In his January 2019 State of the State address, following LAC’s advocacy with the Executive and state agencies, Governor Cuomo directed the New York State Department of Health (DOH) to resubmit its application to the Centers for Medicare and Medicaid Services (CMS) requesting a Medicaid waiver to provide transitional care to individuals during the final 30 days of incarceration.
The legislature enacted a long-time LAC recommendation and allocated funding for the first Electronic Health Record (EHR) system in state prisons. EHRs, which the State says will take three years to install, promise to improve care during incarceration and eventually allow some information-sharing with community-based providers.
Following years of LAC-led advocacy, the State Department of Corrections and Community Supervision (DOCCS) announced increases in the number of correctional facilities offering access to medication to treat opioid use disorders.
LAC worked to ensure health homes receiving State funding would be required to collaborate with alternative to incarceration (ATI) providers.
Again at LAC’s suggestion, the State began reactivating Medicaid for incarcerated individuals 30 days PRIOR to release and providing physical Medicaid cards to individuals as they re-entered their communities to facilitate immediate access to treatment and medications.
In January 2017, New York State pulled its waiver application fearing the request, officially a solicitation to amend the State’s far larger ($7.3 billion) Medicaid waiver, would provide the new Administration an opportunity to re-open or even undo the entire waiver agreement.
LAC recommended New York become the first state to apply for a Medicaid waiver requesting payment for transitional care during the last 30 days of incarceration. We advocated for the waiver application with New York policymakers and in the media. Once DOH filed the application, LAC created a petition that gathered over 1,000 supportive signatures. We submitted comments to CMS and created a template, so others could do the same. Over 200 remarks were submitted - the vast majority in favor of the waiver.
LAC worked with the DOH, the Executive and legislature to win a $5 million budget appropriation to help fund transitional services - medical assessment, needed medications, and linkage to community care - for incarcerated individuals.
After LAC made clear to New York’s Division of the Budget that the State could bill the federal government when people in jails and prisons needed institutional care in the community, the State began planning Medicaid enrollment for all eligible people in prison in order to recoup tens of millions of dollars in annual federal reimbursement. The State now enrolls approximately 500 incarcerated individuals in Medicaid each month before they leave prison.
New York’s Deputy Secretaries for Public Safety and Health asked LAC to co-lead, with the DOH, a project to link justice-involved individuals to coordinated health care. Since then, LAC has helped run the Health Home Working Group (HHWG) - which is made up of over 40 state, city and county agencies, health homes, advocates and service providers, who together oversee six pilot health homes that annually link approximately 1,000 justice-involved individuals to coordinated care.
LAC helped ensure passage of the federal Mental Health Parity and Addiction Equity Act. By mandating equal coverage of addiction and mental health treatment with that of other medical/surgical benefits in large group insurance plans, this law created opportunities for addressing the two most prevalent chronic conditions of the justice-involved.
LAC also formed the Coalition for Whole Health, a working group of over 100 addiction and mental health service organizations and advocates, which was instrumental in ensuring the Affordable Care Act broadened the parity mandate by requiring most plans, including Medicaid, to cover mental health and addiction services at parity with other medical/surgical benefits.
LAC successfully led a campaign to convince New York to suspend, rather than terminate, Medicaid enrollment for incarcerated individuals, to ease care transitions upon returning to their communities.