Public Policy Solution #5
Resources for Addiction Treatment in the Community Should be Identified Prior to Release

While, as we have seen, science teaches us that the most effective programs provide addiction treatment both inside the prison walls and in the community, providing community-based services will be impossible if those who need treatment cannot pay for it after they are released. It is critical to identify resources prior to release and begin the enrollment process during incarceration, both for ease of transition and to engage clients, which can become much more difficult after release.

Some parole departments cover the cost of drug and alcohol treatment, but most people just out of jail and prison depend on Medicaid for outpatient services and, if they need residential care, may be eligible to obtain welfare benefits such as federal Temporary Assistance to Needy Families (TANF), food stamps,¹ or equivalent state resources to help support the cost of residential treatment. However, it can take Medicaid and social services agencies up to 45 days to approve an application. Unless local programs agree to treat people with pending applications, they will be without care precisely when they are facing the stress of returning to their communitiesplacing them at increased risk for a return to drug and alcohol use.²

Under Federal law Medicaid coverage drug and alcohol treatment is optional for states. Many states do not cover alcohol and drug treatment services, which places an extra burden on already scarce state and Federal funding for alcohol and drug treatment services. And, given that most individuals leaving the criminal justice system or are under community supervision have limited incomes, the average patient cost of $54.60 per visit for outpatient clients makes it extremely difficult for most people to afford treatment on their own.³

In states that do provide Medicaid reimbursement for drug and alcohol treatment, it is critical to ensure that all who are eligible enrollin the Medicaid program as quickly as possible. The U.S. Department of Health and Human Services has ruled that individuals who are enrolled in Medicaid when incarcerated must regain that eligibility immediately upon release.

For incarcerated individuals who are not enrolled in Medicaid, some jurisdictions have instituted innovative policies to enroll eligible individuals before they are released. For example:

• The New York City Human Resources Administration, Department of Correction and Department of Health and Mental Hygiene have begun helping inmates in the city jails’ discharge planning program apply for Medicaid and other public assistance at least 45 days before they are released from jail—so that they are covered the day they go home.


• The Connecticut Entitlements Project is an interagency collaboration between Social Services, Mental Health and Addiction Services, Court Support Services and the Department of Corrections to provide entitlement specialists in the institutions that connect inmates with the necessary entitlement approval prior to release.

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