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Medicaid

“Determining how to provide effective mental health treatment for youth involved in the juvenile justice system – and ensuring that it continues after they exit detention – is one of the most complex challenges facing this system. This report examines how one jurisdiction, Bernalillo County, New Mexico, has taken extraordinary steps to address this challenge by ensuring Medicaid eligibility for detained youth and establishing a licensed, free-standing community mental health clinic adjacent to it detention facility. The report also provides an overview of how the county became an active site in Casey’s Juvenile Detention Alternatives Initiative and details how their new mental health clinic is being operated and financed, and the lessons emerging from their innovative approach.” Nine chapters make up this report: understanding the mental health challenge for juvenile detention reform; Bernalillo—becoming a model JDAI site; Bernalillo’s mental health challenge; organizing and building a mental health clinic; nuts and bolts of the clinic; assessing the clinic’s impact; key advantages of the onsite clinic; issues and challenges for Bernalillo County and lessons learned; and questions and implications for other jurisdictions.

Bernalillo County Mental Health Clinic Case Study Cover

"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".

Health Coverage and Care for Youth in the Juvenile Justice System: The Role of Medicaid and CHIP Cover

"Medicaid allows for—and the federal government encourages—continued eligibility for coverage for a person who is incarcerated. Although the ACA [Affordable Care Act] did not address suspension versus termination, for states that are expanding Medicaid the number of inmates eligible for coverage will increase dramatically and the benefits to counties of suspending instead of terminating their coverage will be substantial" (p. 1). This brief addresses issues associated with suspending Medicaid coverage for prisoners. Sections cover: why ensuring access to Medicaid post-release is important to counties; access to treatment positively impacts public safety; what the difference is between suspension and termination of Medicaid coverage; states that suspend rather than terminate; what counties can do with highlights from Maricopa County (AZ), Salt Lake City (UT), California, and Oregon.

Health Coverage and County Jails: Suspension vs. Termination Cover

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.
Health Reform and Public Safety cover

"This webinar explains and clarifies the issues related to allowable uses of federal Medicaid funds for incarcerated individuals, and provides an example of how corrections departments can leverage cost savings as a result. The discussion focuses on the challenges related to implementation and establishment of cross-agency collaboration, and the subsequent successes and cost savings that can be achieved." The agenda of this webinar is: "Introduction" by Fred Osher; "Financing Health Care for Individuals Involved in the Criminal Justice System" by Gabrielle de la Gueronniere; "An Introduction to Medicaid Eligibility and the Application Process" by Terri L. Catlett, Larry Huggins, and William Appel; and "Moderated Q&A Session" moderated by Osher.

Maximizing Medicaid: An Innovative Approach to Finance Health Care for Criminal Justice Populations [Webinar] Cover

"Meaningful use is the linchpin of the Medicare and Medicaid EHR Incentive Programs, established under the Health Information Technology for Economic and Clinical Health (HITECH) Act to provide incentive payments to eligible providers that adopt and demonstrate “meaningful use” of certified EHR [electronic health record] technology. Providers demonstrate meaningful use by “attesting” to certain criteria for different stages of meaningful use … This article provides an overview of the meaningful use landscape, emphasizing the applicability of meaningful use to health care provided in jails, as well as exploring the benefits and difficulties of participating in this program for jail health care providers. It also describes the steps that jail health care systems must pursue in order to participate in meaningful use" (p. 1). Sections of this paper cover: issue introduction; what meaningful use is; benefits of meaningful use for correctional health services; obstacles to jail participation in meaningful use; correctional institutions participating in meaningful use; steps toward eligibility; impact of meaningful use on correctional health systems; and concluding observations.

Meaningful Use and Corrections: Unknown Opportunities Cover

This webinar will: define roles that criminal justice professionals play in Medicaid Administrative Claiming (MAC) and Targeted Case Management (TCM); define service needs of justice involved individuals; highlight community corrections and criminal justice agency examples of resource utilization; explain strategies for meeting increased demand for healthcare services under the Affordable Care Act; and differentiate between MAC and TCM. The webinar aims to: demonstrate that MAC and TCM are excellent fits with day to day activities that Probation Officers and Parole Agents provide; and walk through the process to assist interested individuals in getting MAC/TCM up and running in their locales.

Medicaid Administrative Claiming and Targeted Case Management Cover

“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

Medicaid and Financing Health Care for Individuals Involved with the Criminal Justice System Cover

"Financing health care for inmates can be a significant portion of state correctional spending for some states with health care costs ranging from an estimated 6 percent to 33 percent of institutional corrections spending in 2008, the most recent estimate available. The combination of expanded Medicaid eligibility and enhanced funding for those newly eligible as allowed under PPACA [Patient Protection and Affordable Care Act] gives states additional incentives to enroll inmates in Medicaid and obtain federal matching funds, and increases the federal responsibility for financing allowable services for inmates. Questions exist about the potential costs to the federal government, because little is known about how many inmates are eligible for Medicaid or the extent to which states are obtaining federal matching funds for allowable services … In this report, we provide information on the proportion of inmates eligible for Medicaid, and state efforts to enroll inmates in Medicaid and obtain federal matching funds for allowable services" (p. 2). While a large percentage of inmates will be eligible for Medicaid in the 27 states that have expanded Medicaid eligibility, only a very small percentage will be eligible for federal Medicaid funds. The impact to federal spending will be extremely limited.

Medicaid: Information on Inmate Eligibility and Federal Costs for Allowable Services Cover

"People leaving prison often return to the community lacking health insurance and thus access to appropriate health care. Many have mental illness, substance abuse, and other health issues that need treatment and compound reintegration challenges. Left untreated, they are at risk of falling into a cycle of relapse, reoffending, and reincarceration. Providing Medicaid coverage upon release has the potential to improve continuity of care that may interrupt this cycle. This report examines whether efforts to enroll people in Medicaid prior to their release from prison are successful in generating health insurance coverage after release. Urban Institute (Urban) researchers analyzed data from Oregon’s pre-Affordable Care Act (ACA) Medicaid program to determine the extent to which released prisoners successfully gained coverage" (p. 1). The results from this study my help your state in ensuring continuity of care for newly released offenders.

Prison Inmates' Prerelease Application for Medicaid Cover

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