Urge CMS to Approve NY's Request to Restore Medicaid 1 Month Before Prison/Jail Discharge!

NYAPRS Note: One of our top legislative priorities and successes this past NYS legislative session was to work with our colleagues to help win legislative and Executive approval for New York to apply to the federal Medicaid agency (CMS) for approval to extend Medicaid benefits a month before discharge from prison and jail. Here’s an excerpt from New York’s waiver request below. You can see the entire request at https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ny/ny-partnership-plan-pa4.pdf.

Now, it’s up to advocates for this landmark proposal to urge CMS to approve it: please go to https://public.medicaid.gov/connect.ti/public.comments/answerQuestionnaire?qid=1888355 today!

“ New York State Department of Health (NYSDOH) is submitting this request to the federal Centers for Medicare & Medicaid Services (CMS) to amend the 1115 Waiver, seeking the following changes:

NYSDOH is requesting an authorization of federal Medicaid matching funds for limited and targeted Medicaid services to be provided in the 30-day period immediately prior to release to incarcerated individuals who are eligible for and enrolled in Medicaid, and are eligible for New York’s Health Home program (i.e., they have two or more chronic physical/behavioral conditions, serious mental illness (SMI) or HIV/AIDS).

The goals are to establish linkages to health care prior to release to help ensure individuals can remain healthy and stable in the community. The Amendment will also facilitate the goals of Delivery System Reform Incentive Payment (DSRIP) program to reduce avoidable hospitalizations and health care costs, as well as improve health outcomes.

The covered Medicaid services to be made available during the 30-days prior to release from the correctional facility are:

  • Health Home care management, including outreach, enrollment and development of a care plan;
  • Limited clinical consultation services provided by community based medical and behavioral health practitioners to facilitate continuity of care at post release; and
  • Certain medications including long acting or depot preparations for chronic conditions (e.g. schizophrenia, substance use disorders) or suppressive or curative medications (e.g. HIV, hepatitis C) that would support longer term clinical stability post release.

Individuals released from incarceration often experience significant barriers to successful community re-entry. Research supports that a disproportionate number of persons are incarcerated with behavioral health conditions (i.e., substance use disorders and mental health diagnoses) as well as HIV/AIDS and other chronic diseases. The ability to provide Medicaid services during the 30-day period prior to release will help to bridge the gap in connectivity to health care services for incarcerated individuals as they re-enter the community.

Specifically, the Amendment will provide incarcerated individuals the ability to:

  • Effectively engage with a Health Home care manager to begin to develop an integrated care plan that identifies medical, behavioral health and social needs to support a stable and successful community life;
  • Establish relationships with critical community based medical and behavioral health professionals prior to discharge; and
  • Receive appropriate stabilizing medications prior to release to facilitate maintaining medical and psychiatric stability while facing the challenges of transitioning back to the community.