Fourteen States Seek to Follow California in Providing Pre-Release Services
In January, the Centers for Medicare & Medicaid Services announced that California would become the first state to provide a set of pre-release healthcare services and improve access to care for people returning home from jails and prisons. Now 14 other states are seeking similar approvals from CMS.
CMS approved a first-of-its-kind section 1115 demonstration amendment that will allow Medi-Cal to be able to cover substance-use treatment before a Medicaid beneficiary is released from jail, prison, or youth correctional facility. Additionally, the state will be able to help connect the person to community-based Medicaid providers 90 days prior to their release to ensure they can continue their treatment after they return to the community.
California’s approval coincides with a new report produced by the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) examining the significant health coverage and continuity-of-care needs justice-involved individuals face returning to the community. These include disproportionately high rates of substance use disorder (SUD), serious mental illness, and infectious and other chronic physical health conditions. The report discusses opportunities, like Medicaid section 1115 demonstrations, to improve health and healthcare transitions.
A policy watch item from the nonpartisan KFF (also known as The Henry J. Kaiser Family Foundation) details how 14 other states are approaching providing services to justice-involved individuals.
The KFF researchers Sweta Haldar and Madeline Guth found that most of these states intend to provide coverage to eligible inmates 30 days prior to release. Three states (New Hampshire, New Jersey, and Vermont) seek to provide coverage between 45 and 90 days prior to release. Kentucky proposes to provide fee-for-service benefits for the duration of an inmate’s commitment and through a managed care organization beginning 30 days prior to release. The other two states (Oregon and Massachusetts) would cover some inmates throughout the duration of their commitment, while covering other groups for a more limited pre-release period.
The report said four states (Oregon, Rhode Island, Vermont, and Washington) are seeking to provide benefits to all inmates of state and county facilities. The remaining states would limit these services to inmates who meet health or risk criteria (frequently related to behavioral health needs).
Finally, four states (Massachusetts, Rhode Island, Utah and Vermont) seek to provide full Medicaid State Plan benefits to eligible inmates during the pre-release period. Oregon proposes to provide full benefits to individuals in jail, while state prison inmates would receive a limited package of care coordination services. The remaining states would provide a limited benefit package for all eligible inmates (typically to include services such as reentry support, enhanced case management, and behavioral healthcare).
