic record; paper discharge summary
Executed BAA chain (jail + community)^cite	Mutual BAA with jail + community partner; subprocessor chain published and weekly-verified	Jail handles its own HIPAA; community handoff BAA informal or absent	Vendor BAA with jail facility; community partner BAA separate and commonly absent	No formal BAA across the handoff; coordinator acting on good faith
Built by	LCSW with 14 years across 13 clinical settings, including forensic ACT	Correctional facility IT team; no clinical leadership	Health tech vendor; clinical advisors on retainer	Re-entry coordinator with caseload of 80+; no infrastructure support

Frequently asked questions

Can we actually get HIPAA-compliant data sharing between jail health and community providers?: Yes — with the right BAA structure and a FHIR R4 transport layer. The jail health operation is a covered entity or business associate. The community CBHC or FQHC is a covered entity. HealthcareCheck acts as the business associate processor under executed BAAs with both. FHIR R4 Bundles move from carceral clinical record to community provider under treatment authorization — that's a HIPAA-permitted disclosure. The subprocessor chain (Vertex AI under Google Cloud BAA, AWS RDS with pgcrypto encryption at rest, AWS SES under AWS BAA) is published and weekly-verified on our HIPAA gate. No PHI moves outside BAA-covered infrastructure. The technical safeguards under 45 CFR 164.312 map one-to-one to platform controls. The answer is yes — and the BAA list is public so your own compliance team can verify before you sign.
Cited:hhs-2013-omnibus-rule-baa-requirements, hhs-45-cfr-164-312-technical-safeguards, hl7-fhir-r4-2019
How do we handle someone leaving on a Friday afternoon when our CBHC partner is closed?: The 30-day pre-release window exists so Friday releases don't become Monday deaths. HealthcareCheck schedules the community intake appointment before release day — not at the door. The MAT bridge prescription is confirmed dispensed before the person leaves. The community pharmacy is notified by FHIR R4 MedicationRequest or fax confirmation before close of business Thursday. The CBHC intake is scheduled for the Monday or Tuesday immediately following release, not the next available opening three weeks out. If the release is accelerated — early release on time served, bond posted — the system fires a same-day emergency re-routing task to the on-call care coordinator. The Friday afternoon problem is a scheduling problem, not an infrastructure problem. The infrastructure closes it if you're using it 30 days out.
Cited:binswanger-2007-nejm-postrelease-mortality, marsden-2017-lancet-mat-prison-release
We don't prescribe MAT inside the jail. Does that block the continuity workflow?: No. The continuity workflow works from wherever the person's MAT status sits: (a) if the person was on MAT at the time of incarceration and was taken off, HealthcareCheck documents the prior regimen and routes the reinstatement referral to a community prescriber pre-release; (b) if the person never received MAT but has an OUD diagnosis, the workflow flags the OUD, routes a MAT intake referral to a community prescriber, and schedules an appointment within 72 hours of release; (c) if the jail does offer MAT (buprenorphine in-jail programs are expanding under DOJ and SAMHSA guidance), the platform tracks the current dose and routes the continuation prescription to a community prescriber with dose confirmation. The jail not offering MAT is the most common case. The platform is built for that case, not around it. What matters is that the community prescriber appointment exists before the person leaves — not that the jail was doing the prescribing.
Cited:marsden-2017-lancet-mat-prison-release, binswanger-2007-nejm-postrelease-mortality
Will parole and probation officers actually use a clinical dashboard?: The dashboard is designed to be used by someone who does not have clinical training and does not want clinical training. The officer sees green, yellow, or red — treatment engaged, appointment pending, appointment missed. That's it. No diagnoses visible. No medications visible. No progress notes visible. PHI is visible only to the clinician. The supervision signal (engaged/not engaged) is visible to the officer. When the signal drops to yellow or red, both the officer and the CBHC clinician receive a same-day alert and the response is documented in a shared thread. Officers who have used co-response and integrated supervision models report that clinical visibility reduces the number of violation filings they write — because they now have an alternative response when they see a clinical crisis. The Skeem 2011 meta-analysis documents 20–30% reductions in technical violations across multiple integrated supervision models. Officers file fewer violations when they have somewhere to route the person besides jail.
Cited:skeem-2011-mental-illness-community-corrections
BAA execution path for a correctional facility?: Mutual BAA executed on day one — with the jail, prison, or re-entry program as the covered entity or business associate, depending on their HIPAA status. The subprocessor chain is published: Google Cloud (Vertex AI) under the Google Cloud BAA with no-training settings enforced at the project level; AWS (compute, RDS PostgreSQL with pgcrypto encryption at rest, SES for transactional email) under the existing AWS BAA; CloudWatch and S3 for log retention under that same AWS BAA. The 45 CFR 164.312 technical safeguards map one-to-one to platform controls and are re-verified on the weekly HIPAA gate every Wednesday. No subprocessor is added without a signed BAA. The BAA list is publicly maintained on the compliance page. Your own general counsel can review the chain without scheduling a vendor call. Most correctional health general counsels do not trust verbally stated compliance positions — we don't ask you to. Read the list. Ask us about any gap. That's the conversation.
Cited:hhs-2013-omnibus-rule-baa-requirements, hhs-45-cfr-164-312-technical-safeguards

The platform closes the handoff before the door opens. That is the job. Not after the call comes in. Before the door opens.
— Matthew Sexton, LCSW

I am a Licensed Clinical Social Worker. Fourteen years across thirteen clinical settings. One of those settings was forensic ACT — assertive community treatment for people leaving jail and prison with serious mental illness. I have been the person making calls to find a bed, a pharmacy, a prescriber, and a Medicaid caseworker at 4:30 PM on a Thursday before a Friday morning release.

The re-entry handoff does not fail because nobody cares. It fails because there is no infrastructure. The jail EHR is an island. The CBHC has a waitlist and no advance notice. The MAT prescriber requires a scheduled intake. The Medicaid reinstatement form takes three weeks. The person walks out of the jail on Friday with nothing in hand and a tolerance that is gone.

I built HealthcareCheck for this. Not as a theory. As a direct product of watching people die in the gap between a jail discharge and the first community appointment that never happened. The 12-to-129-times elevated OD risk in the first two weeks post-release is not a statistic I read in a journal. It is people I knew.

The platform closes the handoff before the door opens. That is the job. Not after the call comes in. Before the door opens.

Matthew Sexton, LCSWFounder · Mental Wealth Solutions Inc.

Citations

binswanger-2007-nejm-postrelease-mortalitySee citations/binswanger-2007-nejm-postrelease-mortality.mdx for primary source, DOI/PMID, and key statistics.
marsden-2017-lancet-mat-prison-releaseSee citations/marsden-2017-lancet-mat-prison-release.mdx for primary source, DOI/PMID, and key statistics.
reentry-health-transitions-2019See citations/reentry-health-transitions-2019.mdx for primary source, DOI/PMID, and key statistics.
medicaid-incarceration-suspension-policy-2023See citations/medicaid-incarceration-suspension-policy-2023.mdx for primary source, DOI/PMID, and key statistics.
hcv-correctional-prevalence-cdc-2020See citations/hcv-correctional-prevalence-cdc-2020.mdx for primary source, DOI/PMID, and key statistics.
aasld-idsa-hcv-treatment-guidelines-2023See citations/aasld-idsa-hcv-treatment-guidelines-2023.mdx for primary source, DOI/PMID, and key statistics.
psychotropic-discontinuation-reentry-2018See citations/psychotropic-discontinuation-reentry-2018.mdx for primary source, DOI/PMID, and key statistics.
baillargeon-2010-smi-reentry-outcomesSee citations/baillargeon-2010-smi-reentry-outcomes.mdx for primary source, DOI/PMID, and key statistics.
fontaine-2012-urban-institute-reentry-housingSee citations/fontaine-2012-urban-institute-reentry-housing.mdx for primary source, DOI/PMID, and key statistics.
skeem-2011-mental-illness-community-correctionsSee citations/skeem-2011-mental-illness-community-corrections.mdx for primary source, DOI/PMID, and key statistics.
hl7-fhir-r4-2019See citations/hl7-fhir-r4-2019.mdx for primary source, DOI/PMID, and key statistics.
hhs-2013-omnibus-rule-baa-requirementsSee citations/hhs-2013-omnibus-rule-baa-requirements.mdx for primary source, DOI/PMID, and key statistics.
hhs-45-cfr-164-312-technical-safeguardsSee citations/hhs-45-cfr-164-312-technical-safeguards.mdx for primary source, DOI/PMID, and key statistics.
merrall-2010-postrelease-od-systematic-reviewSee citations/merrall-2010-postrelease-od-systematic-review.mdx for primary source, DOI/PMID, and key statistics.
kinner-2012-incarceration-health-pooledSee citations/kinner-2012-incarceration-health-pooled.mdx for primary source, DOI/PMID, and key statistics.
lamberti-2016-forensic-act-supervision-reviewSee citations/lamberti-2016-forensic-act-supervision-review.mdx for primary source, DOI/PMID, and key statistics.
ocr-2024-hipaa-enforcement-statisticsSee citations/ocr-2024-hipaa-enforcement-statistics.mdx for primary source, DOI/PMID, and key statistics.

Ready to close the gap?

Configure your tenant — 30-min discovery, 48-hour deploy See the 48-hour deploy walkthrough →

Re-entry is the highest-mortality medical handoff in US healthcare. We close it before release day.

Where the pathway breaks — and how we close it

Jail-as-island clinical record

Pre-release clinical roster shared with community providers

Medicaid suspension at booking

Pre-release Medicaid reinstatement workflow

MAT discontinuation at release

MAT continuity contracts with community prescribers

Hep C and HIV undertreatment in carceral settings

HCV and HIV prevention and treatment routing

Mental-health medication interruption on release day

30-day bridge supply and community pharmacy linkage

Housing in the first week post-release

Structured re-entry housing referrals tracked to placement

Parole and probation case management blind to mental health

Integrated mental health supervision routing