NYAPRS Note: NYAPRS is committed to safely moving people from institutional settings to the community where they can be better served and live a more productive life while maintaining recovery. For us, these institutional settings include long term state hospitals, adult homes, as well as jails and prisons. Far too many people living with mental health and substance use challenges end up cycling through hospitals and prisons due to the lack of adequate bridging to community and follow up services. As we have mentioned before, getting peers into jails and prisons is a critical step in addressing these service gap issues for individuals being released from criminal justice institutions. We are extremely happy New York State is preparing to apply for a Medicaid Re-Entry Demonstration Waiver to allow for Medicaid services, including pre- and post-release peer support, up to 90 days prior to an individual’s release. While this waiver has great potential, there are many hurdles to getting peers into these settings, including restrictions on past convictions and difficulty getting Department of Corrections and Community Supervision (DOCCS) leadership to allow continued access to carceral settings. NYAPRS will continue to monitor progress on the Re-Entry waiver, while also pursuing other avenues for getting these needed services. One of those avenues is a piece of federal legislation, The Re-Entry Act, sponsored by U.S. Representative Paul Tonko (D-NY). Harvey and I are currently in D.C. to advocate for the passage of the Re-Entry Act and other peer recovery-oriented legislation. See below for more information on the Re-Entry Demonstration Waiver and the Re-Entry Act.
NY Has yet to Enroll in New Medicaid Program for Inmates
By Raga Justin | Times Union | July 10, 2023
ALBANY — New York is gearing up to take advantage of a federal program that would expand health insurance coverage to people across state and local correctional facilities — an unprecedented move that policymakers and advocates hope will ease the often rocky transition for recently released inmates returning into communities across the state.
It is the first time Medicaid will offer health care coverage for inmates, following the recent approval of California’s successful petition to the federal Centers for Medicaid and Medicare Services to use funding from the federal government for the same purpose. States can now take advantage of Medicaid’s matching funds to provide a specific suite of health care services for New Yorkers who are still in state prisons or jails in the months leading to their release.
Though national policymakers greenlit the funding opportunity earlier this year, New York is not currently taking advantage of the program, which stands to benefit thousands of inmates who often require medical attention while incarcerated.
But that could change soon. A state Department of Health spokeswoman said the agency is still negotiating the final conditions of a larger expansion of Medicaid coverage. That expansion – which involves a request for more than $13.5 billion from the federal government – in part would dovetail with the program to ease inmates’ reentry into the state.
“Providing targeted Medicaid services to incarcerated individuals prior to their release is part of the department’s strategy to address health disparities and improve health equity,” spokeswoman Cadence Acquaviva said in an emailed statement.
A longstanding exclusion prohibits Medicaid payments for most services for people held at a state or county correctional facility. But the recent changes would allow states to skirt Medicaid requirements and use funds to better transition people leaving correctional facilities into health care coverage.
If other states follow California’s example, they could cover health care services up to 90 days prior to an inmates’ scheduled release date. The federal government will provide a 90 percent match for states that take advantage of the program.
“The federal dollar is really a very important kind of carrot for states to move forward,” said Gabrielle de la Guéronnière, a legal policy director with the Legal Action Center. “There are tremendous unmet health needs that people have in incarceration, and that has an impact on people’s lives. People are dying of overdose, people are dying by suicide.”
The link between the criminal justice system and those suffering from addiction is well-documented. Approximately 83 percent of inmates in New York need some sort of substance use treatment upon release, according to a report the state submitted last year to the Center for Medicare and Medicaid Services.
Recently passed New York legislation requires jails and prisons across the state to provide medication-assisted treatment to inmates with substance use issues. Without ongoing treatment, there is an increased risk of overdose within the first few weeks following release, according to the National Institute on Drug Abuse.
Nationally, around 80 percent of people released from prison in the U.S. each year have a substance use disorder or chronic medical condition, including mental health issues. And once they leave, their health care needs can spike. Visits to emergency departments, inpatient hospital stays and psychiatric admissions occur at high rates in the weeks immediately after a person is released. Voluntary medical care is less likely, according to a 2022 petition from New York to CMS.
“Even under the best of circumstances, when a person is discharged … there is a high likelihood they will not engage with critical service providers when they re-enter the community,” the petition reads.
Lawmakers and public health experts contend that medical treatment can help reduce negative outcomes when inmates struggling with an addiction are released back into the community abruptly. And advocates have cheered the recent changes to the Medicaid guidance, calling it a game changer that could potentially reshape systems of care for the state’s most medically vulnerable groups, as well as reduce recidivism.
“This is a very big deal,” de la Guéronnière said. “This is something that we think will help people be healthier and help people avoid additional contact in the criminal legal system.”
She also pointed to federal legislation – sponsored by U.S. Rep. Paul Tonko, a New York Democrat– that could codify the measure. Tonko said his “Reentry Act” pending in Congress would shift the cost burden from local correctional facilities and hopefully increase the political will to provide robust health care for inmates.
“So many state and local governments find that these systems of jails and prisons are under-invested,” Tonko said, adding “This is about saving lives. And doing it with science and evidence-based opportunities.”
NY yet to enroll in unprecedented Medicaid program for inmate care (timesunion.com)