PT: NYS State Wants To Expand Medicaid Into Jails, Prisons

NYAPRS Note: NYAPRS is in very strong support of a current proposal, included in this year’s Executive Budget, to seek federal approval to provide Medicaid coverage to individuals in the criminal justice system during their last 30 days of incarceration for medical, pharmaceutical, and behavioral health care coordination services. The program would be aimed at “high-risk” groups such as those with HIV, mental illness, drug addiction or chronic conditions such as asthma or diabetes. That could include nearly 100,000 people in state correctional facilities, Rikers Island and upstate county jails.

Currently, incarcerated individuals who are Medicaid-eligible cannot receive Medicaid-covered services prior to release under current state and federal law.

As a result, these individuals are not able to get the medications and services that best enable them to successfully transition to the community and avoid relapse, recidivism and tragedy, including a 12-fold rise in the risk of death in the first two weeks post-release.

Last year, NYAPRS successfully joined with the Legal Action Center and other advocates to help win a change in the Social Services Law that authorized the state to seek this federal waiver. If New York is able to gain federal authorization to implement this waiver, we will be the first state in the nation to take such a huge step in transforming the criminal justice system from a punishment to a treatment-focused model.

While this measure does not require any legislative action this year, it is one of NYAPRS’ top NYC policy priorities this year and will be covered at our February 26th Annual Albany Legislative Day. See our next posting for more information.

State Wants To Expand Medicaid Into Jails, Prisons

By Dan Goldberg Politico  January 24, 2019

New York hopes to become the first state to provide Medicaid coverage to prisoners up to 30 days before their release.

Gov. Andrew Cuomo announced during his budget address last week that the state health department would ask the Trump administration for permission to expand the health insurance program into prisons and jails, and, in a second and separate request, would ask permission for Medicaid to be used for housing-support services.

Currently, states are prohibited from using Medicaid money to cover inmates unless they are taken to a hospital, meaning that medicines, mental health treatment, or substance abuse treatment are paid for by the county or state.

This is the second time the Cuomo team has asked to cover inmates. In late 2016, the health department submitted a similar request but rescinded it after Donald Trump's victory over Hillary Clinton.

The fear at the time was that the new administration would use requests as a pretense to examine other state Medicaid programs, possibly restricting liberal offerings. But two years later, officials in the state health department say that is no longer a concern and they are encouraged by CMS Administrator Seema Verma’s push to give states flexibility in managing their Medicaid program.

The SUPPORT Act, H.R. 6 (115), which Trump signed in October, directed CMS to issue a letter explaining how states could design programs to improve care for those eligible for Medicaid and soon to be released from public institutions such as prisons. The letter has not yet been published but Congress’ direction is why state officials believe their request could be approved.

Greg Allen, director of the division of program development and management at the health department, said the state intends to submit the waiver in the next 90 days and will ask that Medicaid be allowed to cover care management services so that prisoners have some link to care when they leave a correctional facility, even if they move to a different part of the state.

The program would be aimed at high-risk populations such as those with HIV, mental illness, drug addiction or chronic conditions such as asthma or diabetes. That could include nearly 100,000 people in state correctional facilities, Rikers Island and upstate county jails, said Erin Silk, a spokesperson for the health department.

Allen said the state had not yet calculated what this would cost.

The second request would allow New York to pay for housing support, such as assisting with the housing application, ensuring the home is safe, and educating individuals on tenant rights. While Medicaid is barred from paying rent, other states such as Washington, Hawaii and North Carolina have received federal waivers so that the program can pay for ancillary services that help people live in a home.

“Supportive housing has been very successful at reducing Medicaid spending,“ said Liz Misa, deputy Medicaid director for the Office of Health Insurance Programs at the New York State Department of Health.