California to Offer Medi-Cal to People Transitioning from Prisons and Jails
First-in-nation program will help reduce suicide, homelessness, and recidivism, and boost health equity
On January 26, 2023, California became the first state in the nation approved to offer Medi-Cal services to youth and eligible adults in state prisons, county jails, and youth correctional facilities up to 90 days before release. Under the justice-involved waiver, approved by the Centers for Medicare & Medicaid Services, Medi-Cal will partner with state agencies, counties, and community-based organizations to establish a coordinated community reentry process that will help connect people to the health services they need before leaving incarceration.
By addressing the unique and considerable health care needs of California’s justice-involved individuals, this initiative will advance health equity across the state. These services should result in reduced gaps in care, improved health outcomes, and the prevention of unnecessary admissions to inpatient hospitals, psychiatric hospitals, nursing homes, and emergency departments. They should also help to reduce overdose, suicide, homelessness, and recidivism.
To learn more about what the justice-involved waiver will achieve, we spoke with Sydney Armendariz, Chief of the Justice Initiative Branch in DHCS’ Office of Strategic Partnerships.
How is it helpful for youth and eligible adults in state prisons, jails, and youth correctional facilities to enroll in Medi-Cal prior to release and receive comprehensive Medi-Cal services?
It will definitely help people coming out of correctional facilities and reentering their community. By connecting eligible adults and youth to providers and services in their community so that they can continue to get the care they need, such as substance use disorder treatment or a mental health provider, for example, we’re ensuring that they can have an easier time returning to their communities and won’t have lapses in care. With more support, these services can help reduce rates of post-release illness and overdose death in the initial weeks after returning to the community.
Also, through this program, we hope to improve health outcomes and reduce health disparities among justice-involved people in California. We’re really excited to be able to offer these services.
How will this help advance health equity in California?
Californians of color are disproportionately incarcerated at sometimes alarming rates, and that includes mental health and substance use disorder related offenses. This initiative will improve health outcomes by connecting people to physical and mental health and substance use services upon, or even prior to, release in order to get them the care that they need so they can successfully reenter their communities.
What is the current process like for justice-involved individuals reentering the community?
I have talked to a lot of people exiting prisons and jails. The stories they shared were alarming. They returned to their communities and didn’t know where their family was or what jobs were available to them. Many people I talked to didn’t even know what health insurance was or how to get their medication prescription filled. It’s not very encouraging to be in that kind of situation.
With the new justice-involved initiative, individuals will have access to services like a case manager who can help set up a transition plan to make sure the person reentering the community has access to the resources they need and knows where to find those resources, and ensures the person’s health care needs are addressed. This means making sure a person leaves prison or jail with a supply of medications or medical equipment they need–like a wheelchair. These are things that people exiting incarceration might not know how to get on their own. We hope these services paint a more encouraging picture for someone post-release.
When will this actually start in jails and prisons?
We expect pre-release Medi-Cal services to go live between April 2024 and March 2026. Correctional facilities will have the flexibility to determine their launch date within that two-year period. To prepare for the go-live, we’re working closely with the California Department of Corrections and Rehabilitation and with probation, county, behavioral health, and social services departments to determine their readiness to launch this process. We also plan to work closely with our Medi-Cal managed care plans and community-based providers partners in this vital work. Services won’t begin immediately, but our current planning efforts are crucial to making sure we get it right when we go live in April 2024
California is the first state to get approval to provide Medicaid services to eligible justice-involved adults and youth. Do you expect other states to extend Medicaid to people in jail and prison close to release?
Yes. As of 2023, 14 other states are seeking partial waivers to the inmate exclusion policy to provide pre-release services to eligible incarcerated people. What this means is that states are asking the federal government for permission to do what California is doing. Our justice-involved initiative will serve as the blueprint for other states with pending waivers for similar initiatives.
