Feminine Hygiene in Prisons and Jails: Inadequate feminine hygiene products correlate with infections and poor mental health outcomes for women. With funding from the Missouri Foundation for Health, Missouri Appleseed began in late 2017 to research the feminine products available in Missouri’s two state prisons for women. Almost a year later, Missouri Appleseed submitted its research findings to the Missouri Department of Corrections (MDOC). The report found that the pads provided in Missouri’s prisons were not large or absorbent enough to meet women’s needs. Many women had been making unsanitary homemade tampons to manage their menstruation. In response, lawmakers filed bills to improve access to feminine products in both Missouri’s prisons and its county jails. MDOC also requested funds from the state to purchase adequate-quality pads and tampons. The Missouri house and senate approved funds for better products.
Missouri Appleseed is now expanding its research on feminine hygiene products for incarcerated women to Missouri’s local jails.
Community-Based Sentences for Primary Caretakers: The incarceration of a caretaker is an Adverse Childhood Experience (ACE). Medical research has linked ACEs to poor health. When a parent is incarcerated, their children are at greater risk for physical health problems such as asthma, migraines, and later-life heart attacks. They are also at risk for mental health problems such as clinical depression and anxiety.
To prevent poor health outcomes in children, Missouri Appleseed is currently advocating for a Primary Caretaker law in Missouri. Primary Caretaker laws allow judges to consider community sentences for parents convicted of nonviolent crimes. With community sentences, parents can be held accountable for breaking the law while continuing to provide and care for their children. If passed, a Primary Caretaker law could reduce foster-care caseloads and improve child health. Since people given community-based sentences are less likely to commit new crimes than people sent to prison, a Primary Caretaker law could also reduce recidivism rates and correctional costs.
Medicaid Suspension for Incarcerated People: Until the 2019 legislative session, Missouri terminated an individual’s Medicaid if that individual was incarcerated. Termination occurred whether the individual was convicted of a crime or merely held pre-trial. Most states only suspend Medicaid for incarcerated individuals. Suspension allows incarcerated individuals to reactivate their health insurance immediately upon release, so that they can maintain access to treatment and essential medications. Individuals leaving confinement with health insurance are less likely to return to jail or prison.
During the 2019 legislative session, Missouri Appleseed worked with St. Louis University law students, psychiatrists, and nonprofits to understand the legal reasoning behind Missouri’s termination policy. The group developed policy recommendations that would better serve Missourians reentering society. Members also testified in favor of Missouri state bills legislating Medicaid suspension rather than termination. On May 16, 2019, Missouri Senate Bill 514 was truly agreed to and finally passed with language changing Missouri’s policy from termination to suspension.
Missouri Appleseed will continue to work to ensure individuals reentering society have access to health care by monitoring Missouri’s implementation of Senate Bill 514. Successful implementation will require communication and collaboration on the state and local level.
Visitation Rights of Children with Incarcerated Parents: As of 2010, more than half of all people incarcerated in the U.S. had minor children. Parental incarceration correlates with negative physical and mental health outcomes for children. While high-quality visitation of incarcerated parents may reduce negative outcomes for children, prison visitation is often poor-quality, logistically difficult, and expensive. Moreover, some children are denied visitation with their incarcerated parents solely on the basis of the parent’s incarceration.
Missouri Appleseed and the law firm Stinson LLP are working together to research current law, policy, and practices in Missouri and to educate stakeholders and decision makers about current research on the benefits of maintaining parent-child relationships even during a parent’s incarceration.
Mental Health Law Survey and Education: Serious mental illness is much more common among justice-involved individuals than among the general population. Nevertheless, most law students do not receive specific instruction on mental illness or mental health law. Research suggests that lawyers who lack experience with mental illness are reluctant to take on mentally ill clients.
In collaboration with forensic psychiatrist Dr. Jacqueline Landess of St. Louis University Medical School, Missouri Appleseed conducted a survey of the Missouri Criminal Bar about mental illness and mental health law: education, attitudes, and personal and professional experiences. Based on survey responses, Missouri Appleseed and Dr. Landess designed a free workshop to supplement the Bar’s knowledge of mental health, legal competency, and special sentencing for the mentally ill. The workshop took place at St. Louis University Law School on July 19th, 2019.