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                                    Topics In Corrections
                                    ACA Mapping Initiative

      

                    
          
    ACA Mapping Initiative
**Why ACA Mapping Now?**State and local criminal justice systems are poised to change the way they do business. With the Patient Protection and Affordable Care Act (ACA), it is now possible for millions of low-income individuals in the criminal justice system to obtain insurance coverage for their physical and behavioral health care needs. This far-reaching system change will affect every decision point of the criminal justice system, from pretrial to reentry, and every partner, from correctional health to behavioral health.A large number of individuals in the criminal justice system struggle with chronic health problems and mental health and substance abuse disorders. Of these individuals, it is expected that four to six million (roughly one-third) of the newly insured Medicaid population in 2016 will include people who will have been booked into jails during the year.As states begin to implement the ACA and the criminal justice-involved population begins to receive care through Medicaid and marketplace insurance coverage, criminal justice agencies must be part of the planning and implementation conversations.ACA Mapping ActivitiesNIC's ACA Mapping Initiative began in early 2013 with the development of the Healthcare Enrollment Intercepts map (shown below) and the creation of the ACA Mapping Process. On December 2-3, 2013, the NIC sponsored a two-day mapping work session in Cheshire, Connecticut. During the two-day work session, participants developed a map of criminal justice system decision-points, discussed existing ACA enrollment activities, and identified and prioritized opportunities for increasing enrollment.Results of this technical assistance to date include expanded Medicaid enrollment at Intercept 2: the Public Defender’s Office has offered enrollment services to medically ill individuals and individuals with substance abuse disorders and the Department of Corrections is in the process of developing a Medicaid enrollment program in their jails.A second two-day mapping session followed in October 2014, which focused on the specific opportunity of improving information flow of health care data between agencies. This responsive technical assistance event focused on mapping the bi-directional current flow of data from point of initial detention and hearings with a focus on identifying opportunities for increased efficiency (standardization), sharing information and reducing duplication of information and services to enhance continuity of care. An outcome of the mapping meeting was the rollover of the priorities identified in the mapping session into a statewide improvement initiative (LeanCT) allowing for the continued analysis on how Medicaid and other entitlement applications are processed with the goals of addressing duplication and inefficiencies inherent in the current process to include enabling suspension versus termination of Medicaid during incarceration; increasing continuity of care opportunities and reducing duplicative work across agencies.Systems mapping creates opportunities for dialogue and relationship building between health and justice stakeholders. By working together to build a visual portrait of how individuals progress through the criminal justice system, health and justice stakeholders gain better understanding of their respective policies and practices. In addition, mapping allows jurisdictions to consider decision points throughout the entire criminal justice system when exploring opportunities to enroll criminal justice involved individuals in insurance coverage.During and ACA Mapping session, participants work together to map the decision points across the entire criminal justice system, from arrest to jail, prison, parole, and beyond where they might integrate health care enrollment or assessment in existing criminal justice processes. In addition, they will identify existing activities and opportunities for enhanced or new activities associated with health coverage enrollment, service referral, and other integration. The mapping process is a launching point for enhancing system efficiency and effectiveness related to the ACA.**Additional Technical Assistance Activities**Kentuckiana Regional Planning & Development Agency (January 2015)NIC sponsored a two- day planning session in Louisville, KY with Kentuckiana Regional Planning & Development Agency (KIPDA) and their partners Healthy Reentry Coalition of KY, Louisville Metro Criminal Justice Commission, Louisville Metro Department of Corrections, and the KY Voices of Health. The two- day work session facilitated discussion between justice and health professionals, identifying existing opportunities and challenges related to the Affordable Care Act and Medicaid eligibility and enrollment. Additionally, work session participants and discussed how the existing infrastructure can be improved and expanded to advance the work of the Louisville Metro Dual Diagnosis/Cross Functional Team, the Lexington Department of Corrections, the KY State Department of Corrections and the Federal Bureau of Prisons, Mid-Atlantic Region.Commonwealth of Massachusetts - Office of Medicaid and Massachusetts Sheriffs Association (February 2015)NIC currently working with the National Criminal Justice Association and several MA state agencies developing a training session and works sessions to improve Medicaid enrollment practices for justice-involved populations and improve the suspension process for Medicaid benefits. Goals identified include increasing continuity of care, reducing recidivism and identifying cost reduction strategies.NORCOR Corrections, The Dalles, ORNIC will assist the regional jail facility develop a coordinated process to connect justice-involved individuals to appropriate medical and mental health service to reduce costs and achieve better outcomes.
                   NIC Resources
          Health Reform and Public Safety: New Opportunities, Better Outcomes [Internet Broadcast]
          Mapping the Criminal Justice System to Connect Justice-Involved Individuals with Treatment and Health Care under the Affordable Care Act
          Medicaid and Financing Health Care for Individuals Involved with the Criminal Justice System

Topic Categories and Resources
The following grey bars are accordions that can be expanded to show a list of "top-shelf" resources that have been hand-picked by our library team around this topic. If you would like additional research assistance on this topic, please contact our help desk. They have access to specialized databases and thousands of resources you won't find online. Click on a grey box below to browse resources in that section.
            
      Accordion    HHS Federal Partners
      
      Bureau of Justice Assistance (BJA)
              Substance Abuse and Mental Health Services Administration (SAMHSA)
              Health Resources & Services Administration (HRSA)
              Centers for Medicare & Medicaid Services
              Office of the Assistant Secretary for Planning and Evaluation (ASPE)
              Accordion    Enrollment
      
      Prison Inmates' Prerelease Application for Medicaid: Take-up Rates in Oregon

            
      
"People leaving prison often return to the community lacking health insurance and thus access to appropriate health care. Many have mental illness, substance abuse, and other health issues that need treatment and compound reintegration challenges. Left untreated, they are at risk of falling into a
              Health Coverage and County Jails: Suspension vs. Termination

            
      
"Medicaid allows for-and the federal government encourages-continued eligibility for coverage for a person who is incarcerated. Although the ACA [Affordable Care Act] did not address suspension versus termination, for states that are expanding Medicaid the number of inmates eligible for coverage
              Medicaid: Information on Inmate Eligibility and Federal Costs for Allowable Services

            
      
"Financing health care for inmates can be a significant portion of state correctional spending for some states with health care costs ranging from an estimated 6 percent to 33 percent of institutional corrections spending in 2008, the most recent estimate available. The combination of expanded
              Price
              $0.00

Maximizing Medicaid: An Innovative Approach to Finance Health Care for Criminal Justice Populations [Webinar]

            
      
"This webinar explains and clarifies the issues related to allowable uses of federal Medicaid funds for incarcerated individuals, and provides an example of how corrections departments can leverage cost savings as a result.
      
  Accession Number
              033666

  Amount in Stock
              0
  
      RE: To Facilitate Successful Re-entry for Individuals Transitioning from Incarceration to Their Communities (2016)
              Linking Low-Income Men to Medicaid and the Health Insurance Marketplace (2016)
              Presumptive Eligibility: New Options in 2014 (2013)
              Steps to Maximize Healthcare Reform for Justice Systems - Enrolling Newly-Eligible Participants (Corrections Systems) (2013)
              Accordion    Funding & Budgets
      
      Meaningful Use and Corrections: Unknown Opportunities

            
      
"Meaningful use is the linchpin of the Medicare and Medicaid EHR Incentive Programs, established under the Health Information Technology for Economic and Clinical Health (HITECH) Act to provide incentive payments to eligible providers that adopt and demonstrate “meaningful use” of certified EHR
  
      Access to Health Care and Criminal Behavior: Short-Run Evidence from the ACA Medicaid Expansions (2017)
              Managing Prison Health Care Spending (2014)
              How Medicaid Expansion Can Lower Prison Costs, Recidivism (2013)
              The 2013-2014 Budget: Maximizing Federal Reimbursement for Parolee Mental Health Care (2013)
              The 2013-14 Budget: Obtaining Federal Funds for Inmate Medical Care-A Status Report (2013)
              Accordion    General
      
      Questions & Answers: The Affordable Care Act and County Jails

            
      
"The implementation of the Affordable Care Act (ACA) has set off reforms in health care systems across the country, including in county jails ... Many of those who cycle in and out of county jails may now be able to obtain health insurance through the Health Insurance Marketplace or expanded
              Health Coverage and Care for Youth in the Juvenile Justice System: The Role of Medicaid and CHIP

            
      
"This brief provides an overview of the health and mental health needs of girls and boys in the juvenile justice system and the role of Medicaid in addressing those needs. It focuses on the circumstances of those girls and boys who are placed in juvenile justice residential facilities, the
              On Life Support: Public Health in the Age of Mass Incarceration

            
      
This report is an excellent introduction to the relationship between incarceration and public health and its significance for society. It is essential reading for anyone working within the fields of corrections and public health. Sections cover: the burden of disease behind bars-mental health
              Price
              $0.00

The Patient Protection and Affordable Care Act and the Pretrial System: A "Front Door" to Health and Safety

            
      
"The Patient Protection and Affordable Care Act (ACA) provides an historic opportunity for millions of low-income individuals to obtain insurance coverage for their physical and behavioral health care needs. For the last several years, diverse behavioral health advocates, health care providers and

  Amount in Stock
              0
              Health Reform and Public Safety: New Opportunities, Better Outcomes [Internet Broadcast]

            
      
Research shows that there are a disproportionate number of justice involved individuals suffering from chronic illness and/ or mental health and substance abuse disorders.
      
  Accession Number
              028236
              Mapping the Criminal Justice System to Connect Justice-Involved Individuals with Treatment and Health Care under the Affordable Care Act

            
      
"By working together to build a visual portrait of how individuals progress through the criminal justice system, health and justice stakeholders gain better understanding of their respective policies and practices. In addition, mapping allows jurisdictions to consider decision points throughout the
              Medicaid and Financing Health Care for Individuals Involved with the Criminal Justice System

            
      
“This brief outlines opportunities for states and local jurisdictions to improve public health and safety outcomes, and reduce spending on corrections and health care services by maximizing the appropriate use of Medicaid coverage for people involved with the criminal justice system.” Sections
              Health Care Reform and County Criminal Justice Systems: An Introduction to Health Care Reform and the Opportunities and Challenges for County Criminal Justice Systems

            
      
“This course provides an overview of how upcoming changes to California’s health care system will impact local criminal justice systems. Speakers compare and contrast health care in the county corrections systems today with health care in the years to come under the Affordable Care Act. A framework
              Frequently Asked Questions (FAQ): The Affordable Care Act (ACA) and Justice-Involved Populations

            
      
The answers to the eleven most asked questions about providing health care in a correctional setting as directed by the Affordable Care Act (ACA) are given. This is important information for correctional agencies trying to address the costs they incur in the provision of inmate health services.
              Proceedings of the Large Jail Network Meeting Aurora, Colorado, September 15 - 17, 2013

            
      
Sections of these proceedings are: about this meeting; meeting highlights; “The Affordable Care Act: Health Care Reform and Jails” by Donna Strugar-Fritsch; “Handling Corrections Staff Wellness/Performance Issues: From Corrections Fatigue to Fulfillment” by Caterina G. Spinaris and Micheal D. Denhof
              Healthcare Not Handcuffs: Putting the Affordable Care Act to Work for Criminal Justice and Drug Policy Reform

            
      
“The Affordable Care Act (ACA) sets the stage for a new health-oriented policy framework to address substance use and mental health disorders. By dramatically expanding and funding healthcare coverage to millions of currently uninsured people, the ACA represents a remarkable opportunity for criminal
  
      The Importance of Medicaid Coverage for Criminal Justice Involved Individuals Reentering Their Communities (2016)
              State Medicaid Eligibility Policies for Individuals Moving Into and Out of Incarceration (2015)
              The Unseen Provider: Health Care in Our Jails (2014)
              Guidelines for the Successful Transition of People with Behavioral Health Disorders from Jail and Prison (2013)
              Leveraging National Health Reform to Reduce Recidivism & Build Recovery (2013)
              Accordion    Implementation
      
      Development of a Performance-Based RFP for Correctional Health Care Services in Vermont (2015)
              Accordion    Policies & Legal Issues
      
      Nursing Home Release
              The ACA and the Criminal Justice Reentry Population: Opportunities & Challenges (2015)
              Consumer Rights Come to Jail: How the Affordable Care Act Changes the Rights of Individuals Pending Disposition (2015)

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          Katie Green
      
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              Correctional Program Specialist

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              Community Services Division

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              National Institute of Corrections

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