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Connecticut and the National Institute of Corrections Identify Opportunities to Increase Medicaid Enrollment
NIC News & Updates


With the Patient Protection and Affordable Care Act (ACA), it is now possible for millions of low-income individuals in the criminal justice system to obtain insurance coverage for their physical and behavioral health care needs.  The National Institute of Corrections (NIC) has provided technical assistance to the state of Connecticut for two work sessions to identify opportunities for increasing Medicaid enrollment.

The purpose of the first work session was to convene Connecticut stakeholders to identify and discuss opportunities and challenges related to the Affordable Care Act (ACA) and Medicaid eligibility determination and enrollment at decision points in the criminal justice system. During this two-day work session, participants developed a map of criminal justice system decision-points, discussed existing ACA enrollment activities, and identified and prioritized opportunities for increasing enrollment. The second work session was convened to follow-up on a particular area of focus to analyze and increase the understanding of the flow of information across the criminal justice system and beyond, including what data are collected, who collects it, where it is stored and how it is shared.ACA Mapping

The key method used in the first session to address improving enrollment was a systems mapping process. Systems mapping creates opportunities for dialogue and relationship building between health and justice stakeholders. By working together to build a visual portrait of how individuals progress through the criminal justice system, health and justice stakeholders gain better understanding of their respective policies and practices. In addition, mapping allows jurisdictions to consider decision points throughout the entire criminal justice system when exploring opportunities to enroll criminal justice-involved individuals in insurance coverage.

While developing the systems map for Connecticut, four opportunities/issues for improving enrollment were identified and prioritized:

  1. Termination versus Suspension of Medicaid Benefits for Jail and/or Prison
  2. Enrolling Inmates and Detainees at DOC Intake
  3. Enrolling Defendants at Court Appearances
  4. Information Flow / Smooth Handoffs

The fourth opportunity around information flow/smooth handoffs became the focus of the second work session.

Both sessions successfully resulted in bringing together a wide representation of participants, with over 45 individuals across state organizations and community providers, to improve their understanding of the opportunities ACA provides and to identify and prioritize Connecticut’s next steps in improving Medicaid enrollment.

From Dr. Kathleen Maurer, Connecticut DOC Director of Health Services, NIC’s technical assistance was beneficial to “allow us to focus on how and where to act and prioritize with enrollment” and “gain communication between state and local agencies and commissioner support.  We realized as a state we were dealing with common interests and a common clientele”.  By working with NIC, Dr. Maurer was able to progress toward achieving her three goals: connecting to the community, sharing information on Medicaid eligible offenders and effective electronic transmission of information.  An additional benefit from the two working sessions was to improve processes in the Connecticut DOC by leveraging an existing Connecticut program, LeanCT.  The LeanCT program assists agencies in using organizational, process and programmatic improvement techniques, such as Lean, to help create a sustainable, customer-focused, and more efficient future for Connecticut.

See additional resources on NIC’s ACA Mapping Initiative

Posted Wed, Apr 8 2015 6:51 AM by Susan Powell


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This blog is funded by a contract from the National Institute of Corrections, U.S. Department of Justice. Points of view or opinions stated 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.