States that expanded Medicaid coverage under the Affordable Care Act have unprecedented opportunities to connect adults released from prison or jail with needed physical and behavioral health services and social supports. This population – disproportionate­ly male, minority, and poor – suffers from high rates of mental illness and substance use disor­ders. Providing critical health services and social supports for these individuals can potentially slow the revolving door of recidivism plaguing the justice system and reduce avoidable health care costs.

This brief, made possible through the Milbank Memorial Fund’s Reforming States Group, examines how innovative state and county authorities are improving health services for the justice-involved, mainly through comprehensive care coordination interventions to ensure access to physical and behavioral health services and social supports as individuals transition into their communities. Some of these interventions – in both expansion as well as non-expansion states – include peer supports, case management, and integrated mental health, substance use, and social supports. Programs like the Transitions Clinic Network in seven states across the country, the New York State Criminal Justice Health Homes, and the Miami-Dade County Criminal Mental Health Project are just a few of the innovations featured.

In addition to focusing on implementing Medicaid enrollment for the justice-involved population, the brief outlines key strategies for supporting care coordination for individuals transitioning from incarceration. It also examines the literature on evidence-based and promising programs for the treatment of mental health and substance use disorders for the justice-involved population and the authorities under which states can target these services.