Expedited Medicaid Restoration for Persons with Severe Mental Illness Released from Jails, Prisons, and State Hospitals: A One-Year Follow-Up

The loss of Medicaid is widely thought to be a barrier to successful community reintegration for persons with severe mental illness who are released from jails, prisons and state hospitals. Several states have adopted expedited Medicaid restoration programs to reconnect consumers to their benefits prior to release from institutional settings; however, the impact of these programs is unclear. Here, linked administrative data from Washington State were used to examine hospital, service utilization and criminal justice outcomes among 2,516 consumers who were referred to an expedited Medicaid restoration program prior to their release from one of three institutional settings: jails, state prisons, or state mental hospitals. Among 2,516 referrals in 2006, 51% (1,283) were from jails, 21% (528) were from prisons and 28% (705) were from state hospitals. Restoration rates were lower for jails (57%) compared to hospitals (91%) or prisons (79%). Consumers with restored benefits accessed mental health services at higher rates over a three-month post-release period versus those without restored benefits (75% vs. 45% for restored and not restored groups, respectively, p<.05). Also, consumers with restored benefits had lower recidivism rates over a six-month post-release period versus those without restored benefits (24% vs. 34% for restored and not restored groups, respectively, p<.05). Findings suggest that expedited Medicaid restoration can increase service use and decrease recidivism; however, Medicaid alone is not enough. Housing, employment, and evidence-based practices should be available to further facilitate successful community reentry for consumers who are released from jails, prisons and hospitals.