Massive Shift in Potential Funding for Healthcare in County Jails

Federal agencies make good on January promise to provide more guidance on how states can fund inmate healthcare through Medicaid.

In January the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid (CMS), approved a waiver for California to begin using Medicaid funds for inmate services provided they were used 90 days prior to release. At the time this was even more than foreshadowing, as the CMS press release said guidance would be forthcoming for other states to apply for similar waivers. This initial approval was the first of its kind, signaling the potential to overturn a long-standing policy to exclude inmates from coverage, including presumed innocent, pre-trial detainees and inmates with a substance use disorder.

Yesterday HHS and CMS made good on that promise, issuing a press release and 42-page document outlining the policy shift and guidance for other states to follow suit. Funding and workforce volatility has been a major barrier to implementation of HB 116 in local correctional facilities, which is the requirement for all county jails to offer medication-assisted treatment to inmates found to have an opioid use disorder. Coverage of services for eligible detainees and inmates would allow local facilities more financial flexibility in providing services and allows for the potential to reallocate vital and scarce resources to immediate and long-standing infrastructure needs.

Read NACo presentation on inmate healthcare and recidivism.

Read previous MACo coverage on inmate healthcare.