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FRANKFORT, Ky. (Oct. 17, 2024) — Members of the Interim Joint Committee on Judiciary learned during Thursday’s meeting about a Medicaid services reentry project designated to improve care transitions for adults and juveniles who are incarcerated.
Deputy Commissioner Leslie Hoffman and Behavioral Health Supervisor Angela Sparrow, both of the Kentucky Department for Medicaid Services, offered testimony and answered several questions from committee members.
“Kentucky has a wonderful opportunity to improve health care for incarcerated individuals and juvenile offenders. There are many challenges and needs still that we have to address in Kentucky,” Hoffman said.
Eligible populations include all adults who would be eligible for Medicaid if not for their incarcerated status in one of Kentucky’s state prisons overseen by the Kentucky Department of Corrections. This excludes state inmates housed in county jails, according to the state Department for Medicaid Services.
All adjudicated youth who would be eligible for Medicaid if not for placement in one of the state’s Youth Development Centers overseen by the state Department of Juvenile Justice could participate, according to the Department for Medicaid Services.
“Incarcerated individuals and juvenile offenders face disproportionate challenges and barriers upon reentry to society and therefore they are at higher risk for injury and death – higher than the general public,” Hoffman said.
On July 2, 2024, the Centers for Medicare and Medicaid Services approved the state Department for Medicaid Services’ 1115 reentry project application. CMS is a federal agency that administers Medicare, Medicaid and other health programs.
“This was the first opportunity of its kind to allow state Medicaid agencies across the nation to reimburse for targeted services pre-release,” Hoffman said.
The project will enhance and streamline the reentry processes by improving care coordination through systematic collaboration and ensuring continuity of care while linking justice-involved individuals to medical and behavioral health services upon their release, she said.
The Department for Medicaid Services was able to demonstrate to CMS that the project will be budget neutral and this will be monitored throughout the implementation, Sparrow said.
Rep. Kimberly Poore Moser, R-Taylor Mill, asked if the needed resources and partnerships to refer those in the program for treatment and follow-up are available.
“I’ve been working on this for eight years, so I couldn’t be happier that this has been approved. It’s been a long journey. Lots of different applications, you know, scenarios. And some of my questions have been answered, but do we know that we have all the resources and the staff in our 12 state prisons to carry this out?” she said.
Sparrow said these issues are part of the planning process that’s being built in.
“Short answer, yes, there are some staffing needs. Again, that’s through the planning process. We will plan on how to address those needs to be able to support the implementation,” she said.
Sen. Phillip Wheeler, R-Pikeville, said determining who is covered and who is not is somewhat confusing, and he noticed the “glaring omission” that inmates in county jails will not be covered.
“Generally, the largest cost for any rural county government is the maintenance of the county jail, and a very large portion of that is, in fact, the health care costs associated with managing the county jail,” he said.
Wheeler said the program could help alleviate costs that are straining rural counties, and Sparrow said they agree.
“It’s a very complex project, so again, there are many things that we need to be able to demonstrate to CMS for approval in terms of, if we think of the infrastructure, there are nearly 80 jails across Kentucky that do operate differently,” Sparrow said.
Sparrow said the department would like to eventually onboard the county jails.
Wheeler said he is also concerned about medication-assisted treatment for counseling individuals with a substance abuse disorder up to 60 days prior to their release.
“I mean, frankly, one of the most common street drugs you see in Eastern Kentucky right now is Suboxone from people going to medication-assisted treatment,” he said.
Rep. Keturah Herron, D-Louisville, said she welcomes the project.
“So, it’s exciting to hear that we as a state should be proud that we are one of the states to be part of this and the only state in the south. And so, I am very excited about the possibilities and the partnerships,” she said.
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