California Becomes First State to Expand Medicaid to Incarcerated People – State of Reform

On Thursday, California became the first state in the nation to offer a specific set of Medicaid services to youth and adults in state prisons, county jails and juvenile correctional facilities up to 90 days prior to release. Prior to this announcement, services were generally available after release from incarceration.

The California Department of Health Care Services (DHCS) will establish a coordinated community re-entry process through the federal government. Medicaid Demonstration Waiver 1115that will connect people leaving prison settings with the physical and behavioral health services they need upon release.

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“Californians re-entering the community after incarceration have significant physical and behavioral health needs and are at high risk of injury and death, especially in the days and weeks immediately following their release,” said the state’s Medicaid director. , Jacey Cooper.

People of color are disproportionately incarcerated. In California, approximately 29% of the male prison population is black, despite accounting for 6% of California’s male population, according to the DHCS. Formerly incarcerated individuals are more likely to experience negative health outcomes and face higher rates of physical and behavioral health diagnoses.

DHCS states that the number of people incarcerated in California jails and prisons who are in active care for mental health issues has increased by 63% over the past decade, and about 66% of people in California prison settings have a moderate or high need for substance use. treatment of the disorder. In the two weeks after release from incarceration, overdose death rates are more than 100 times higher compared to the general population, according to the DHCS.

“Our justice-related initiative is a key part of the state’s plan to create a new standard of care that is person-centered and equitable for all Californians, including current and former inmates,” Cooper said.

The waiver will provide earlier appropriate healthcare interventions to reduce acute service use and adverse health outcomes, including decompensation, suicide-related death, overdose, overdose-related death, and death from all Causes. The waiver will also improve coordination and communication efforts between correctional systems, Medicaid systems, and community providers. According to DHCS, more than one million adults and youth enter and leave state correctional facilities each year, and at least 80% of these individuals are eligible for Medi-Cal.

“Historically, Californians residing in prisons, jails and juvenile detention centers experience gaps in their health care services and transition back into their communities with limited services and without a robust plan,” said the Secretary of the Agency for California Health and Human Services, Dr. Mark Ghaly, said.

Ghaly explained how people living with HIV, high blood pressure, diabetes, epilepsy, cancer, schizophrenia or addictions can now expect to have extra support by getting the medicines, appointments and services they need when they are released from prisons and jails.

“Through this initiative, those who are released from prison settings will have access to services that will make it less likely that they will go directly from a prison setting to an emergency room or hospital,” Ghaly said. “This initiative will have a lasting impact on people as they return to the community by providing stable and reliable access to the care they need. We extend our gratitude and appreciation to our federal partners for their innovative spirit and collaborative partnership.”

CMS approved California’s first demonstration amendment to section 1115 that makes this coverage possible. Pre-release services for incarcerated individuals will focus on comprehensive care management, including physical and behavioral clinical consultations, labs and radiology, medication assisted treatment (MAT), community health worker services, medications, and durable medical equipment .

Those who are eligible will be assigned a care manager in the prison setting or via telehealth to establish relationships, understand health needs, coordinate vital services, and plan for community transition, such as connecting individuals with managers community-based care to work. with the release.

“In partnership with HHS, the State of California is leading the way in providing coverage to those involved in justice,” said HHS Secretary Xavier Becerra. “This is the first time in history that Medicaid will cover people connected to justice before they are released. It is a step forward in closing the gaps in services experienced by this underserved community, and I encourage other states to follow California’s example.”

State of Reform contacted DHCS and did not receive a response at the time of publication.