BATON ROUGE, La. – Numerous studies show that access to mental health, substance use and other health care services helps former offenders better integrate back into their communities, lessening the likelihood of these individuals committing future crimes. Now, because of Medicaid expansion, the Louisiana Department of Health and the Louisiana Department of Public Safety and Corrections are helping incarcerated individuals enroll into Medicaid, with coverage beginning once the individual’s sentence is complete and they transition out of prison.
“This is a key solution to reducing Louisiana’s high incarceration rate, reducing the state’s recidivism rate, keeping citizens safe, and saving taxpayer money,” said Department of Public Safety and Corrections Secretary James M. Le Blanc. “Nearly a quarter of the state’s offenders have serious mental health issues, and 75 percent have substance use disorders. For every dollar we spend toward treatment in the community, we save six dollars toward criminal justice costs.”
Nationwide, as well as in Louisiana, offenders enter prison with high rates of mental illness, substance use disorders, chronic health conditions and infectious diseases. While incarcerated, offenders receive care, but studies show that almost all offenders who leave prison do not have health care coverage, nor are they likely to find employment that offers coverage. Because continuity of care is critical to better health, this is an especially vulnerable population.
Dr. Rebekah Gee, secretary of the Department of Health, said that under Medicaid expansion, states such as Louisiana can use enhanced federal funding to make health care coverage available to individuals who are transitioning out of prison.
“Coverage begins when the offender completes their sentence and leaves prison. As we developed our program, we found other states that already started similar programs found health coverage contributes to better care continuity and also reduces the use of emergency rooms this population typically uses for basic care,” Gee said.
The Department of Health (LDH) and Department of Corrections (DOC) began planning for this program in late 2015, scheduling implementation in phases beginning with the seven state correctional facilities. Subsequent phases include offenders housed in local jails. LDH and DOC developed an automated enrollment process that allows the agencies to share information about offenders who are set for release within the next nine months, and get them enrolled in Medicaid and linked to a health plan pre-release. This enrollment process ensures that the health plan insurance card is mailed to DOC in time for release so that the former offender knows who to contact for access to care after release.
Dr. Raman Singh, DOC medical director, added that DOC identifies offenders who have a high need for health care services for the Healthy Louisiana plans to perform case management activities immediately prior to their release to ensure a more seamless transition of care. This includes offenders who
use a wheelchair, or have a serious mental illness, co-occurring substance use disorders, two or more medical conditions, HIV or other chronic health conditions.
“As these individuals are identified, information is shared with the Medicaid managed care plans which then develop care plans that include doctor appointments and prescriptions. This is all included as a component of the prison discharge planning,” said Dr. Singh.
LDH and DOC implemented phase one of the pre-release enrollment initiative in January for offenders in the seven DOC state facilities. As of February 27, 2017, 230 offenders have been linked to a health plan, and it is expected that approximately 2,800 offenders will qualify for coverage annually, with about 30 percent of these former offenders being eligible for case management.