Monday, April 28, 2025
4/28/2025
Quality Improvement Fund - Justice Involved - Oregon has been approved to implement a Medicaid 1115 waiver to allow limited Medicaid coverage in carceral settings. This benefit is estimated to start in early 2026. Lane County, Oregon operates both Lane County Adult Corrections, the county jail, and the largest Federally Qualified Health Center (FQHC) in the community, making it an ideal organization to act as an early adopter of Health Center-provided services in carceral settings. Today, health services are provided in the jail by an outside contractor. Services include medical evaluation and treatment, mental health treatment, and medication-assisted treatment. All of these activities are included within the approved scope of service for Lane County’s FQHC, which will support transitions of care upon release. The jail medical provider has identified that the majority of individuals in the Lane County jail have a chronic physical and/or behavioral health condition that would benefit from transition of care assistance. Additionally, Lane County is the Continuum of Care, Community Action Agency, adult workforce provider, and local veteran’s service provider for the county. These designations mean that Lane County has well developed skills in the provision of housing, employment, and financial support programs. Lane County also has well developed relationships with numerous community-based organizations who provide these services and accept referrals from Lane County. For this project, the Community Health Centers of Lane County will employ four staff who work in the jail to coordinate transitions of care for adults in custody (AICs). The staff will include one RN case manager to assist with complex medical transitions, including patients who need outpatient specialty services, or who need rapid access to the Health Center’s primary care, behavioral health, or medication-assisted treatment clinics. The program will also employ two peer support specialists. These staff will meet with AICs, as well as the jail medical staff, to identify health and social determinants of health needs, and evaluate the readiness of clients to access services upon release. The peers will help their clients understand the benefits of accessing services and building motivation to follow through on treatment plans. They will also make referrals to local social service agencies and follow up with clients after release, as they are able, to encourage them to follow through on care plans. The final staff person for this project will be an office assistant who will assist with referrals and the transition of medical records. Upon release, the office assistant will ensure clients who were on Medicaid prior to incarceration have their health benefits reactivated, and will assist those who were uninsured prior to incarceration to apply for Medicaid if they qualify. The goals of this project include understanding the staffing levels needed to assist the population in Lane County Adult Corrections to transition successfully into outpatient services, to identify promising practices for best connecting adults in custody to outpatient providers, and to measure whether successful connection with outpatient providers affects recidivism rates. Lane County will create measures related to each of these goals as part of the final application. Additionally, Lane County will be an early adopter of Health Center services in carceral settings, prior to the implementation of the 1115 waiver. The goal is to continue the services provided through this one-time funding using Medicaid 1115 waiver reimbursements after the grant expires. Lane County will also support the 1115 waiver implementation by providing information to the Oregon Health Authority as well as the local Coordinated Care Organizations around practices that work in partnerships between Health Centers and correctional facilities.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).