The Wayne State University School of Social Work Center for Behavioral Health and Justice (CBHJ) recently partnered with TBD Solutions (TBDS), located in Grand Rapids, Michigan, to assess the issue of Medicaid continuity for those entering and exiting jails across Michigan. The report found widespread barriers faced by county jails to accessing and reactivating Medicaid for the previously incarcerated population, an already disenfranchised population, and outlines best practices and recommendations to improve access to Medicaid for those released from Michigan's jails.

"In our work with jails across the state, concerns around Medicaid continuity were continually raised," said Liz Tillander, deputy director for the CBHJ. "We heard from jail administrators and behavioral health providers about lapses in Medicaid coverage when individuals were leaving the jail. This obviously impacts care continuity from jail back into the community."

In its role in providing external facilitation, technical assistance, and evaluation services to counties across the state, the CBHJ often serves as a conduit between local communities and state-level practices and policies. When an issue is raised repeatedly across a wide spectrum of stakeholders and jail types, the CBHJ seeks solutions in the form of best or evidence-based practices. "For this issue, there is no better partner than TBD Solutions to help us provide guidance to local communities and offer potential solutions to the state. Joanne Sheldon's command of Medicaid in Michigan is outstanding," continued Tillander.

Under a grant from the state's Mental Health Diversion Council, the CBHJ and TBDS partnered in June 2020 to conduct a focused study of Medicaid enrollment and reactivation processes with the incarcerated population. While similar issues exist for the prison population and for youth in secure placements, this study focused on the adult population. The goal of the study was to inform Michigan's efforts to strengthen Medicaid enrollment practices for the justice-involved population, specifically those entering and exiting jails.

Together, the CBHJ and TBDS selected 12 counties comprised of rural, urban, and metro geographical classifications to develop an understanding of the barriers faced by jails and community partners. TBDS interviewed 34 stakeholders across 14 interviews including sheriffs, jail administrators, CMH clinicians, and jail nurses.

"TBDS is passionate about improving the lives of those currently or previously incarcerated. By zeroing in on improving Medicaid coverage for these individuals, we know we will improve their ability to access the care they need in the community. It is our hope that, consistent with national research, this will lead to not only improved health outcomes but also to reduced recidivism, which is costly for counties," said Joanne Sheldon, a consultant for TBD Solutions.

"This report pulls together many of the initiatives the Diversion Council has been working on over the past few years," said Steven Mays, the state's diversion administrator. "In many ways it acts as the culmination of connecting several individual efforts into a cohesive plan to address some major issues, all interconnected and effected by one another."

To learn more, read the full report.

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About the Center for Behavioral Health and Justice: The Wayne State University School of Social Work Center for Behavioral Health and envisions communities in which research, data, and best practices are used by multiple stakeholders to enhance the optimal well-being of individuals with mental illness and/or substance use disorders who come into contact with the criminal/legal system. Learn more

About TBD Solutions: TBD Solutions is a Michigan-based consultancy with a rich background in healthcare leadership, research, policy analysis, quality improvement, program evaluation, and technology-based applications. The TBD Solutions Team assists organizations in successful project, process, and technology management, planning, and outcomes. Learn more