The Substance Abuse and Mental Health Services Administration (SAMHSA) has published a new study on the success of a model program that helps individuals with serious mental illnesses enroll in Medicaid upon release from a correctional facility. The model assistance program took place in Oklahoma and was designed to strategically collate local, state, and federal resources to help enroll eligible inmates with mental illnesses in the Medicaid program upon the day of their discharge. At the end of SAMHSA’s study, Medicaid enrollment among this population increased by 15 percent. In general, the ability to obtain health care coverage for those who suffer mental illnesses and have a criminal history tends to be quite difficult. Yet SAMHSA’s model program efficiently increased the likelihood of ex-offenders accessing mental health services by eliminating obstacles for health insurance enrollment.
The model program is a gradual process that takes the proper steps needed to reach its overall goal of successful Medicaid enrollment and continued health care treatment for those ex-offenders most in need. These steps take place over time while the eligible inmates are still incarcerated, preparing them for their imminent discharge from their correctional facility and reentry into their communities. First, the inmates are evaluated regarding their eligibility for Medicaid 6–9 months prior to their release based on the severity of their mental illness. Then, participants receive assistance in applying for federal disability benefits 4 months prior to their release. Lastly, participants receive guidance in completing their Medicaid applications 2 months prior to their release to ensure that their coverage begins the same day they are released.
Mental illness among criminal offenders is very prevalent. According to the U.S. Department of Justice, an estimated 1.3 million offenders in state or federal institutions or local jails had a mental illness in 2005. SAMHSA reports that more than half of the inmates in prison or jail exhibit symptoms of a mental illness, and one-fourth were diagnosed with a disorder within the past 12 months. Criminals diagnosed with a mental illness may suffer from such disorders as a substance abuse disorder, depression, trauma, personality disorders, or schizophrenia. Once these offenders are released from a correctional facility, many face several barriers in obtaining stable employment, housing, and medical assistance. Without support for their mental health, these individuals are more likely to fall to recidivism, and their illnesses continue to go untreated as the cycle repeats. Without treatment, these individuals become a hazard to taxpayers and the safety of their communities.
Applying for federal disability alone is a complex process that requires the coordination of local, state, and federal agencies in order to complete an application. Medicaid is the most common form of health care coverage for ex-offenders suffering from a mental illness once they rejoin society. Yet Medicaid is obligated to suspend coverage for any adult submitted to a correctional facility in most states since federal dollars fund its participants’ health care services. For those offenders suffering a mental illness and in serious need of treatment, getting medical coverage is the biggest hurdle for them to overcome, and if not obtained prevents them for ever gaining a stable shot at life.
Based on findings from its study, SAMHSA relates the effectiveness of its model program to the coherent coordination between local, state, and federal agencies. Thanks to the collaboration of these multiple agencies, the many obstacles that prevent these individuals from gaining proper health care and a chance at regaining their lives are alleviated. The model program involved staff training, interagency contracts, and comprehensive program implementation by all the agencies. By developing a reliable reentry plan, treatment becomes a more feasible reality for these ex-offenders. In turn, their communities can benefit from their productivity, contributions to their economy and society, and their maintenance of their families’ welfare and stability. The costs needed to provide assistance and medical outreach to these ex-offenders costs dramatically less than the amount that would be required to keep them behind bars for a single year should they re-commit a crime.
Also necessary for the successful recovery of individuals suffering mental illnesses, SAMHSA states, is the involvement of community-based programs that assist those released from mental health facilities get enrolled in Medicaid. SAMHSA hopes that its study will help better inform policymakers and health care providers regarding substance abuse and mental health issues in the U.S. The complete study called “Establishing and Maintaining Medical Eligibility upon Release from Public Institutions” can be accessed by visiting www.samhsa.gov/shin.