Start a Post-Incarceration Health Navigation Service

1. 1

   Design the first-90-days protocol

   Pre-release where access allows (medication reconciliation, insurance activation, appointments booked before the gate) and post-release always: a first-week contact, pharmacy walk-through, transportation solved, warm handoffs to primary care, behavioral health, and MAT providers, and check-ins tied to the highest-risk windows. Write it as a replicable protocol with metrics; funders buy protocols, not intentions.

2. 2

   Staff with credible messengers plus clinical backbone

   Peer navigators with lived experience of incarceration open doors no badge or lanyard can, and many states fund certified peer support and community health worker roles; a nurse or licensed clinician sets protocols, supervises escalation, and owns medication-related judgment. This pairing is the operating model, and hiring reentry talent makes the business its own mission.

3. 3

   Build the institutional partnerships early

   County jails and sheriffs (release schedules and in-reach access), probation and parole, reentry nonprofits and halfway houses, FQHCs (natural clinical partners with aligned funding), and hospital EDs tired of the revolving door. You are the connective tissue between systems that do not talk; formal MOUs make it real.

4. 4

   Chase the money that already exists

   Medicaid reentry waivers and managed care in-lieu-of services in a growing list of states, county behavioral health and opioid settlement funds, state reentry grants, and hospital community benefit budgets. Contract structures run per-enrollee per-month or per-completed-navigation; a small consulting lane helping counties design these programs can fund the early quarters.

5. 5

   Measure what the funders are penalized on

   Days-to-first-prescription-fill, appointment completion, ED visits and readmissions avoided, overdose events, and reincarceration touchpoints. Clean data collection from client one; this field is full of good hearts and thin evidence, and the operator with numbers wins the renewals.

6. 6

   Stay disciplined about scope and safety

   Navigation is coordination and education, not treatment: clinical care happens at the partnered providers, crisis protocols are written and drilled, and staff safety practices (paired visits, location sharing) are policy, not vibes. Deep respect plus firm boundaries is what makes this durable for the people doing it.

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