State Planning Grant to Promote Continuity of Care for Medicaid and CHIP Beneficiaries Following Incarceration. - The New Hampshire (NH) Department of Health and Human Services (DHHS) is working to promote continuity of care for inmates of public institutions who are eligible for medical assistance under the state Medicaid program through the CAA 5121 provision for juveniles in carceral settings and the 1115 Medicaid waiver for adult residents in carceral settings with serious mental illness or substance use disorders. New Hampshire DHHS is partnering with the Department of Corrections, the ten NH county corrections facilities, the Sununu Youth Service Center (SYSC), and stakeholders to successfully implement the new benefits. The benefit package for adults under the 1115 includes: care management and coordination services, SUD/SMI intake appointments with community providers, MAT treatment, peer support, and prescription drugs upon release. The benefit package for eligible youth under the Consolidated Appropriations Act includes: targeted case management (TCM) and screening and diagnostic services. Increasing the complication of implementation, a subset of those 18-21 (or in case of foster care, 26) are eligible for both programs and will be provided both sets of benefits. This proposal, submitted by the NH DHHS Division of Medicaid Services, is for $5 million dollars over 4 years beginning in March 2025. The primary activities planned to support continuity of care for our residents in carceral facilities include: 1. Purchase of telehealth materials for state prisons, transitional facilities, 10 county jails, and one youth detention center. This will enable residents to seek care from clinicians outside the walls of the carceral setting, allowing for post-release continuity of care. These materials include secure telehealth booths and specialized telehealth-enabled iPads to complete visits. 2. Creation and dissemination of communication materials for the public, staff of carceral settings, inmates (through existing iPads) and their families, and providers. 3. Provision of 12 on-site trainings of carceral staff on Medicaid eligibility and enrollment through New Hampshire EASY, our eligibility and enrollment platform. 4. Through a help desk, ongoing training and support for carceral staff and carceral settings to complete Medicaid enrollment. Ongoing support of residents to maintain social services and coverage. 5. Provision of funds to allow necessary electronic health record upgrades or add-ons for recordkeeping and billing to improve continuity of care and ensure participation in re-entry benefits for Medicaid beneficiaries. 6. Salary support for two new employees at New Hampshire Department of Health and Human Services, Medicaid to support this project and the eligibility, benefits and processes needed for success. 7. Continued use of contractors devoted to implementation and monitoring of re-entry programs who provide expertise and project management support to DHHS and Department of Corrections staff to facilitate faster implementation at county facilities for both programs. Short term outcomes include timely determination of eligibility and enrollment, warm handoffs of care from the carceral setting to the managed care organizations and community health care providers, and timely provision of screening, diagnostic, and behavioral health treatment, depending on population. Longer-term outcomes sought include lower recidivism, reduced morbidity/mortality including fewer overdose deaths upon release, reductions in chronic and infectious diseases in formerly incarcerated populations leading to reduced disparities, and to provide financial support to our state and county carceral facilities to facilitate continuity of care through transition to the community.
