July 2025

Policymakers can strengthen behavioral health supports for people returning to communities after incarceration through policies that promote continuity of care, including removing barriers to care, during this critical transition period. Key areas of focus include:

• Formalize cross-system collaboration to improve care coordination and data sharing. Health care, behavioral health, and criminal legal systems have historically operated in silos. Greater alignment among Medicaid and CHIP agencies, state departments of corrections, county health departments, local jails, reentry providers, behavioral health providers, and community-based organizations can support more seamless care transitions and better outcomes during reentry and beyond. Policymakers can encourage formal partnerships, shared governance models, stakeholder convenings, and data-sharing infrastructure.
• Identify funding opportunities for pre-release and reentry services. Behavioral health and care coordination services during the pre-release period are typically not covered by Medicaid. Section 1115 demonstration waivers offer states a mechanism to expand Medicaid coverage and access to care for people leaving incarceration. Other opportunities include aligning with state general funds, federal grants, and local partnerships to braid or blend funding across systems.
• Align planning with federal requirements and existing authorities. Recent federal legislation — most notably the Consolidated Appropriations Acts of 2023 and 2024 — establish new Medicaid and CHIP requirements related to eligibility, suspension of coverage, and pre-release services for incarcerated individuals. Specifically: (1) beginning January 1, 2025, states must provide EPSDT-comparable screening, diagnostic, and targeted case management services during the 30-day pre-release window for Medicaid- and CHIP-eligible youth — and may opt to provide the full Medicaid benefit package during this period; and (2) beginning January 1, 2026, states must suspend rather than terminate Medicaid and CHIP coverage during incarceration for all enrollees, expanding protections for adults that are already in place for youth. States with approved 1115 Medicaid waivers to provide pre-release services for reentry populations may already have additional infrastructure in place to support these transitions. Policymakers can look to ensure any 1115 waiver implementation planning efforts are aligned with these new requirements.
• Prioritize access to community-based care for people with criminal legal system involvement. Individuals with a history of criminal legal system involvement often face stigma, unique health challenges, and barriers to care. Policymakers can prioritize this population in planning efforts for community-based services, support providers in building capacity to serve justice-involved individuals, and align incentives to encourage engagement from providers and health plans. Partnering with existing safety-net infrastructure — such as community mental health centers, certified community behavioral health clinics, and federally qualified health centers — can support integrated, high-quality primary and behavioral health care.
• Strengthen the behavioral-health workforce capacity across correctional and community settings. Persistent shortages of behavioral health providers can limit access to care during reentry and exacerbate gaps in care. Policymakers can expand capacity by: (1) increasing access to targeted training and supervision; (2) creating streamlined enrollment pathways for specialty clinicians and peer navigators; and (3) broadening telehealth options, including dedicated tele-behavioral-health pods in correctional facilities.
• Embed peers and community health workers with lived experience throughout the reentry care continuum. Peers and community health workers with lived experience play a critical role in building trust, enhancing engagement, and supporting recovery. Policymakers can support their integration by enabling streamlined security clearance processes within correctional settings, ensuring access to trauma-informed supervision, and developing tailored financing strategies — such as Medicaid reimbursement pathways for peer support providers — to support their engagement in both pre- and post-release care.