
Your Journey Back,
Our Commitment Forward.
Our Re-Entry Services
Pathway to Health
Our re-entry palliative care program is designed to provide compassionate support and care for individuals transitioning back into the community after experiencing incarceration. We understand the unique challenges and needs of individuals in this situation and are here to help you navigate this journey with dignity and respect. Together we can provide a better quality of life to the target population.
Justice-Involved Program
The Justice-Involved (JI) Program supports individuals transitioning from incarceration back into the community by ensuring access to coordinated and continuous healthcare services. In alignment with Enhanced Care Management (ECM), the program addresses the medical, behavioral, and social needs of individuals who are at increased risk of care disruption during reentry.
This program focuses on establishing continuity of care by connecting patients to essential services, including primary care, palliative support, mental health services, and chronic condition management. Through structured coordination, patients are supported in maintaining treatment plans, attending medical appointments, and accessing appropriate healthcare resources.
Care coordination is tailored to each individual’s needs and may include assistance with appointment scheduling, medication management, and linkage to community-based services. The program also incorporates behavioral health support to address conditions such as anxiety, depression, and trauma that may impact overall health and stability.
For patients with serious or complex conditions, palliative care services are integrated to support symptom management and improve overall quality of life. This ensures that care remains patient-centered and responsive to both medical and supportive needs during the transition period.
By supporting individuals during reentry, the program helps reduce gaps in care, improve health outcomes, and promote stability within the community.


Who We Serve
The Justice-Involved (JI) Program serves adults who are transitioning from jail, prison, or other correctional facilities back into the community and who may need support accessing healthcare services. Individuals with chronic medical conditions, behavioral health needs, substance use disorders, disabilities, or complex care needs may benefit from additional care coordination during reentry.
How the Program Works
Our care team works closely with patients before and after their release to help ensure a smooth transition into community-based healthcare services. We coordinate with healthcare providers, behavioral health professionals, community organizations, and support systems to create a personalized care plan that addresses each individual's unique needs.
Eligibility and Population
This program serves individuals who are recently released from incarceration and require coordinated healthcare support. It is particularly relevant for patients enrolled in Enhanced Care Management (ECM) who present with chronic conditions, behavioral health needs, or require assistance navigating healthcare systems.
Services May Include

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Primary care provider connection and follow-up
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Care coordination and case management
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Behavioral and mental health support
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Chronic disease management
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Medication reconciliation and management
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Palliative care consultation and support
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Health education and self-management coaching
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Assistance with scheduling appointments
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Referrals to community resources and support services
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Care transition planning following release from incarceration
Why Continuity of Care Matters
Individuals returning to the community often experience interruptions in healthcare services, medications, and treatment plans. These gaps in care can increase the risk of worsening health conditions, emergency room visits, hospitalization, and behavioral health crises. The Justice-Involved Program helps bridge these gaps by ensuring timely access to healthcare services and ongoing support.

Our Vision
The art of palliative re-entry program has been designed to address mental health, physical well-being and criminal risk factors. Our agencies goal is to educate, treat and provide resources to incarcerated or formerly incarcerated individuals that need short or long term care. Together with the cognitive behavior method and the medical treatment component is an evidence-based approach that will help this population understand the importance of mental health and physical well-being. These two compliment Mental Health and medical illnesses so that every individual has the ability to have a sustainable healthy journey for a better quality of life.

Why Choose Us?
Our program has specialized individuals in every target area that will facilitate curriculum and obtain data that will help meet the mandate of CalAim. We are HIPPA compliant and our program will share data exclusively with the designated agency.

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CONTACT US
132 Alta Street, Gonzales CA 93926
Phone: 1.800.437.3168
Fax: 1.800.445.0734
