12:29am Wednesday 18 October 2017

Model Program Effective in Helping Individuals with Serious Mental Illness Get Medicaid Coverage Upon Release from Correctional Facilities

The effort significantly improved access to mental health treatment and services by reducing barriers to health insurance for eligible individuals leaving state institutions.

“The study underscores the importance of interagency collaboration to help people with serious mental illness and substance abuse disorders obtain access to needed services to sustain their life in the community,” said SAMHSA Administrator Pamela S. Hyde J.D. “As a result, barriers to health and behavioral health care are reduced and recovery is supported so that people do not find their way back into higher cost systems.”

The report is part of SAMHSA’s strategic initiative on data, outcomes, and quality – an effort to inform policy makers and service providers on the nature and scope of behavioral health issues.

The model program, implemented in Oklahoma, aimed to achieve Medicaid enrollment on the day of discharge for all eligible inmates with mental illness. The areas of focus involved:

  •  Identifying individuals with severe mental illness who were likely eligible for Medicaid about 6-9 months before their release from correctional facilities;
  • Helping them apply for federal disability benefits 4 months before their release;
  • Assisting them with subsequent Medicaid applications 2 months before their release.

The new program significantly improved access to Medicaid for discharged inmates with mental illness due to staff training, interagency agreements, and agency collaboration in program implementation.

Critical to the success of the program was the funding of three managers to improve discharge planning. Overall, the evaluation of Oklahoma’s efforts to ensure Medicaid enrollment for eligible individuals leaving state institutions showed:

  •  The effectiveness of the state’s model program for inmates with serious mental illness;
  • The need for community-based programs to help potentially eligible clients discharged from mental health facilities to enroll in Medicaid.

The U.S. Department of Justice estimates that 1.3 million individuals with mental illness were in state or Federal prisons or local jails in 2005.  More than half of all prison and jail inmates showed symptoms of a mental disorder, and about a quarter had mental health problems diagnosed within the past 12 months. 

For many adults with mental illness, Medicaid is the primary source of health care coverage when they reenter their communities after a stay in a public institution. Many states suspend Medicaid eligibility for adults while they reside in public institutions, since Medicaid regulations preclude the use of federal Medicaid dollars to pay for health services for most persons in state institutions.  In addition, applying for federal disability benefits can be complex and requires coordination among local institutions, state agencies and federal agencies.

 This publication, Establishing and Maintaining Medical Eligibility upon Release from Public Institutions may be downloaded or ordered at www.samhsa.gov/shin. Or call SAMHSA’s Health Information Network at 1-877-SAMHSA-7.

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SAMHSA is a public health agency within the Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America’s communities.

Media Contact: SAMHSA Press Office
Telephone: 240-276-2130


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