In January 2023, California turned into the primary state within the country to be authorized to supply a collection of pre-release healthcare services and products and support get admission to to maintain other folks returning house from jails and prisons. Many different states are actually growing Medicaid re-entry waiver proposals following steering from the Facilities for Medicare and Medicaid Services and products. 

With approval from CMS, Washington state will be offering some Medicaid protection to early life and adults in correctional amenities as much as 90 days sooner than they’re launched, beginning July 1, 2025.

Six states—Illinois, Kentucky, Massachusetts, Rhode Island, Utah, and West Virginia—have pending Medicaid re-entry demonstration waivers. A number of different states, together with Arizona, Montana, New Hampshire, New Jersey, New Mexico, New York, Oregon, and Vermont, are reported to be growing waiver proposals.

Right through a Nov. 14 match hosted by way of KFF, Jennifer Strohecker, Pharm.D., the Medicaid director in Utah, spoke in regards to the efforts in her state. “Like many different states, Utah could be very invested in justice-involved re-entry projects. As we have now now had additional steering from CMS, we’re in point of fact eager about the alternatives this permits for enhancements in that connection of care and continuity of care thru pre-release services and products,” she mentioned. 

“With the speed of psychological sickness in Utah jails being six occasions upper than most people, really extensive gaps in care is what we are noticing. Incarcerated people who could have a substance use dysfunction, who’ve untreated psychological sickness are transferring in the course of the gadget and having gaps,” Strohecker added. “They’re no longer receiving that stage of care we would like. We’re running with our prisons and our jails to in point of fact rise up the infrastructure for this in anticipation that those conversations with CMS shall be transferring against approval of this very important carrier quickly. That is no doubt a high-priority merchandise for us.”

In June 2022 Jami Snyder, who then oversaw Arizona’s Medicaid and CHIP program, mentioned “We would like in an effort to reimburse for services and products when a person is getting ready to depart a correctional atmosphere. We would like in an effort to reimburse for the ones care coordination and case control services and products, so we will get people attached to care briefly after they depart that correctional surroundings thru plenty of suppliers, together with our justice medical institution websites.”


The farthest alongside in this trail is California, which has taken a number of steps in setting up its Justice-Concerned initiative. 

The state is taking steps to handle deficient well being results on this inhabitants by way of setting up pre-release Medi-Cal enrollment methods to make sure people have continuity of protection upon their launch, in addition to get admission to to key services and products to lend a hand them effectively go back to their communities.

The Justice-Concerned Initiative lets in eligible Californians who’re incarcerated to join Medi-Cal and obtain a focused set of services and products within the 90 days sooner than their launch. This initiative objectives to make sure continuity of healthcare protection and services and products between the time they’re incarcerated and when they’re launched. It additionally supplies people who find themselves re-entering the network with the prescribed drugs and sturdy clinical apparatus they want, and get admission to to systems and services and products to beef up this transition.

A number of projects that focal point efforts on making sure Medi-Cal enrollment and advantages upon launch from correctional amenities come with the next:

• Since 2015, state prisons had been required to make use of a standardized procedure for amassing and processing pre-release programs to make sure that JI people are enrolled in Medi-Cal sooner than their go back to the network.

• From 2016 to 2021, 17 counties presented whole-person care (WPC) pilots devoted to serving people reentering the network post-incarceration and feature designed systems to without delay interact native jails and/or probation departments. Those systems have transitioned to grow to be Enhanced Care Control (ECM)/Neighborhood Helps systems in CalAIM.

• Since January 1, 2023, all counties are mandated to enforce pre-release Medi- Cal utility processes in county jails and early life correctional amenities.

• Since January 1, 2023, and as licensed by way of SB 184, Medi-Cal advantages for juveniles and adults is also stored in suspended standing till the person is now not an inmate of a public establishment.

• A 2021 state legislation (AB 133) calls for correctional services and products to enforce a procedure to facilitate referrals to county forte psychological well being services and products (SMHS), Drug Medi-Cal (DMC), the Drug Medi-Cal Arranged Supply Machine (DMC-ODS), and/or Medi-Cal MCPs for incarcerated people who gained behavioral well being services and products whilst incarcerated, to permit for the continuation of behavioral well being remedy. Those referrals are referred to as behavioral well being linkages.

• Controlled care plans are required to supply in depth, community-based care control for people transitioning to the network in the course of the statewide ECM and Neighborhood Helps receive advantages. All people who are eligible for pre-release Medi-Cal services and products and enrolled in controlled care can be eligible to obtain ECM upon launch to the network.

CMS is requiring state Medicaid systems to evaluate whether or not those interventions are having certain affects on well being results and prices. 

As an example, in its letter approving Washington state’s waiver, CMS mentioned that “by way of permitting early interventions to happen within the complete 90-day length straight away previous to anticipated launch, akin to for sure behavioral well being prerequisites and together with stabilizing drugs like long-acting injectable anti-psychotics and drugs for habit remedy for SUDs, Washington expects that it’ll have the ability to scale back decompensation, suicide-related deaths, overdoses, and overdose-related deaths within the near-term post-release. The state will take a look at, and comprehensively overview thru tough hypotheses checking out, the effectiveness of the prolonged complete 90-day protection length sooner than the beneficiary’s anticipated date of launch on attaining those articulated targets of the initiative.”