NYAPRS Note: In New York State, too many of those coming out of jails and prisons – especially those with behavioral health conditions – fall through the cracks because of ineffective transition and discharge planning and a lack of Medicaid reimbursement for such activities.
Assembly bill A.9320 seeks to change that by allowing Medicaid to provide coverage for inmates with serious behavioral health conditions 30 days prior to their release to support the “warm handoffs” critical to transition.
Additionally, there is $5 million set aside to build health homes for justice-involved individuals to ensure that those being released from jails and prisons have access to the specialized services they require upon discharge.
NYAPRS – in partnership with MHANYS and the Legal Action Center – is fervently advocating for the passage of this legislation, as well as immediate access to the health home dollars. Indeed, we are counting on the Cuomo administration and the Legislature to get this done in an effort to help save countless lives.
NYS Advocates Seek Changes To Medicaid Rules For Inmates
Mental Health Weekly March 21, 2016
New York state mental health advocates are working to support a legislative proposal to expand crisis intervention services across the state and support re-entry strategies for people with serious mental health and addiction-related issues. The move is also part of an effort to help justice-involved individuals avoid relapse
“There is a real crisis that exists in the criminal justice system for people with behavioral health conditions,” Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services (NYAPRS), told MHW. “The real problem is how do we get people successfully transitioned out of the criminal justice system.”
Rosenthal added, “The biggest impediment to success transition lies in the fact that many people fall through the cracks upon discharge because there isn’t a successful transition plan or Medicaid reimbursement to fund it.”
“The state can’t do it by itself,” he said. The Assembly bill, A. 9320, would require the state to seek federal authority to provide Medicaid coverage for inmates with serious behavioral health conditions 30 days prior to their release, he noted. The budget proposal would expand crisis intervention teams (CITs) across
the state, and addresses diversion, prison care and re-entry efforts.
The days leading up to getting discharged are critical, Rosenthal noted. “We can only do so much to avoid relapse, homelessness and other tragedies,”
he said. There is no Medicaid reimbursement to pay for transitional supports, such as care coordination and medical and behavioral health care. The state budget bill includes language that would make rate adjustments for new specialized health home pilots to enroll and support incarcerated individuals with serious behavioral conditions.
Right supports needed
Rosenthal pointed to a new study released by University of North Carolina at Chapel Hill researchers and published in Psychiatric Services in Advance that found
that expedited Medicaid enrollment for inmates with serious mental illness increased use of mental health services but did not reduce criminal recidivism.
“It’s not only important to have funding for transition support; it’s critical to have the right kinds of support [in place],” he said. New York state has developed health homes, which are accountable care organizations.
Accountable care coordination and service network providers coordinate wraparound services for people with the most serious behavioral needs, said Rosenthal. “We have $5 million set aside to build health homes for justice-involved individuals. We had a technicality that prevented us from starting up in this budget,” he said.
The funding request is in the Assembly budget bill. “Starting Medicaid early is only half the work,” said Rosenthal. “We have to make sure they’re leaving with and going to the right kinds of specialized support. That’s what our health homes will do.”
“We believe there’s support here from the Assembly and the administration,” he said. Rosenthal said advocates will now be seeking support from the Senate.
The proposal is supported by NYAPRS, the Mental Health Association in New York State (MHANYS) and the Legal Action Center.
In a letter to lawmakers to address the need to ensure prisoners with mental illness and chemical dependency issues receive treatment to avoid relapse and recidivism, Rosenthal and MHANYS Executive Director Glenn Liebman stated that advocates have worked hard to achieve recent and current legislative proposals to expand CITs and landmark prison reforms associated with passage of special housing unit exclusion legislation.
Rosenthal added, “I’m sure that what we’re proposing here is of national significance. These proposals could go a long way to saving lives and dollars.”