Medicaid Pre-Release Enrollment Program

Ohio’s Inmate Population 27 institutions located across the state There are currently over 50,000 inmates 91.6% male, 8.4% female Average age: 37 years Average stay in prison: 2.3 years 18% of inmates are over 50 years of age High prevalence of chronic care, mental health issues, and history of drug/alcohol addiction Sources: ODRC Fact Sheet, Sept 2016 http://www.drc.ohio.gov/Portals/0/Reentry/Reports/Monthly/2016/September%202016%20Fact%20Sheet.pdf?ver=2016-09-15-120941-800

Medicaid Pre-Release Enrollment Program Program Partners: Ohio Department of Rehabilitation and Corrections (ODRC) and Ohio Department of Medicaid (ODM) Ohio Mental Health and Addiction Services (OhioMHAS) and Ohio Department of Health (ODH) Medicaid Managed Care Plans Medicaid Consumer Hotline Implemented a specialized Medicaid

Pre-Release Program Goals Access to Health Services Reduce Recidivism Improve Health Outcomes

Medicaid Enrollment Process Overview Pre-enrollment Class held by Peer to Peer Medicaid Guides Pre-enrollment Class held by Peer to Peer Medicaid Guides Enrollment Class *Must sign Medicaid Authorization, Provide Forwarding Address, & Release of Information Form Enrollment Class *Must sign Medicaid Authorization, Provide Forwarding Address, & Release of Information Form Medicaid eligibility is determined and if eligible, individual is enrolled in a Managed Care Plan Medicaid eligibility is determined and if eligible, individual is enrolled in a Managed Care Plan Medicaid card is provided to Individual upon release Medicaid card is provided to Individual upon release Individual successfully transitions to healthcare plan upon release Individual successfully transitions to healthcare plan upon release If an individual chooses to opt-out, re- educated about benefits of applying. If Medicaid is denied, individual can Appeal Medicaid’s decision Five Plans to Choose from: BUCKEYE HEALTH PLAN, CARESOURCE, MOLINA HEALTHCARE, PARMOUNT ADVANTAGE & UNITEDHEALTHCARE COMMUNITY PLAN

Pre-Release Care Management: Who is Eligible? Mental Illness Substance Abuse Chronic Condition HIV Positive Hepatitis C Pregnancy Must meet two or more to qualify Qualify automatically

Pre-Release Care Management: Transition to the Community 30 – 60 Days prior to release DRC conducts pre-screening: Does individual qualify? MCP care manager assigned & develops transition plan 7 – 14 Days prior to release MCP care manager and individual review transition plan via teleconference Date of release Individual receives final copy of transition plan and insurance card Post-Release Individual accesses health care services and maintains relationship with MCP care manager. 11/19/2018 7

Accomplishments (September 2014 – Present) ODM and ODRC visited 25 of 27 facilities since September 2014 Trained 60 Peer to Peer Medicaid Guides 7,500+ individuals able to access Medicaid benefits on day of release ~1,200 individuals received transition assistance from an MCP care manager prior to release. What’s to Come All facilities activated by January 2017 Partner with DRC on robust program evaluation Explore program expansion opportunities

Care Management – Success Story Release Challenges No housing, primary care physician or transportation Addiction and history of relapse Care Manager Outreach Established primary care physician, connected member to a sober living home and mental health resources Member Success Referred for Hepatitis C treatment, smoking cessation, mental health and substance abuse treatments Completed financial aid applications for college and plans to attend the University of Toledo Social Work Program

Participant Feedback Appreciation for support and regular contact with care manager Strengthened by health plan’s involvement and care managers that stayed connected and followed progress Renewed sense of hope and determination