Transitions out of the Criminal Justice System
Enrollment Suspense IGA
AHCCCS is engaged with the Arizona Department of Corrections (ADOC) and most of Arizona’s counties, including Maricopa and Pima, in a data exchange process that suspends AHCCCS enrollment upon incarceration, instead of terminating coverage. This exchange allows ADOC and counties to electronically send discharge dates for AHCCCS members, which simplifies the process of transitioning members directly into care. Through this enrollment suspension process, care can be coordinated by county jails or prisons upon discharge for over 95% of members involved in Arizona’s criminal justice system.
Hospital Inpatient IGA
AHCCCS has intergovernmental agreements in place with the majority of counties in AZ (including Maricopa and Pima) and ADOC to provide services to people in detention who are admitted temporarily into an inpatient hospital setting. This process includes a determination of eligibility for AHCCCS. When a detainee is released from custody temporarily to an inpatient hospital setting, designated staff assist the detainee with completing an application for AHCCCS Health Insurance. The application is submitted to a special unit that determines AHCCCS eligibility for the specific period of the hospital stay. When the detainee is determined eligible, the hospital will submit a bill to AHCCCS to pay for the brief hospital stay.
ADOC and multiple most AZ counties (including Maricopa, Pima and Navajo) submit pre-release applications via HEAplus for AHCCCS Health Insurance approximately 30 days before detainees are released from incarceration. If additional information is required, These applications are submitted to special units at AHCCCS and the Department of Economic Security (DES) for review and processing assist. Staff in these special units review the applications for eligibility and approvals become effective when the applicant is released from custody. Submission of applications prior to release helps to ensure that people who need critical care are enrolled in AHCCCS immediately upon their release.
Individuals who are at risk of needing an institutional level of care upon their release, receive a pre-admission screening while incarcerated and have a Medicaid application completed. When eligible, the member is connected to the Arizona Long Term Care System (ALTCS) program and placed into a long-term care setting immediately upon their release.
All AHCCCS Managed Care Organizations (MCOs) are contractually required to provide “reach-in” care coordination to identify members with complex health needs prior to their release from incarceration. MCOs (including Regional Behavioral Health Authorities (RBHAs)) connect case managers to members pre-release to provide information and schedule appointments with primary care physicians and behavioral health providers, as appropriate.
More information about the Justice System Transitions can be found below:
- Targeted Investments Program – Co-location of health clinics and probation/parole offices
- FOX 10: Program Aims To Help Give Arizona's Inmates A Second Chance, Outside Of Prison
- Information Sharing between Medicaid and Corrections Systems to Enroll the Justice-Involved Population: Arizona and Washington
- Critical Connections - Getting People Leaving Prison and Jail the Mental Health Care and Substance Use Treatment They Need What Policymakers Need to Know about Health Care Coverage
- Coconino County, Justice Council partner with White House on Data- Driven Justice Initiative
- White House Recognizes Pima County in its Data-Driven Justice Initiative
- Connecting the Justice-Involved Population to Medicaid Coverage and Care (Kaiser Family Foundation Brief)
- Yuma County Sherriff’s Office Newsletter – Working Beyond Boundaries for Positive Health Outcomes
- Justice System Initiatives in AZ 2015
- Enrolling in AHCCCS and Behavioral Health Services for Individuals Releasing from the Criminal Justice System
- County partners with state, nonprofits to help inmates get health care before released
- New program aims to help Maricopa County inmates get health coverage
- My Turn: How Maricopa County is helping those with serious mental illness
- 24 Hours From Arrest To Release To Services For Seriously Mentally Ill In New Program