Incarcerated individuals in New Hampshire will soon receive access to Medicaid 45 days before their release, which is a part of the state’s approval for expanded Medicaid coverage for mental health and substance use treatment services.

“It’s a very exciting approval,” said Helen Hanks, commissioner of the Department of Corrections. “The concept is building a better bridge between transitions from incarceration to community healthcare partnerships and compliance with people’s treatment.”

The first year after release is crucial, often determining whether individuals will re-offend, and this program aims to reduce recidivism, facilitate smoother community reintegration, support long-term stability and recovery, and reduce overdose deaths.

At any given time, around 35% to 45% of incarcerated men receive mental health services, while the percentage for women ranges from 70% to 90%.

The female population is much smaller — approximately 120 women compared to nearly 2,000 men.

Under the newly approved Medicaid waiver, eligible individuals will have their Medicaid activated 45 days before release.

The hope is to have at least two provider contacts before release, said Hanks.

This could include primary healthcare or psychiatric care and two peer-to-peer contacts, all covered under Medicaid for any mental illness, including substance use disorders.

Another crucial component is the coverage of a 30-day supply of discharge medications, ensuring continuity of care as individuals transition back into the community.

Hanks explained that the 45 days were carefully chosen to allow the department sufficient time to arrange provider appointments and peer contacts while individuals prepare for housing and parole.

“It fits nicely in that normal transitional period,” Hanks explained. “You don’t want to do it too soon. You don’t want to do it too late.”

The prison healthcare expansion is expected to launch in January.

Currently, the state applies for Medicaid for incarcerated individuals before their release, with case managers working with them to create reentry plans and schedule appointments. But it’s up to the individuals to follow through with the plan and make the connections once they are released.

However, with this new program, individuals can have those provider contacts before release, rather than waiting for it to happen after release.

Mental health advocates have praised the initiative, emphasizing that transitions from correctional institutions are particularly vulnerable times.

Katja Fox, director of the division for behavioral health for the state Department of Health and Human Services, emphasizes that Medicaid expansion is crucial for a smoother transition from incarceration to community life by providing essential support and resources, which helps reduce risks such as suicide, overdose, and reoffending, ultimately contributing to more successful reintegration into society.

“You can’t just take somebody who’s been tucked away from society for two, five, 10 years, and then go find your services,” said Fox. “You can’t do that and expect people to be successful. So this is one step and one component of a system and that was one that we had a gap in and this is going to help us fill that.”

The state is also considering implementing a similar program for juveniles in correctional facilities, with Medicaid access beginning 30 days before their release.

Henry Lipman, the state’s Medicaid director noted that while the number of individuals affected by this program is relatively small, it still has a meaningful impact.

Every day in New Hampshire, adults and children spend days in hospital emergency rooms waiting for treatment beds to become available at one of the psychiatric facilities.

“By giving us the ounce of prevention, we’re hoping that we can achieve a pound of cure,” said Lipman. “Having the right resources in the community helps prevent people from escalating that may result in them needing to be boarded in an emergency room to begin with.”