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Center for Mental Health and Addiction Policy

State and Local Initiatives to Enroll Individuals in Medicaid in Criminal Justice Settings

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Prepared by

Sachini Bandara, Lauren Riedel, Beth McGinty, Colleen Barry, and Haiden Huskamp

Supported by

The Laura and John Arnold Foundation

Given the changing landscape of insurance eligibility under the Affordable Care Act (ACA) and the significant overlap between those newly eligible for Medicaid and the justice-involved population, many state and local jurisdictions have launched programs to enroll detained or incarcerated individuals in Medicaid.

This inventory attempts to capture a national picture of the enrollment efforts that are taking place within these jurisdictions. More specifically, this inventory includes programs directly associated with county and state corrections departments to initiate Medicaid enrollment of justice-involved individuals during detention, incarceration, or the release process. The inventory does not include community-based organizations and clinics, such as the Transitions Clinics, that initiate and conduct Medicaid enrollment of clients who have a history of criminal justice involvement exclusively in community settings. The information in the inventory is current as of January 2015 and includes a total of 64 programs.

Programs were identified between June and December 2014 using two data collection strategies: 1) referral by policy experts around the country who were aware of specific programs, and 2) review of publicly available information including published research, news media reporting, and other public documents. We made initial contact with personnel running programs in each jurisdiction by email and/or telephone to develop a standardized program summary, and then to validate the accuracy of the final program summary. Summaries were compiled using a coding instrument to categorize the key components of each program including: program setting, the personnel enrolling justice-involved populations, the target enrollment population, and the time point when justice-involved individuals are screened for Medicaid eligibility.

Definitions of Fields:

  • SETTING: Criminal justice setting where enrollment takes place (jail, prison, probation/parole, other)
  • POINT OF SCREENING: Time point when inmates are screened for Medicaid eligibility (during booking, during incarceration, during release, post-release)
  • ENROLLMENT PERSONNEL: Personnel who screen and enroll individuals in Medicaid (corrections staff, community-based organization/non-profit organization, public health department/social service agency/other health agency, other personnel)
  • TARGET POPULATION: Whether program targets a specific portion of those justice-involved individuals eligible for Medicaid, or screens and enrolls all individuals eligible for Medicaid (general population, serious mental illness, substance use disorder, chronic disease, other special population)

This study was supported under a grant to Johns Hopkins Bloomberg School of Public Health and Harvard Medical School from the Laura and John Arnold Foundation.

We thankfully acknowledge assistance from Californians for Safety and Justice in connecting us with a number of the programs in counties in California and from the early adopters in the Open Societies Foundations Medicaid Jail Enrollment Initiative.

Prepared by:

Sachini Bandara, M.S.
Doctoral Student
Johns Hopkins Bloomberg School of Public Health

Lauren Riedel
Project Director
Harvard Medical School

Beth McGinty, PhD, M.S.
Assistant Professor
Johns Hopkins Bloomberg School of Public Health

Colleen Barry, PhD, MPP
Associate Professor
Johns Hopkins Bloomberg School of Public Health

Haiden Huskamp, PhD
Harvard Medical School