NYAPRS, MHANYS Back Proposal to Extend Medicaid 30 Days Before Prison/Jail Release

NYAPRS Note: In keeping with our long and strong commitment to advancing the needs of criminal justice-involved individuals with behavioral health conditions, NYAPRS is working with groups including the Legal Action Center and MHANYS to drum up support amongst the Governor and legislature for language changes and a Medicaid waiver application to extend Medicaid to individuals with serious behavioral health conditions 30 days before discharge from prisons and jails. Below is copy of a letter we are sending this morning to top Administration and legislative officials.

NYAPRS is also supporting Assembly bill language that would make rate adjustments for new specialized health home pilots to enroll and support incarcerated individuals with serious behavioral health conditions.

Ensuring Prisoners with Mental Illness and Chemical Dependency Issues Receive Treatment to Avoid Relapse and Recidivism

NYAPRS and MHANYS share a long commitment to supporting initiatives that help divert New Yorkers with serious behavioral health conditions from avoidable incarcerations, ensure appropriate treatment and prison conditions when incarcerated and in support of effective re-entry strategies and successful community transitions to reduce avoidable relapses and recidivism.

That’s why we have worked to achieve recent and current legislative proposals to expand Crisis Intervention Teams as well as landmark prison reforms associated with the passage of SHU (solitary confinement) Exclusion legislation.

And that’s why we are in strong support of a current proposal, included in this year’s Assembly budget bill, to support successful re-entry strategies for people with ‘high needs’ associated serious mental health and addiction related conditions.

While the Governor has given robust attention to these issues via last year’s OMH transitional support initiatives and the creation of DOH criminal justice focused health homes, such reforms are incomplete, insofar as incarcerated individuals who are Medicaid-eligible cannot receive Medicaid-covered services prior to release under current state and federal law. As result, individuals are not able to get the medications and services that best enable them to transition to the community and avoid relapse and recidivism.

We are joining with the Legal Action Center and other groups in our strong support of a change in the Social Services Law and a waiver or other authorization from the Federal Centers for Medicare and Medicaid Services that would allow Medicaid coverage of such services, and reduce unnecessary health care, criminal justice and related costs for such individuals, as well as the likelihood that they will commit additional crimes

This change would achieve the essential goal of extending Medicaid coverage to “high needs” individuals 30 days immediately prior to release for incarceration for services required as part of successful transition plan to the community, while also accruing state and local savings from avoided relapse and hospitalization of justice-involved individuals, and from federal Medicaid matching funds for care provided prior to release.

Furthermore, the vast majority of those who are incarcerated would be eligible for the increased federal Medicaid match, which will eventually rise to 90% as a result of the Affordable Care Act. As a result, the upfront cost to the State would be very small, thereby increasing the size of the savings to the State

The proposal would directly support New York State’s ongoing effort to provide high-quality, comprehensive care to New Yorkers who need it the most.

Proposed Amendment to Social Services Law Section 366(1-a)

In order to implement this proposal, state law would need to be amended to allow Medicaid coverage to be provided prior to release. This could be accomplished by the following language:

Social Services Law sec. 366(1-a):

1-a. Notwithstanding any other provision of law, in the event that a person who is an inmate of a state or local correctional facility, as defined in section two of the correction law, was in receipt of medical assistance pursuant to this title immediately prior to being admitted to such facility, such person shall remain eligible for medical assistance while an inmate, except that no medical assistance shall be furnished pursuant to this title for any care, services, or supplies provided during such time as the person is an inmate; provided, however, that nothing herein shall be deemed as preventing the provision of medical assistance for inpatient hospital services furnished to an inmate at a hospital outside of the premises of such correctional facility OR PURSUANT TO OTHER FEDERAL AUTHORITY AUTHORIZING THE PROVISION OF MEDICAL ASSISTANCE TO AN INMATE OF A STATE OR LOCAL CORRECTIONAL FACILITY, to the extent that federal financial participation is available for the costs of such services. Upon release from such facility, such person shall continue to be eligible for receipt of medical assistance furnished pursuant to this title until such time as the person is determined to no longer be eligible for receipt of such assistance. To the extent permitted by federal law, the time during which such person is an inmate shall not be included in any calculation of when the person must recertify his or her eligibility for medical assistance in accordance with this article. THE STATE SHALL SEEK FEDERAL AUTHORITY TO PROVIDE MEDICAID COVERAGE FOR TRANSITION SERVICES FOR HIGH NEED INMATES FOR 30 DAYS PRIOR TO RELEASE.

Please feel free to contact us about these issues,

Harvey Rosenthal Glenn Liebman

NYAPRS Executive Director MHANYS CEO