"The Affordable Care Act (ACA) is expected to help lower county jail healthcare costs, reduce recidivism, and create healthier individuals, families and communities partly because of provisions for expanded Medicaid eligibility and other healthcare affordability measures available to previously uninsured populations, including the offender population in county jails. This guide is meant to help Sheriffs and County Jail Administrators consider practical strategies and suggests steps that support cost savings while producing other benefits through the implementation of healthcare enrollment protocols, education of the inmate population, enrollment assistance and facilitation of the application process upon inmate release" (p. i). Sections of this brief are: why you should implement an ACA plan; some of the expected benefits of provisions of the ACA to county jails and their communities; Step 1-assemble the team and lead from the top; Step 2-determine offender needs/scope; Step 3-develop a screening process and related forms; Step 4-Limited Durable Power of Attorney; Step 5-hire Enrollment Specialists; enrollment reminders; Step 6-educate offenders; inmate program-Healthy Living; Step 7-train and educate staff, and draft procedures; Step 8-track, measure, report (and refine); and facts about the ACA.