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New York Partnership Plan - Amendment to serve Incarcerated Individuals

Oct 21st 2016 3:44 pm Response: #225609 I don't see why not I also believe in rehabilitation I do however think some if workable should pay it forward.
Oct 26th 2016 9:24 am Response: #225637 As a member of a County Reentry Task Force, this is a much needed change to the current limitations. Many of the people reentering to our County are in need of housing, medical and behavioral health services. This will help with their transition and integration into the community. This will also assist with community safety by reducing potential return to criminal activity motivated either by an illness, need for funds to purchase medication and/or lack of support through the transition to the community.
Oct 27th 2016 2:55 pm Response: #225677 October 27, 2016

Mr. Eliot Fishman
Director, Center for Medicaid and CHIP Services (CMCS)
Center for Medicare and Medicaid Services
7500 Security Blvd, Mail Stop S2-01-16
Baltimore, Maryland 21244-1850

Dear Mr. Fishman,

I am the Advocacy Director at Southern Tier Independence Center (STIC) in Binghamton, NY. STIC serves people of all ages and all disabilities across many counties of the Southern Tier. I am writing to comment on NYSDOH’s request for authorization of federal Medicaid funds (1115) to provide limited and targeted Medicaid services for incarcerated individuals in the thirty day period prior to release. The goals are to establish linkages to health care before the person walks out the door.

When people leave jail or prison, depending upon the length of stay, the existence of family, and any prior relationships with medical or community services, the individuals may be facing (in addition to homelessness) a lack of access to medical, mental health and/or substance abuse services. At our independence center, we have worked with people who are struggling to find the needed supports in order to prevent recidivism. There is a phrase that describes this: “Out on Thursday, back in on Sunday.” For some, the lack of supports results in overdose deaths.

We support this request from NYSDOH and hope that CMS will approve it. If we could add anything, it would be that thirty days may be too short a time to do adequate discharge planning and to set up linkages, as there are waiting lists for services in many counties. We were pleased to see this request, but actually would have preferred it to be for sixty days prior to release. Thank you for the opportunity to comment.


Susan Ruff
Advocacy Director
Southern Tier Independence Center
135 East Frederick Street
Binghamton, NY 13904
Nov 1st 2016 4:21 pm Response: #225717 The American Public Health Association’s Jail / Prison Health Committee supports the pending New York State waiver request to the federal government (Centers for Medicare & Medicaid Services (CMS)/HHS to permit use of Medicaid dollars to support 30-day pre-release care coordination for inmates in NYS. We believe these funds need to be available for inmates being released from both jails and prisons.

Approximately 9 million individuals are released from jail every year. During incarceration, many of them become stable due to the accessibility of medical and mental health care. In addition, most prisoners become institutionally clean and sober. A large proportion of jail prisoners are homeless at the time of arrest or become homeless because of their incarceration. The immediate post-release period is critical for prevention of relapse and recidivism. Reentry planning is the key to successful continuity of care for patients with serious medical and mental health problems and linkage with crucial social services for food, housing, education and employment.

With appropriate reentry planning, both the individuals and the community benefit from better health, reduced crime, and an improved quality of life. The ability to provide Medicaid services during the 30-day period prior to release will help to bridge the gap in connectivity to health care services for incarcerated individuals as they re-enter the community.
Nov 2nd 2016 6:15 am Response: #225721 Please allow prisoners to restore their Medicaid before release. For inmates with a mental health disorder, waiting 4-6 weeks for coverage is agony.
Nov 2nd 2016 7:09 am Response: #225725 In support of the following:

"NYSDOH is requesting an authorization of federal Medicaid matching funds for limited
and targeted Medicaid services to be provided in the 30-day period immediately prior to release
to incarcerated individuals who are eligible for and enrolled in Medicaid, and are eligible for New
York’s Health Home program (i.e., they have two or more chronic physical/behavioral
conditions, serious mental illness (SMI) or HIV/AIDS). The goals are to establish linkages to
health care prior to release to help ensure individuals can remain healthy and stable in the
community. The Amendment will also facilitate the goals of Delivery System Reform Incentive
Payment (DSRIP) program to reduce avoidable hospitalizations and health care costs, as well
as improve health outcomes."

My thoughts:

The first month to six weeks is when a person who has been incarcerated comes up against the most obstacles. Navigating being back in community, family pressure, finding work, grocery shopping, laundry, changing thought patterns, these and so much more (not having a sense of hope, feeling defeated, lack of a solid support network) creates a great deal of stress for an individual.

Having the following in place before someone is released will create a make easier space of working their way back into their communities, hopefully minimize the stress, avoid re-incarceration and of course improve health care costs:

- Effectively engage with a Health Home care manager to begin to develop an integrated
care plan that identifies medical, behavioral health and social needs to support a stable
and successful community life;
-? Establish relationships with critical community based medical and behavioral health
professionals prior to discharge; and
-? Receive appropriate stabilizing medications prior to release to facilitate maintaining
medical and psychiatric stability while facing the challenges of transitioning back to the

Please amend the 1115 waiver to accommodate these changes.
Nov 2nd 2016 7:52 am Response: #225729 I work providing housing to people with a mental health diagnosis who are being discharged from prison and state hospitals. I often see people who do not have immediate access to healthcare (psychiatric medications) due to lack of Medicaid. My agencies success rate with these people would be significantly higher if the 1115 waiver were amended to allow them to have Medicaid immediately upon discharge.
Thank you.
Nov 2nd 2016 7:57 am Response: #225733 Please approve the 1115 Waiver for NYS incarcerated individuals. As a community provider for this population I know how essential having these supports will be to their success in reintegrating back into the community.
Nov 2nd 2016 11:06 am Response: #225745 I am an Advocate at a mental health day program, Hands Across Long Island. As necessary we assist individuals who are released from prison. Based on that experience, I support the proposed amendment to serve Incarcerated Individuals through the New York Partnership Plan, to secure and expedite their care.
Nov 2nd 2016 11:14 am Response: #225749 Medicaid is probably the one and only most helpful entitlement for individuals serving jail and/or prison time with a release day scheduled . They need to have access to medical and/or psychiatric services as well as medications and other services that will make easier to assist them prior release date. Active Medicaid prior being released will help to reduce recidivism.
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