New Medicaid Opportunities to Support Youth Transitioning From Confinement

A pol­i­cy cheat sheet aims to help agen­cies pre­pare for new fed­er­al leg­is­la­tion that expands Med­ic­aid cov­er­age for youth tran­si­tion­ing out of deten­tion or incarceration.

“Med­ic­aid Oppor­tu­ni­ties to Sup­port Youth Tran­si­tion­ing From Incar­cer­a­tion” was cre­at­ed by the Cen­ter for Health Care Strate­gies with sup­port from the Annie E. Casey Foun­da­tion. It explains that, on Jan­u­ary 1, 2025, pro­vi­sions will expand Med­ic­aid options to cov­er spe­cif­ic med­ical and behav­ioral health ser­vices for youth who are detained or incar­cer­at­ed. All juve­nile jus­tice insti­tu­tions, as well as adult jails and pris­ons where eli­gi­ble youth may be held, will be required to com­ply with this legislation.

Read the cheat sheet

The five-page guide is divid­ed into eight sections:

1. Why does this matter?
2. Which youth are eligible?
3. What are the new requirements?
4. What insti­tu­tions or set­tings are required to pro­vide the new­ly cov­ered services?
5. What new part­ner­ships are need­ed with the state Med­ic­aid agency, Chil­dren Health Insur­ance Pro­gram and com­mu­ni­ty-based health care providers?
6. Who are oth­er crit­i­cal part­ners and what are their roles in imple­ment­ing these provisions:
7. What’s next?
8. What’s the bot­tom line?

A key goal of these pro­vi­sions is to improve the health of youth when they are in cor­rec­tion­al insti­tu­tions and when they return to their com­mu­ni­ties. Near­ly two-thirds of youth in cor­rec­tion­al set­tings have a diag­nos­able men­tal health or sub­stance use dis­or­der, and many have sig­nif­i­cant unmet health needs. The leg­is­la­tion will man­date that eli­gi­ble youth must be cov­ered by state Med­ic­aid agen­cies for screen­ing or diag­nos­tic ser­vices that meet rea­son­able stan­dards or that are indi­cat­ed as med­ical­ly nec­es­sary. This includes a behav­ioral health screen­ing or diag­nos­tic ser­vice 30 days pri­or to sched­uled release (or no lat­er than one week or as soon as prac­ti­cal fol­low­ing release). Agen­cies must include tar­get­ed case man­age­ment cov­er­age for eli­gi­ble youth — including:

• assess­ment;
• devel­op­ment of a care plan;
• refer­rals;
• mon­i­tor­ing and fol­low-up to appro­pri­ate care; and
• ser­vices in the home and community.

These require­ments go into effect 30 days pri­or to a per­son­’s release and extend at least 30 days post-release.

“All youth-serv­ing sys­tems and providers need to be aware of these new oppor­tu­ni­ties to ensure youth have access to the sup­port and ser­vices they need as they tran­si­tion back to their com­mu­ni­ties,” said Joe Rib­sam, the Foundation’s direc­tor of child wel­fare and juve­nile jus­tice policy.

Read Med­ic­aid Oppor­tu­ni­ties to Sup­port Youth Tran­si­tion­ing from Incarceration