CalAIM Justice-Involved Initiative

Effective October 1, 2024, only Out-of-County Behavioral Health Links will be available.

In-county services will be implemented at a later date, in conjunction with our local adult and youth correctional facilities.

What is the California Advancing and Innovating Medi-Cal (CalAIM) Justice-Involved (JI) Initiative?

The CalAIM JI is a new initiative aimed at addressing systemic inequities in the criminal justice system, particularly the high rates of incarceration linked to mental health issues and the criminalization of substance use disorders. Through CalAIM JI, youth and adults in state prisons, county jails, and youth correctional facilities can access a targeted set of Medicaid services for up to 90 days prior to their release. By providing these pre-release services, CalAIM aims to improve health outcomes for JI individuals as they prepare to re-enter their communities.

Goals

CalAIM JI initiative seeks to create a healthier and more equitable reentry experience for JI individuals by addressing their healthcare needs related to incarceration. This initiative aims to reduce health disparities, support rehabilitation, and promote sustainable reintegration into the community, ensuring that individuals have the necessary resources and support needed to thrive post-incarceration.

Objectives

Enhance physical and mental health outcomes.
Create a coordinated community reentry process to connect individuals leaving incarceration with necessary health services before their release.
Ensure continuity of healthcare coverage post-incarceration to facilitate access to essential programs and services.
Improving connections between pre-release and community-based services to bridge gaps in care.
Prevent unnecessary admissions to inpatient hospitals, psychiatric hospitals, nursing homes, and emergency departments.

What are the roles and responsibilities of Behavioral Health Services (BHS) under the CalAIM JI Initiative?

The role and responsibilities of BHS in the CalAIM JI initiative include:

Creating care linkages and coordinating with community-based providers to ensure smooth transitions and support.
Conducting clinical consultation services to help inform the pre-release care plans.
Participating in transition of care encounters as identified reentry care plans, documenting them in medical records.
Initiating behavioral health services during incarceration or detention and supporting service coordination both pre-release and upon reentry.
Arranging appointments and ensuring timely access to appropriate community-based care.

Eligibility Criteria

Medi-Cal members who meet the following eligibility criteria can access the 90-day pre-release services while in custody at local jails, youth detention facilities, and state prisons.

1. Adults who have one or more of the following qualifying health needs:

Confirmed or suspected mental health diagnosis;
A substance use disorder or suspected diagnosis;

2. Youth who are in custody of a correctional facility do not need to meet clinical criteria.

Pre-Release Medi-Cal Services (in-custody)

Reentry care management services;

Physical and behavioral health clinical consultation services provided through telehealth or in-person, as needed, to diagnose health conditions, provide treatment as appropriate, and support pre-release care managers’ development of a post-release treatment plan and discharge planning;

Laboratory and radiology services;

Medications and medication administration;

Medication Assisted Therapy (MAT), for all Food and Drug Administration-approved medications, including coverage for counseling; and

Services provided by community health works with lived experience.

In addition to the above pre-release services, qualifying members will receive covered outpatient prescribed medications and over-the-county drugs (a minimum 30-day supply as clinically appropriate, and durable medical equipment (DME) upon release.

Behavioral Health Links Referral (for community re-entry)

To ensure a smooth referral process for behavioral health services, please download and complete the CalAIM JI Referral on the right ribbon. Once completed, submit the form to dhs-bhs-jail_referral@saccounty.gov. Your submission will be reviewed and assigned to a clinician to complete an assessment and behavioral health linkages.

For out-of-county correctional facilities: Assessment, linkage, and coordination of care will be provided via telehealth. Please download and complete the Release of Information (ROI) form on the right ribbon and attach it to the referral form when submitting to BHS.

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