Connecting Criminal Justice to Health Care Initiative (CCJH): Request for Proposals Webinar for Interested Jurisdictions November 30, 2015 1:00 2:30 PM ET
Agenda 2 CCJH Initiative Overview Scope of the CCJH Initiative CCJH Initiative Application CCJH Initiative Team
CCJH Initiative Overview 3
CCJH Initiative Overview 4 With support from the U.S. Department of Justice s Bureau of Justice Assistance, the Urban Institute and Manatt are facilitating The Connecting Criminal Justice with Health Care Initiative (CCJH), which brings together state and local corrections and health care officials to develop and implement strategies for connecting justice-involved individuals with health care. Participants in CCJH will develop, test, and implement innovative strategies in three key areas: Enrolling the justice involved population into Medicaid; Establishing systems of health care tailored to meet the distinctive needs of the justiceinvolved population; and Creating sustainable financing mechanisms for health care provided to inmates in justice settings. Selected state/local partnerships will participate in learning collaboratives to identify their highest priority problems and develop potential solutions. The insights, policies, and operational strategies that emerge from the LCs will be incorporated into resources for stakeholders around the nation.
Setting the Stage: Criminal Justice and Health Care 5 Vulnerable, high cost population Opportunities for progress Justice-involved individuals are seven times as likely as the general population to experience mental health and substance use disorders (M/SUD), infectious disease, and chronic health conditions. Individuals face a 12-fold increased risk of death during the first 2 weeks after release. Health care costs for prisoners account for 6 to 33 percent of institutional corrections spending. 70 to 90 percent of individuals released from prison and jail each year lack health insurance. In states that expand Medicaid, a majority of inmates are now eligible for coverage. Even in non-expansion states, justiceinvolved individuals can sometimes qualify for Medicaid or subsidized private coverage through health insurance Marketplaces. Now that the Affordable Care Act is past the early stages of implementation, states and localities are focusing on new opportunities to connect justice-involved individuals to coverage and care.
Goal of CCJH Initiative 6 1 2 The CCJH Initiative will support participants ability to improve health outcomes for justice-involved individuals, enhance public safety, and conserve taxpayer resources Participants will have the opportunity to: Bring together criminal justice agencies with the state Medicaid program to develop actionable policies Receive technical assistance that includes active problem-solving with other states Collaborate with national experts on innovative options to 1) expedite enrollment, 2) build comprehensive and coordinated systems of care, and 3) obtain permitted Medicaid funding Participate in learning collaboratives, a time-tested method for rapidly designing, implementing, and revising promising ideas Strengthen the capacity of state and local justice agencies to document and measure the effects of their policies and practices Teams successes and experiences will serve as examples to other stakeholders through national policy guides and webinars
Scope of the CCJH Initiative 7
Scope of the CCJH Initiative 8 Selected state/local teams will have the opportunity to: Participate in the CCJH Learning Collaboratives Strengthen Capacity for Monitoring and Implementation
Participate in the CCJH Learning Collaboratives 9 Urban/Manatt expert faculty will provide technical assistance to state/local partners through three Learning Collaboratives (LCs) Scope of Work Under the LC model, members from different regions come together in learning sessions and action periods to achieve progress on specific issues Before LCs begin, Urban/Manatt will coordinate site visits and teleconferences to identify teams goals, obstacles and experiences. The LCs will cover: (1) linkage to coverage; (2) coordinated, comprehensive systems of care; and (3) sustainable funding for corrections-based health care. LCs will focus on: practical strategies and solutions; learning from false starts and pivoting; peer-topeer learning. Team members share information about their progress and problems, serving as coaches along with faculty.
LC #1: Linkage to Coverage 10 Objectives This LC will focus on enrolling the justice involved population into Medicaid and other forms of health coverage using strategies that focus on key intercept points within the justice system and impose the least possible burden on state and local resources. The key intercept points will focus on the front end and back end of individuals interaction with the justice system. Strategies will leverage innovative Medicaid business rules and data matches to minimize laborintensive enrollment work by justice agency staff. Participation This LC may include: representatives from state and local health agencies, such as Medicaid and Marketplaces; and, justice officials who are knowledgeable about front-end justice intercept points and re-entry
LC #2: Coordinated, Comprehensive Systems of Care 11 Objectives This LC will pursue strategies to establish systems of health care tailored to meet the distinctive needs of the justice-involved population, including comprehensive coverage of mental health and substance use disorders and care coordinated between community and justice settings. Participation This LC may include: Medicaid agency staff; behavioral health agency staff; justice agency staff familiar with health care provided in correctional settings and following reentry; other relevant agencies, potentially including local housing authorities; and community-based health care providers or health plans.
LC #3: Sustainable Funding for Corrections-Based Health Care 12 Objectives This LC will develop strategies to create sustainable financing mechanisms for health care provided to inmates in justice settings without running afoul of federal restrictions or the policies underlying those restrictions. Participation This LC may include: representatives of state Medicaid agencies; Marketplaces officials; and officials from the state prison and local jails.
Strengthen Capacity for Monitoring and Implementation 13 The Urban team will support each partnership site to document and measure the impact of the interventions. Scope of Work Collaborate with state/local teams to apply a performance measurement perspective that translates LC goals into concrete performance indicators Identify data elements to track key measures, develop local definitions for those measures, and create scorecards that serve as reporting vehicles Provide assistance in identifying key data gaps, including (1) data integration across systems and (2) limits on capacity to extract, analyze, and report information Develop a process for routinely updating the scorecard, including after the project is complete
CCJH Initiative Application 14
Eligibility 15 To qualify, a state/local team needs participants in each of the following categories: State criminal justice agencies, including individuals responsible for handling initial contact with the criminal justice system, providing health care in prison, structuring reentry, and overseeing post-release integration into the community Local criminal justice agencies, from a single, major jurisdiction (either county or city) within the state involved in the activities mentioned above The state Medicaid agency, including officials responsible for eligibility, enrollment policies and systems, health care delivery system reform that focuses on care coordination, coverage of M/SUD services, and Alternative Benefit Plans for low-income adults Other agencies deemed necessary by the state/local team such as leaders of state and/or local government agencies that focus on M/SUD services, housing agencies, providers or health plans. If a team would like to include State-based Marketplace officials, but is not able to recruit due to open enrollment constraints, the team may indicate its intent to solicit involvement from Marketplace officials in 2016.
Expectations of CCJH Teams 16 Commit to 9-month engagement Actively participate in all three LCs, including action periods Collaborate with Urban to develop and implement monitoring systems Designate one staff member who will coordinate activities Allow information-sharing with local, state, and national partners regularly Support program operation and staffing costs associated with this project Commit to the ongoing self-evaluation of their CCJH efforts
Application and Selection 17 Application narratives should not exceed 18 single-spaced pages. Prerequisites Letter of Interest and Commitment from Team Members Letters of Commitment from Jurisdictional Chief Executives Selection Factors Why are your team s agencies interested in participating in the CCJH Initiative? What is your team s capacity to generate and implement practical policy and operational changes that support coverage and care for justice-involved populations? What is the nature of the proposed partnership, and who is involved? Who will serve as the CCJH coordinator for your jurisdiction? What is your team s capacity to generate and use relevant Medicaid and criminal justice data?
Timeline 18 December 11, 2015 at 5pm ET: Applications for CCJH Initiative due 2015 2016 Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep ~December 28, 2015: Selected teams notified January 1, 2016 September 30, 2016: Technical assistance is provided by Urban and Manatt; Learning collaboratives convene for peer-topeer learning; learning sessions are followed by action periods
CCJH Initiative Team 19
CCJH Team 20 Stan Dorn, J.D., Co-Principal Investigator, Senior Fellow at Urban Institute s Health Policy Center Mr. Dorn is a leading expert on state implementation of the Affordable Care Act (ACA), including provisions involving streamlined enrollment into Medicaid, and has provided direct technical assistance to many states on the issue. Jesse Jannetta, M.P.P., Co-Principal Investigator, Senior Research Associate in Urban s Justice Policy Center Mr. Jannetta serves as the director of the Transition from Jail to Community Initiative, the Co-Principal Investigator of the evaluation of pre-release Medicaid enrollment as a reentry strategy, and the Co-Principal Investigator of the Los Angeles Gang Reduction and Youth Development Strategy. Kamala Mallik-Kane, M.P.H., Research Associate in Urban s Justice Policy Center With 20 years of experience researching criminal justice, public health, and human services issues, Ms. Mallik-Kane directs Urban s Evaluation of Early Access to Medicaid as Reentry Strategy and has written on the role of physical and behavioral health in prisoner reentry. Melinda Dutton, J.D., Partner Ms. Dutton has extensive experience working with public health insurance programs and the healthcare safety net, advising foundations, state governments, the federal Department of Health and Human Services, and provider groups on the ACA s implications. Jocelyn Guyer, M.P.A., Director Ms. Guyer provides policy expertise, strategic advice, and technical support to states, foundations, and other clients on ACA implementation, Medicaid, and the Children's Health Insurance Program (CHIP). Kinda Serafi, J.D., Counsel Ms. Serafi has extensive experience implementing the coverage continuum under federal health care reform and navigating the legal, policy and operational challenges of the ACA, Medicaid, CHIP, Marketplace and payment and delivery reform.
Questions and Answers 21
Submission Guidelines 22 Please submit applications and all supporting attachments in electronic form to CCJH@urban.org. You may ask about the application process by contacting the project manager at Urban: Jesse Jannetta The Urban Institute 2100 M Street, N.W. Washington, DC 20037 Telephone: 202-261-5593 JJannetta@urban.org
This project was supported by Grant No. 2015-CZ-BX-K011 awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the Department of Justice's Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, and the SMART Office. Points of view or opinions in this document are those of the authors and do not necessarily represent the official position or policies of the U.S. Department of Justice. 23