The Cook County Sheriff’s Department, Cook County Health and Hospitals System (CCHHS), and TASC worked with the Illinois Department of Healthcare and Family Services (HFS) and the Illinois Department of Human Services (DHS) to develop a jail-specific process for CountyCare application assistance, a Medicaid program for uninsured adults in Cook County. The partners created a system at jail intake in which people detained are screened for possible eligibility for CountyCare. With continued strategic planning and partnerships to ensure continuity of healthcare access in the community, the groundwork is being laid for significant correctional healthcare cost savings and improved public health and public safety. 

The Cook County jail is the largest single-site jail in the United States, holding some 9,000 individuals at any given time. The vast majority—90 percent—are pretrial detainees, and 50 percent are released within two weeks. Serious mental health and substance use disorders are widely prevalent among the detained population, and health literacy is minimal. Without treatment, men and women go through the system repeatedly, perpetuating cycles of untreated health issues, arrest, and incarceration.