December 11, 2017

Inmate Pre-release Medicaid Application Process Named “Good Government”

AHCCCS, Department of Corrections, and Department of Economic Security received the Good Government Award, recognition from Governor Doug Ducey for improving inmates’ access to health care upon release.

Ensuring access to health care is a key component of Arizona’s effort to reduce recidivism and provide opportunities for citizens to move from incarceration to productive and successful civilian life. In December 2017, Governor Doug Ducey recognized efforts AHCCCS, the Arizona Department of Corrections (ADC), and the Arizona Department of Economic Security (DES) are making to streamline the Medicaid application process for inmates prior to their release from a state prison or jail. Gilbert Davidson, Chief of Operations in the Office of the Governor, presented the Good Government Award to the three agency directors, stating, “Our State is better because of the improvements you helped make.”

Since September 2016, ADC officers have used online application and verification systems to help inmates apply for Medicaid coverage 30 days before their scheduled release. While the manual, paper-based pre-release application process has been in place for certain high risk/high need inmates since the early 2000’s, online systems make the verification process nearly real-time, enabling the agencies to expand the process to all inmates leaving ADC. Special units at AHCCCS and DES were created to handle pre-release applications, and approval is effective on the inmate’s date of release.

“In short, we are
getting people
the care they
need faster than
ever before.”

Julie Swenson, AHCCCS administrator

Five Arizona counties have also rolled out the online pre-release application process, and others are in the works. In just over one year, more than 9000 applications have been processed and 92 percent of Medicaid-eligible inmates have been approved for AHCCCS coverage upon release.

Pre-release Medicaid applications are just one example of innovations designed to reduce administrative burdens and streamline government services for citizens in the justice system. In the early 2000’s, AHCCCS, ADC and DES began suspending, instead of terminating, Medicaid coverage for AHCCCS members who became incarcerated. Nearly every county in Arizona participates in the automated suspension and reinstatement process. With this change, inmates no longer had to re-apply and wait for AHCCCS coverage to be reinstated. Hand in hand with pre-release for new applicants, this change means people with serious mental illness, end-stage disease, or life-threatening illnesses have immediate access to the care they need.

“Suspending AHCCCS coverage, instead of terminating it, is a huge administrative savings for the state,” said Julie Swenson, AHCCCS eligibility compliance and oversight administrator. “It has reduced administrative overhead and provided better continuity of care. In short, we are getting people the care they need faster than ever before.”

AHCCCS also created intergovernmental agreements with most Arizona counties to provide health care coverage to eligible inmates who are temporarily admitted to a hospital as an inpatient. Designated staff members help the patient complete the application which is reviewed by a special DES unit to determine eligibility. Once approved, the hospital submits a bill to AHCCCS for the patient’s hospital stay.

In October 2016, AHCCCS health plans began providing “reach-in” to individuals with a complex health need who were 30 days from their release. Justice Liaisons from the plans reach out to the incarcerated individual to coordinate where they will receive their ongoing care upon their release. This contractual requirement has resulted in several thousand AHCCCS members having health appointments and care ready for them upon their release.

With these procedures now in place and generating positive results, AHCCCS plans to further refine the online system functionality and augment system supports at each agency.