Connecticut is pursuing a new waiver to allow incarcerated residents to enroll in Medicaid prior to their release from prison in hopes of curbing high rates of overdose deaths often seen among those transitioning back to society.
Officials with the Department of Social Services — the state’s primary Medicaid-administering agency — briefed members of the legislature’s Black and Puerto Rican Caucus on the effort during a Tuesday morning policy forum.
“These services really are desperately needed,” DSS Commissioner Andrea Barton Reeves said of mental health and substance abuse treatment, housing assistance and other programs expected to be covered under the waiver.
“We also want to reduce deaths in the near-term of post-release,” she said later. “We find that people die from overdoses and from untreated mental health. We find a lot of folks get out of being incarcerated and feel hopeless and suicidal and we really want to turn that around.”
The waiver would provide an exemption from a longstanding “inmate exclusion,” which effectively prohibits Medicaid coverage for otherwise eligible residents who are incarcerated in prison. If approved, the waiver would allow those residents to regain some coverage up to 90 days prior to their release.
According to Barton Reeves, Connecticut is one of 18 states now seeking to follow in the footsteps of California and Washington, where state administrators received approval from the Centers for Medicare & Medicaid Services last year to implement plans extending coverage to some soon-to-be-released individuals.
The waiver is expected to apply to all Medicaid-eligible youths leaving Department of Correction custody, as well as Medicaid-eligible adults who meet one of a handful of criteria.
Those include having a mental illness or substance abuse disorder, having an acquired brain injury or an intellectual or developmental disability. Other eligible criteria include pregnancy or HIV/AIDS, according to DSS.
The state estimates that roughly 650 minors and 12,000 adults leave correctional facilities each year. Most are expected to qualify for the waiver, according to slides presented Tuesday to lawmakers.
About 85% of adults are expected to meet the waiver’s medical needs criteria. Meanwhile, a 2022 DOC analysis estimated that more than 95% of the incarcerated population had either a mental health disorder or history of substance use disorder. More than 80% had an active disorder requiring treatment.
Initially, DSS is proposing to cover transitional case management for people leaving prison, a 30-day supply of medication, as well as medication treatment for those with substance abuse disorders.
Later, the agency hopes to implement other services including laboratory services, access to contraceptives, and medication and screening for health conditions like diabetes, HIV, hepatitis C, and high blood pressure, according to DSS.
Barton Reeves said the state would also like the waiver to cover certain housing supports including one-time transition and moving costs or security deposits.
“We know how expensive it is in order to be able to move and there’s just no way for you to be able to have any of those resources, having just been released from incarceration,” she said.
Some of the lawmakers who attended Tuesday’s virtual forum expressed support for the state’s plans to seek the Medicaid waiver. Human Services Committee co-chair, Sen. Matt Lesser, D-Middletown, said his panel was interested in implementing the waiver.
Sen. Patricia Billie Miller, a Stamford Democrat who chairs the Black and Puerto Rican Caucus, thanked the agency for applying for the change.
“This has been a long-forgotten group of individuals,” she said of incarcerated people. “We look forward to hopefully doing what we need to do to get this passed.”
