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In 2016, Penn senior and Biological Basis of Behavior major Kriya Patel was one of the second annual cohort of President’s Engagement Prize recipients. The University of Pennsylvania are awarded to “academically excellent and civically engaged” Penn seniors for the implementation of projects that aim to transform the lives of others during the first year after they graduate from Penn. The recipients thereby exemplify the Penn tradition of “doing well by doing good.”
Patel used her prize to launch a healthcare reentry program at Riverside Correctional Facility, a Philadelphia women’s jail. Two years later, CURF Fellow Kathryn Morgan reached out to Kriya to follow up on her fellowship experience and the path it set her on. Kriya responded candidly about the unexpected challenges she faced, the importance of her Penn mentors, and her continued determination to do good in the world through expanding access to healthcare.
You’ve pointed out that your PEP project aims to help a population—incarcerated women--against whom an inherent social bias exists. How did you personally overcome this bias? How did you identify this population as the one you wanted to serve?
I took a class my junior fall called “Women and Incarceration” where we went once a week to Riverside Correctional Facility (RCF) to teach interactive health seminars. The proximity to this population is what helped me overcome the bias. I was first shocked by how little access to both healthcare and health education the women had. So many of the questions they asked I had assumed were general knowledge, and it really opened my eyes to how we were failing this group of women. But what really pushed me to action was the week we covered intimate partner violence. The stories the women shared of abuse that started early and how that led to future bad decisions made me cry. I left that session feeling both heartbroken for their suffering and outraged that we as a society were not doing more for these women.
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Wanting to help solve a problem is one thing. Knowing where to start, and how to get started, is a bigger stumbling-block for most people. Once you identified your problem, what was Step 1 of how to address it, and how did you figure that out? What’s your #1 piece of advice for students who have a Big Idea but don’t know where to go from there?
The class I took was led by Dr. Kathleen Brown (Practice Associate Professor in Penn’s School of Nursing), who is just incredible. In addition to her work with the nursing school, she also helped run transition housing for women and helps the juvenile lifers without parole who are now being released reenter society. When I learned about PEP I knew I wanted her to be my Penn Mentor—she was so knowledgeable about the barriers women who are reentering face, and also cared deeply for the target population. So step one for me was to connect with her and ask her what she saw as one of the biggest challenges women face upon release. From her work with the transition housing, she knew that women left the jail with 5 days of medication, and in those 5 days she worked to get them health insurance and a doctor’s appointment for another prescription.
By getting a better sense of the problem we were able to brainstorm what would be the ideal situation, which was that when women are released they already have health insurance and a scheduled doctor’s appointment. We then did research together to figure out how to make that happen. My #1 piece of advice would be to find a good mentor and use their expertise to get a better sense of the problem and then work together to develop a practical and ideal solution.
Nobody can tackle a big project like yours alone. How did you go about building your team?
Honestly, my team fell into place after finding my Penn Mentor, Dr. Brown. Through her work, she knew Dr. Bruce Herdman, Chief of Medical Operations at the jail, who became the project’s biggest champion. The two of them really helped me prepare for my PEP interview and figure out next steps after I got the grant.
Through Dr. Herdman, I was able to make connections at the County Assistance Office; they became great partners who both helped the program grow, and helped ensure timely enrollments in Medicaid. The final part of my team came from the Reentry Coalition. I had interned with them as a Penn senior and the Director, Aviva Tevah, was one of my biggest supporters; she helped connect me with organizations that helped while starting the project.
How did being a student at Penn prepare you to undertake your PEP project? What’s the #1 thing you wish you had done as a student (skill acquired, class taken, connection made) that you didn’t get a chance to? How would it have helped you in your life/career/project?
The “Women and Incarceration” class I took at Penn was the main reason I was so motivated to even apply for PEP in the first place. Having taken that class gave me a better understanding of how little we support the women coming out of RCF. I do wish I had taken a negotiation class at Penn as during my work there were a lot of times where I really had to argue and negotiate for different resources for the program. While I of course learned on the job, it would have been nice to have some of those skills going in—arguing and negotiating wasn’t one of my fortes.
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You’re one year out from your President’s Engagement Prize experience. Did you achieve what you hoped to in the time you were given? What were some of the challenges/pitfalls/delays you encountered that you didn’t bargain for?
When I initially wrote the proposal for this project I wanted to complete Medicaid applications for women and their children. I estimated that, given a 78% enrollment rate and the statistic that on average each woman had 2 children, after one year I would have enrolled 12,150 people into Medicaid. In reality, that year I was able to enroll 1,200 women into Medicaid.
Despite the many obstacles and constraints, I feel this was a successful pilot year. There were a few significant obstacles and constraints; first and foremost, we were not able to enroll any children through my program. Two weeks into my project I met with our contacts at the Department of Human Services who informed us that in order for them to give us a 5-day expedited enrollment, we could not include children on applications. They said that it would take them too long to verify custody of children and therefore they could not guarantee turning on health insurance within 5 days. They explained that most women would be able to enroll their children after release. That cut the number of enrollments down to 4,050. Second, our population was further reduced by patients working with other existing enrollment programs such as the HIV linkage program and Forensic Intensive Recovery (FIR), a drug treatment program.
Also, due to delays in paperwork and hiring, enrollments did not start until October, losing us 3 months. That brought the potential number of enrollments down to 3,038. And the initial 4,050 projection included all the women who entered the jail and left within 24 hours. With that quick a turnaround, I was unable to reach them.
A final operational constraint was that the original prediction accounted for two full-time employees, but I faced hiring and retention issues for a number of reasons (including employee medical issues) which reduced the number of people working on this project at a time.
But I learned a lot through the process and we impacted quite a large number of women. Though we did not hit the initial targets, the project is a clear success given the realities. In one year, I interviewed 1,559 women and complete Medicaid applications for 1,200 women, a success rate of 76.9%.
What have you been doing since your prize year ended? How have you leveraged the skills and connections you made as a PEP winner in your career since then? I hear you’ve expanded the reach of your project to men’s prisons—how is the situation similar or different?
I helped set up the expansion of my program to the six men’s jails at the Philadelphia Department of Prisons (PDP). The process of how to efficiently enroll people into Medicaid and coordinate their first doctors’ appointments post release had been worked out during my first year at the women’s jail so that was really helpful to already have that part be the same. The new challenge was coordinating between the six men’s jails as patients move between jails frequently. It was also different because we were dealing with much higher numbers but all of the connections I had with partnering organizations helped make the transition a little smoother. I was able to set up the expansion so that it could be taken over by PDP.
What’s next for Kriya Patel?
I want to continue to work within the criminal justice system and help with criminal justice reform.
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