Affordable Care Act - General
The answers to the eleven most asked questions about providing health care in a correctional setting as directed by the Affordable Care Act (ACA) are given. This is important information for correctional agencies trying to address the costs they incur in the provision of inmate health services.
[These] guidelines promote the criminal justice partnerships that are necessary to develop successful approaches for identifying individuals in need of services, determining what services those individuals need, and addressing these needs during transition from incarceration to community-based treatment and supervision.
“This course provides an overview of how upcoming changes to California’s health care system will impact local criminal justice systems. Speakers compare and contrast health care in the county corrections systems today with health care in the years to come under the Affordable Care Act. A framework for providing health care to the criminal justice population is presented to facilitate preparations at the county level that can help to maximize criminal justice resources. Highlights include: How improving access to health care can reduce recidivism; Health care for the criminal justice population today and tomorrow--How it will work in 2014 and beyond; [and] Laying out a framework: An overview of the steps criminal justice systems can take to take advantage of health care reform opportunities.” The home website provides access to: course materials including slides from the following presentations: “Public Health and Public Safety: Explaining the Critical Intersection of Healthcare and Recidivism” by Community Oriented Correctional Health Services (COCHS); “Covered California: Understanding Health Benefits” by David Panush; “Counties and Medi-Cal for Inmates: Current Rules – Future Considerations” by Cathy Senderling-McDonald; “Health Care Reform and Medi-Cal: Looking to 2014” by Leonard J. Finocchio; “Covered California: Understanding Health Benefits” by California Health Benefit Exchange; “Public Health and Public Safety: Explaining the Critical Intersection of Healthcare and Recidivism” by Community Oriented Correctional Health Services (COCHS); and “Counties and Medi-Cal for Inmates: Current Rules – Future Considerations” by Cathy Senderling-McDonald; links to course related materials about public health and public safety, healthcare for today and tomorrow, and framework development; and links to other resources.
"This brief provides an overview of the health and mental health needs of girls and boys in the juvenile justice system and the role of Medicaid in addressing those needs. It focuses on the circumstances of those girls and boys who are placed in juvenile justice residential facilities, the discontinuity of Medicaid coverage for those youth, and the options for improving coverage, continuity of care and access to needed services post-discharge, including new opportunities provided by the Affordable Care Act" (p. 1). Sections of this publication cover: profile of youth in the juvenile justice system; types of juvenile justice residential placements; health needs of girls and boys in the juvenile justice system; health services for youth in juvenile justice residential placements; the roles of Medicaid and the Children's health Insurance Program (CHIP); and key issues looking forward. Also includes are these appendixes: "Girls and Boys in the Juvenile Justice by State, 2010" (table); "Girls Health Screen (GHS)"—description; and "Origins of Medicaid's Inmate Exclusion".
Research shows that there are a disproportionate number of justice involved individuals suffering from chronic illness and/ or mental health and substance abuse disorders. We also know that a majority of the justice-involved individuals are young adults and unemployed or earn an income that is well below the federal poverty line leaving them without the ability to obtain health care. There is now an opportunity to enhance collaboration between the criminal justice/corrections and healthcare systems. Early estimates indicate a significant number of justice-involved individuals may be eligible for provisions under the Patient Protection and Affordable Care Act (ACA), specifically; enrollment in Medicaid or the ability to purchase health care coverage through state health insurance exchanges. Because of the many health care expansion possibilities for this population we are witnessing an unprecedented opportunity to help connect the justice population to healthcare coverage and the associated healthcare services.
Federal, state and local criminal justice systems are poised to change the way they do business with the advent of the ACA. It is now possible for millions of low income, justice- involved individuals to obtain healthcare or insurance coverage for their physical and behavioral health needs. This far reaching system change will impact every decision point in the criminal justice system from arrest to individuals returning to the community upon release.
Presented on June 18, 2014, this program informed and increased awareness around this historic healthcare expansion opportunity. The broadcast highlighted promising practices by providing resources and strategies to expand healthcare coverage to justice-involved individuals. During this national discussion and broadcast by the National Institute of Corrections, presenters:
- Established the relevance of the Affordable Care Act to the criminal justice system.
- Provided concrete examples for collaboration and system linkages between the criminal justice system and healthcare system.
- Provided healthcare enrollment strategies to increase informed decision-making between criminal justice and healthcare stakeholders.
“The Affordable Care Act (ACA) sets the stage for a new health-oriented policy framework to address substance use and mental health disorders. By dramatically expanding and funding healthcare coverage to millions of currently uninsured people, the ACA represents a remarkable opportunity for criminal justice and drug policy reform advocates to advance efforts for policies promoting safe and healthy communities, without excessive reliance on the criminal justice solutions that have become so prevalent under the War on Drugs. This paper is intended as a starting framework for criminal justice and drug policy advocates to navigate the ACA, and to take advantage of the conceptual and practical opportunities it offers for shifting the conversation and the landscape” (p. 2). This report is divided into two parts. Part One--Basics Of The Affordable Care Act For Advocates: Insurance; Medicaid Expansion--Healthcare Insurance for Poor and Low-Income; What is Covered? Essential Health Benefits; and Healthcare Access and Coordinated Care Models Under the ACA. Part Two--Putting the ACA to Work for Criminal Justice and Drug Policy Reform: Support Expansion of Medicaid and Other Forms of Healthcare Coverage; Increase Insurance Enrollment of People Currently in the Criminal Justice System; Maintain Active Medicaid Enrollment During Periods of Incarceration; Expand Use of Alternatives to Incarceration; Push for Use of Pre-Booking Diversion Programs (i.e. Front-End Diversion); Promote Changes in the Care Delivery System to Improve Outcomes for People Who Use Drugs; and Advocate for the Decriminalization of Drug Possession and Drug Paraphernalia. Also included is an executive summary.
This presentation from the TASC Institute for Consulting and Training addresses three areas: Why should you pay attention to health care reform? What is health reform? Examples of proactive planning going on now in Cook County (Chicago) and New York State.
"By working together to build a visual portrait of how individuals progress through the criminal justice system, health and justice stakeholders gain better understanding of their respective policies and practices. In addition, mapping allows jurisdictions to consider decision points throughout the entire criminal justice system when exploring opportunities to enroll criminal justice-involved individuals in insurance coverage. This guide is for states and local jurisdictions interested in using system mapping to maximize opportunities for criminal justice and health care system integration and efficiency through the ACA " (p. 3). Sections comprising this document include: the Affordable Care Act (ACA) at a glance; the need for a systems mapping process; the NIC Sample Decision Points Map; and the seven steps of the criminal justice/ACA mapping process. "General health and behavioral health issues with criminal justice-involved individuals intersect. Hence, it is critical that the needs of the population are considered as jurisdictions develop policies and processes to implement the ACA at state and local levels. Bringing together stakeholders from criminal justice, health care, and behavioral health care systems for dialogue around these issues builds increased understanding and collaboration across systems. Using the ACA to do a better job of delivering health care and behavioral health care services to this population not only improves the health of our communities, but makes them safer" (p. 11). Appendixes provide: Sample Intercept Map for ACA Eligibility/Enrollment Priorities; Completed Intercept Map for ACA Eligibility/Enrollment Priorities in Connecticut; and Action Plan Template.
For addtional information on this topic contact NIC Correctional Program Specialist Katie Green.
“This brief outlines opportunities for states and local jurisdictions to improve public health and safety outcomes, and reduce spending on corrections and health care services by maximizing the appropriate use of Medicaid coverage for people involved with the criminal justice system.” Sections discuss: federal Medicaid rules on coverage of criminal justice populations; what Medicaid entails; allowable uses of Medicaid for incarcerated persons; understanding Medicaid enrollment, suspension, and termination; the ACA’s (Affordable Care Act’s) Medicaid expansion—opportunities to increase health coverage for individuals involved with the criminal justice system; opportunities to maximize Medicaid enrollment; state approaches to utilizing Medicaid for justice-involved individuals—North Carolina, New York, and Colorado; special benefits considerations for the Medicaid expansion population; and four opportunities and recommendations for state policymakers. On-site use only
In Alaska, inmate health care comprises approximately 13% of the Alaska Department of Corrections (ADOC) budget and is largely funded through General Fund expenditures.