New Federal Funding Could Improve Opioid Use Disorder Treatment in Correction Facilities
Late last year, the streaming platform Hulu aired the critically-acclaimed 8-part drama miniseries “Dopesick.” The show is based on a non-fiction book about America’s opioid addiction crisis, Oxycodone, and the pharmaceutical company that has promulgated its devastating impact on unsuspecting patients and their physicians.

“Dopesick” tracks the lives of those impacted by the drug. In doing so, the program drew national attention to the dangers of Oxycodone abuse. It also showed the undeniable connection between Opioid Use Disorder (OUD) and criminal conduct. For some, the program brought light to this shocking epidemic. For others, the information was another reminder of the prevalence of opioid addiction and its inseparable connection with the criminal justice system.

According to a report published in the Health and Justice Journal, 2016 survey evidence revealed that 1 in 4 people with an OUD had contact with some part of the criminal justice system in the preceding year. The data also showed that those with criminal justice system involvement had significantly higher rates of OUD than those without criminal justice involvement.

Lifetime rates of OUD increase as people penetrate further into the justice system. Further, the greater the severity of opioid use, the higher the likelihood of criminal justice involvement. Therefore, not surprisingly, Opioid Use Disorders are believed to be highly prevalent in incarcerated populations. U.S. Department of Justice data shows that approximately half of federal and state prisoners meet the criteria for substance abuse disorder. However, according to a report by the National Academy of Sciences, only 5% of people with OUD in jail and prison settings receive medication treatment. Moreover, criminal justice institutions have been reluctant to use methadone, buprenorphine, and naltrexone to treat OUD. Consequently, those with OUD usually discontinue treatment while incarcerated and resume use soon after they are released.

Medicaid Funding and OUD

A disproportionate number of these incarcerated individuals have low incomes, meaning they qualify for Medicaid coverage. However, under federal law, the Medicaid program cannot pay for health services, including OUD treatment, during incarceration. Currently, there is proposed legislation in Congress that seeks to address this issue by creating a new funding source for correctional health care, which could include OUD treatment.

According to a recent report, the Medicaid Reentry Act of 2021, the Due Process Continuity of Care Act, and the Humane Correctional Health Act would authorize Medicaid to:

  • Cover services for patients 30 days before release from incarceration,
  • Cover individuals detained pretrial, and
  • Be made available for all eligible individuals for the duration of their incarceration

CMS Program Coverage

In addition, several states are petitioning the Centers for Medicare and Medicaid Services (CMS) to cover at least some parts of correctional health care through the agency’s Section 1115 demonstration waiver program. The waiver program permits states to implement pilot programs with Medicaid dollars.

It's believed that Medicaid funds for OUD treatment would improve treatment and provide greater access to essential care services. However, Medicaid has never paid for correctional health care services. Therefore, implementation would require establishing a regulatory structure and other operational features to allow the facilities to be reimbursed for treatment and care services.

CMS has strict quality and data reporting requirements. Further facilities regulated by the program are subject to audit and review. At present, correctional facilities don't have uniform health care quality measures, and creating the necessary infrastructure and adapting to these standards may prove to be challenging. However, the fact remains that opioid addiction is a continuing and growing problem within the criminal justice system. Without wide-scale systematic change, this population will increase, and correctional facilities will be left without the resources needed to address treatment needs.
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental disabilities. To schedule a consultation, contact us or call (509) 991-7058.

Additional Resources
Keeping Mental Health Crises Out of the Criminal Justice System
AUSTIN, Texas – Across the nation and within Travis County, a disproportionate number of people living with mental health and substance use disorders end up in jail instead of getting the mental health treatment and support they need.
Mental health experts at Dell Medical School at The University of Texas at Austin are joining forces with the Travis County Commissioners Court and a wide range of community partners to address this problem by rethinking – and ultimately redesigning – the local intersection of criminal, legal and behavioral health systems. The goal of the effort, known as the Travis County Forensic Mental Health Project, is to establish solutions rooted in person-centered and evidence-based care for people stuck at or repeatedly cycling through this intersection.
Breaking the ‘revolving door’ of people with serious mental illness in the courts
People with serious mental illness sometimes find themselves in what’s come to be called a “revolving door” of the criminal justice system – cycling in and out of courtrooms, incarceration, and involuntary hospitalization.
There are measures in place to help curb the issue, but gaps remain.
An attempt was made to close one of those gaps in 2017 when Tim’s Law was passed. The goal of the law was to allow Kentucky judges to mandate assistant outpatient treatment for some with serious mental illness.

Heat waves can impact our mental health. Here's how
Heat waves not only impact our physical health, they can worsen mental health conditions too, studies show.

High temperatures and humidity have been linked to a rise of symptoms in people with depression, generalized anxiety disorder and bipolar disorder.

Research has found that for every 1C increase in monthly average temperature, mental health-related deaths increase by 2.2%.

Heat waves also impact cognitive ability, increasing aggressive behavior and violent crime rates.

The best thing we can do to help ourselves and future generations is to act on climate change, say experts.
She ‘fell’ out of a patrol car and died, police say. Her family wants answers.
When Brianna Grier’s parents phoned police, explaining that their 28-year-old daughter was in the middle of a mental health crisis, they expected paramedics to come help, as they had done in the past.
But when sheriff’s deputies arrived at their home in Sparta, Ga., late one night this month, they told Grier they smelled alcohol on her breath. And after she admitted she had been drinking, they placed her in handcuffs, loaded her into a patrol car and told her that they were going to detain her for intoxication, her father recalled.
She was supposed to receive medical treatment the next morning, but she never got the help. Instead, she died from injuries she suffered in police custody.

‘So rudderless’: A couple’s quest for autism treatment for their son hits repeated obstacles
When Sebastian Rios was a toddler, he hardly talked. "Don't worry," his pediatrician told Amparo and Victor Rios, Sebastian's parents. Kids who grow up in households in which both Spanish and English are spoken are sometimes slower to develop language skills, she said.

Plus, Sebastian was developing well in other ways: When he was just 18 months old, for example, he could identify the magnetized letters of the alphabet on the refrigerator at their home in Bronxville, a short train ride north of New York City.

But by the time Sebastian was a little over 2 years old, his skills weren't keeping up with those of other kids his age: He spoke only simple words, like "mama" and "dada," and had problems interacting with people, Amparo Rios said. He didn't know how to play with other kids and didn't care about showing people his toys or sharing them. He made eye contact less and less.

How to protect your privacy when using mental health care apps
Online therapy has become a booming industry in recent years, but with that growth comes questions about how well these types of companies are protecting the privacy of their patients.

Most recently, in June, Sens. Elizabeth Warren, Cory Booker and Ron Wyden asked two leading online therapy companies, BetterHelp and Talkspace, to provide information about how they handle user data and their privacy practices.

The Democratic senators said they were concerned that the companies could be leaving their patients "vulnerable to exploitation from large technology platforms and other online actors."
BetterHelp markets itself as the world's largest online therapy service with nearly 2 million users, according to its website. The company operates through thousands of therapists who can communicate with patients via phone, text or video chat.

Representing People with Mental Disabilities: A Criminal Defense Lawyer's Best Practice Manual

Published by the American Bar Association. Topics include:

  • Competency
  • Sanity
  • Malingering
  • Neuroscience
  • Jail and Prison Conditions
Representing People with Autism Spectrum Disorder: A Practical Guide for Criminal Defense Lawyers

Published by the American Bar Association. Topics include:

  • Co-Occurring Disorders
  • Testing
  • Competency
  • Risk of Violence
  • Mitigation
Suicide and its Impact on the Criminal Justice System

Published by the American Bar Association. Topics include:

  • Co-Occurring Disorders
  • Testing
  • Competency
  • Risk of Violence
  • Mitigation.
Families' Guide to Working with a Criminal Defense Lawyer
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