CalAIM
On January 26, 2023, California became the first state in the nation to receive federal approval to offer a targeted set of Medicaid services to Medi-Cal-eligible youth and adults in state prisons, county jails, and youth correctional facilities for up to 90 days prior to release. Through a federal Medicaid 1115 demonstration waiver approved by the Centers for Medicare & Medicaid Services (CMS), the Department of Health Care Services (DHCS) will partner with state agencies, counties, providers, and community-based organizations (CBOs) to establish a coordinated community reentry process that will assist people leaving incarceration in connecting to the physical and behavioral health services they need prior to release and reentering their communities. The initiative will help California address the unique and considerable health care needs of justice-involved (JI) individuals, improve health outcomes, deliver care more efficiently, and advance health equity across the state.
The CalAIM Justice-Involved Initiative is Comprised of Pre-Release and Reentry Components
CalAIM justice-involved initiatives support justice-involved individuals by providing key services pre-release, enrolling them in Medi-Cal coverage, and connecting them with behavioral health, social services, and other providers that can support their re-entry.
Pre-Release Medi-Cal Application Processes (went live January 1, 2023)
All counties are mandated to implement pre-release Medi-Cal application processes in county jails and youth correctional facilities and as authorized by SB 184, Medi-Cal benefits for juveniles and adults may be kept in suspended status until the individual is no longer an inmate of a public institution.
Behavioral Health Links (goes live October 1, 2024)
Behavioral health links seek to ensure continuity of treatment for individuals who receive behavioral health services while incarcerated and who wish to continue to receive these services in the community. CA Penal Code §4011.11 (2021) requires DHCS to develop and implement a mandatory process by which county jails and county juvenile facilities coordinate with Medi-Cal managed care plans and Medi-Cal behavioral health delivery systems to facilitate continued behavioral health treatment in the community.
Specifically, behavioral health links include reentry care coordination for Justice Involved (JI) individuals to the following Medi-Cal delivery systems post-release:
- SMHS/County MHP: If an individual is identified as needing MHP services at any point of incarceration, they will qualify for SMHS and require a behavioral health link to a SMHS provider prior to release.
- DMC/DMC-ODS: If an individual is identified as needing MAT at any point of incarceration, they will qualify for DMC/DMC-ODS and require a behavioral health link to a county DMC or DMC-ODS provider prior to release. If an individual meets the diagnostic criteria for SUD, or if they previously had an SUD diagnosis prior to incarceration, they will qualify for DMC/DMC-ODS and require a behavioral health link to a DMC or DMC-ODS provider prior to release.
- MCP or FFS Providers: If an individual has an identified behavioral health need that does not meet criteria for SMHS (e.g., members defined on page 4 of APL 22-006), their mental health needs will be managed by providers through their MCP. These individuals will have their behavioral health link facilitated through the ECM Lead Care Manager.
Correctional Facilities may submit referrals to Monterey County Behavioral Health (the Mental Health Plan) for individuals in need of Specialty Mental Health Services (SMHS) or DMC-ODS services by clicking below. View Information for CFs submitting referrals.
Have questions?
Contact someone from our team. Please submit a request through the Contact Us link below and indicate CalAIM BH Links in the subject line. Please indicate if your question is related to a transition from an Adult or Youth Correctional Facility.
Justice- Involved Initiative Timeline
References for additional information regarding this Initiative