Expedited Medicaid restoration: Introduction and overview

Mentally ill persons involved in the criminal justice system represent a new frontier for community mental health and disability research. The scope of this problem is truly staggering with upwards of 86,000 persons with severe mental illness (SMI) released from state prisons each year with high rates of recidivism. The loss of Medicaid benefits by incarcerated offenders is thought to be a major obstacle to successful community reentry. Several states have adopted expedited restoration programs to reconnect eligible prisoners to their Medicaid benefits prior to release. It is widely believed that early benefit restoration can avoid disruptions in medication regimens and treatments for offenders with SMI when they are released to the community. However, few rigorous research studies have been conducted to establish the impact or cost-effectiveness of these policies. This presentation describes the rationale and design for the first statewide study of the effects of expedited Medicaid restoration programs in Connecticut and Washington state prisons on the community adjustment and recidivism of offenders with a severe mental illness. Administrative data from corrections, Medicaid, and public mental health authorities in each state were linked in a longitudinal case/control design (3 years pre-post EMR initiation) using propensity score matching techniques. Findings highlight the characteristics of participating offenders, use and costs of Medicaid-reimbursed services in the community, and subsequent criminal recidivism. Discussion will highlight Medicaid's role in community re-entry for this vulnerable population.