RALEIGH – As people transition from incarceration to the community, they face an increased risk of visits to hospital emergency rooms, drug overdose, and death. Mental health and homeless challenges await many as well.
Medicaid is a vital tool for addressing these challenges.
North Carolina has taken steps in dealing with these issues, as well as planning for reentry challenges through Reentry 2030. Now, North Carolina is one of six states selected to participate in a six-month Medicaid and Corrections Policy Academy in a pilot initiative to enhance reentry outcomes for people with complex needs transitioning from incarceration to the community.
North Carolina joins Alaska, Colorado, Maine, Oklahoma, and Wisconsin in the Academy sponsored by The Council of State Governments Justice Center and Center for Health Care Strategies that runs through February 2025. The North Carolina Department of Adult Correction, the N.C. Department of Health and Human Services and the Governor’s Office will represent our state in the Medicaid and Corrections Policy Academy that will bring together teams of senior leaders across state Medicaid, correctional and behavioral health agencies.
These leaders will work together virtually and in-person to develop a shared vision for reentry services, build partnerships, and identify strategies to harness Medicaid’s potential to improve to health coverage access, quality of care, and reentry outcomes.
“This is a big part of reentry and rehabilitation, a priority of our department and a major part of the reentry strategic plan (Reentry 2030),” said NCDAC Director of Social Work Services Mary Grillo, one of the department’s main points of contact regarding the initiative.
According to Grillo, the Policy Academy is not just about offenders and Medicaid coverage. It also involves looking at social determents to health coverage: housing, transportation, employment, education and social relationships.
The state teams will participate in exercises and discussions that support the development of:
- A shared understanding of how different state systems operate.
- Effective enrollment and suspension strategies for people leaving prisons.
- Practices to coordinate medical and behavioral health care in the correctional settings.
- Best practices for offender reentry.
- Reentry planning processes that include housing and other health-related social needs.
- Data and information sharing
On Oct. 24, 2018, the federal Centers for Medicare and Medicaid Services (CMS) approved North Carolina's 1115 Demonstration Waiver application. The 1115 Waiver provides eligible citizens, including offenders, a “whole-person, well-coordinated system of care that addresses both medical and non-medical drivers of health and advances health access by reducing disparities for historically marginalized populations,” according to NCDHHS. The approval was effective Jan. 1, 2019, through Oct. 31, 2024. The state is looking to renew the Waiver for another five years.
NCDAC has been very proactive in teaching offenders about Medicaid and how they can apply to receive coverage. According to Reentry 2030 data, 80% of North Carolina offenders are eligible for Medicaid, and staff continue to work with offenders on filling out paper forms for submission (electronic submissions are forthcoming) and become eligible for external medical services 90 days from release.
“We’re building a system from the ground up,” Grillo said. “We are getting as many offenders as we can to apply. We’ve held Medicaid information sessions with the highest number of eligible offenders and 65% have applied. We’re sending in an average of 100 applications per week.”
According to the Council of State Governments, the Policy Academy’s first in-person meeting will take place later next month in Washington, D.C. Grillo and NCDAC are looking forward to sharing and learning from other states and implementing ideas that will benefit offenders both inside our institutions and in the community.
“The end goal is for people to have life-saving health continuity of care when they leave our facilities,” Grillo said.