Today, the federal Centers for Medicaid and Medicare Services
(CMS) notified California that it is the first state in the
nation to receive approval to offer a targeted set of Medicaid
services to youth and adults in state prisons, county jails, and
youth correctional facilities for up to 90 days prior to release.
Through a federal Medicaid 1115 demonstration waiver, the
Department of Health Care Services (DHCS) will work with local
partners and stakeholders to establish a coordinated community
re-entry process to assist individuals leaving incarceration to
connect to the physical and behavioral health services they need
upon release.
Until now, due to a provision of federal Medicaid law known as
the “inmate exclusion,” inpatient hospital care was the
only service that could be covered by Medicaid for incarcerated
individuals. According to DHCS, more than one million adults
and youth enter or are released from California prisons and jails
annually, and at least 80 percent of these justice-involved
individuals are eligible for Medi-Cal.
The intent of the demonstration is to build a bridge to
community-based care for justice-involved Medi-Cal members,
offering them services to stabilize their condition(s) and
establishing a re-entry plan for their community-based care prior
to release to improve health outcomes and prevent unnecessary
admissions to inpatient hospitals, psychiatric hospitals, nursing
homes, and emergency departments, and reduce overdose, suicide,
homelessness, and recidivism.
The waiver additionally authorizes $410 million for Providing
Access and Transforming Health, Justice-Involved Capacity
Building grants to support collaborative planning, and IT
investments intended to support implementation of pre-release and
reentry planning.
DHCS’s full press release on the announcement is available
here. For more details on the initiative, please see
the DHCS
Justice-Involved webpage.
