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Obamacare and Criminal Justice-- New York Developments

Obamacare and Criminal Justice-- New York Developments. Tracie M. Gardner October 22, 2013. Legal Action Center -- who we are:. Country’s only public interest law and policy org focused on with addiction, criminal records, and HIV/AIDS

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Obamacare and Criminal Justice-- New York Developments

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  1. Obamacare and Criminal Justice-- New York Developments Tracie M. Gardner October 22, 2013

  2. Legal Action Center -- who we are: • Country’s only public interest law and policy org focused on with addiction, criminal records, and HIV/AIDS • Co-Chair nationalCoalition for Whole Health, over 100 national, state and local members advocating for strong ACA implementation for MH/SUD. • Focus on expanding access to care for people with SUD, HIV/AIDS and people in the criminal justice system; promoting health care not criminal justice responses to addiction

  3. Executive Changes on Public Safety and Health • "It is of compelling public importance that the State conduct a fundamental restructuring of its Medicaid program to achieve measurable improvement in health outcomes, sustainable cost control and a more efficient administrative structure."- Governor Andrew M. Cuomo, January 5, 2011 • Governor Cuomo Announces Closure of Seven State Prison Facilities-- Action fulfills Governor's pledge to make appropriate changes based on declining inmate population and provides $184 million in savings to state taxpayers over next two years. June 30, 2011

  4. Maximizing the ACA for criminal justice-involved individuals Major opportunities for the CJ Population • Significantly close the insurance and treatment gaps • Better ensure that our constituencies have all of their complex health needs met • Shift to new payers, less reliance on unstable funding streams • Foster a paradigm shift in the criminal justice system for people with SUD--opportunities at each intercept

  5. It’s prison, stupid. test

  6. New research shows precisely how the prison-to-poverty cycle does its damage.

  7. Unlike men, the highest concentration of women living with HIV/AIDS falls almost entirely within the highest poverty neighborhoods in the City.

  8. LAC role in bringing Health and CJ together • Medicaid suspension vs. termination • Early efforts in NY to facilitate Medicaid applications for people who are about to leave prison. • LAC provided information about provision of Medicaid law that allows federal reimbursement for certain institutional care provided in the community for people in prison.

  9. New York Work • Overarching goal: improve health care access and health outcomes for individuals at all stages of involvement in New York State’s criminal justice system utilizing opportunity of recent and ongoing federal and state health care reform efforts.

  10. Opportunities for the Criminal Justice System--NYS • Improve Health and Reduce Recidivism and Incarceration of Criminal Justice Population by: (1) Enrolling Them in Medicaid and (2) Linking them to and providing them the health and other care • Link Individuals in the Criminal Justice System to Health Homes: front and back end • Inclusion of criminal justice services in the MA waiver

  11. Sequential Intercept Model: A teaching tool.

  12. Health Homes • Health homes are meant to build on other care coordination models to create linkages to community and social supports, enhance coordination of physical health, mental health and substance use care, and to improve health outcomes for high-cost patients.

  13. Health Home Highest Risk Population – Multiple Co-occurring Complex Disease so Care MUST Be Integrated

  14. Preliminary 2011 NYC CJ Data • Sample of 2,055 unique Medicaid IDs from NYC CJ data; 1,121 members matched to HHs • Medicaid IDs matched to the calendar year 2011 Health Home eligible population.

  15. Health Home Eligibles in NYS(1M Medicaid Members out of 5M) Total Complex N=1,050,385 $2,366 PMPM 32% Dual 55% MMC $28.2 Billion test Time Period: July 1, 2010 – June 30, 2011

  16. Workgroup on CJ and Health Homes Goals: • Engage the criminal justice population in health homes by creating 6 health home pilots that will pioneer effective engagement of people in state prisons, local jails and probation and alternative to incarceration/reentry programs. • Identify models for successful collaborations between the health care and criminal justice systems to engage and serve this population most effectively.

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