States are Using Federal Authority to Support Community Reentry and Improve Care Transitions for Justice-Involved Populations

On April 17, 2023, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), issued State Medicaid Director Letter #23-003 entitled, Opportunities to Test Transition-Related Strategies to Support Community Reentry and Improve Care Transitions for Individuals Who Are Incarcerated announcing a new opportunity for states to help increase care for individuals who are incarcerated in the period immediately prior to their release to help them succeed and thrive during reentry. This Reentry Section 1115 Demonstration Opportunity allows state Medicaid programs to cover services that address various health concerns, including substance use disorders and other chronic health conditions.

Specifically, this opportunity focuses on covering high-quality services for individuals who are incarcerated, eligible for Medicaid, and returning home to their communities – a group of individuals who have been historically underserved and adversely affected by persistent poverty and inequality. Improving health care transitions and addressing social determinants of health – from case management to medication-assisted treatment – for individuals after they have been released from carceral settings increases the likelihood that they may continue to receive crucial substance-use disorder, mental health, and other health care treatment during this vital period. It also holds promise for reducing emergency department visits, inpatient hospital admissions, overdose, and overdose-related issues, including death, and improving health outcomes overall. Moreover, addressing people’s underlying health needs enhances their ability to succeed and thrive during reentry, thereby lowering the risk of recidivism, helping make our communities healthier and safer.[1]

Learn More about Myers and Stauffer’s Justice Involved Services. Our experienced consultants can help support the development, submission, and negotiation of your Reentry Section 1115 Demonstration waiver application and CMS-required post approval protocols, as well as all aspects of waiver implementation, operations, and evaluation.

Since CMS issued this guidance, several states have applied for the demonstration with 19 pending and four states having received approval as of June 2024.