Re-Entry Into Community

For people with mental health conditions who fail to receive appropriate services and supports, the justice system can become a revolving door. Periods of incarceration disrupt any treatment being received and progress toward recovery. Thus, the period post-incarceration becomes a critical time to support people to thrive. Federal policy can ensure that every community has access to the resources and evidence-based information it needs to provide effective supports post-incarceration.

Continuity of Care

Medicaid does not cover services during periods of incarceration. In many states, incarceration causes people to become disenrolled entirely. This can lead to dangerous gaps in care for people with mental health conditions.1 Research has found that ensuring enrollment post-release leads to higher rates of accessing mental health treatment,2 3 which in turn has been linked to lower rates of recidivism.4 Before release, people should be enrolled in coverage and connected to services in the community.

  • The federal government should introduce incentives into its justice system funding for enrolling people in Medicaid before release and require protocols for connecting to community services similar to those required for hospital discharge planning.
  • The federal government should introduce a performance measure into its justice system funding of receiving mental health treatment 7- and 30-days post-release, similar to how hospital performance is measured.
  • The federal government should support jails and prisons to build processes that automate enrollment of incarcerated individuals in Medicaid using the documentation for which states may already have access.5 6

Re-Entry Programming

Over the past several decades, access to re-entry services has increased dramatically and parole/probation practices are becoming more evidence-based. At the same time, evidence has developed on how to effectively support people with mental health conditions to participate in social and economic life. The growth of re-entry programming can be built on by integrating evidence-based support for mental health.

  • CMS should clarify how Medicaid-funds can be used with treatment while incarcerated and re-entry programming to ensure that they meet the needs of individuals with mental health conditions and provide guidance on reimbursement and liability issues associated with hiring peer support specialists with the experience of being justice involved.7
  • The federal government should fund additional demonstrations of specialty mental health parole and probation programs for justice systems.8
  • The federal government should require re-entry programs it funds to create linkages with other community resources, including mental health services and supports, supportive housing programs, as well as other workforce programs that could continue to support individuals even after the re-entry period.9 CMS should issue the 1115 guidance facilitating care transitions at re-entry that was required in the SUPPORT Act.