Discharge Planning for Inmates Being Released from Jail or Prison
People with serious mental illnesses who have been in jail or prison
are especially susceptible to rearrest when released-as they often are-with
nothing but a few bus tokens, a few pills and a paper with the address
of a mental health center. Discharge planning, to help them obtain to
public benefits and link them to community treatment, is an important
tool for breaking such a cycle of rearrest and incarceration. Yet nationally
only one third of inmates with mental illnesses receive discharge planning
services. The Bazelon Center has produced a booklet explaining
the federal rules for access by released inmates to public benefits such
as SSI and Medicaid, which they could used to obtain housing
and mental health treatment.
In a precedent-setting class action, a state court required New York
City to provide discharge planning for jail inmates who have a mental
illness. The September 12 decision,
Brad H. v. City of New York, was unanimously upheld on October 31,
2000, by the Appellate Division of the New York State Supreme Court. The
plaintiffs in the case were represented by Debevoise & Plimpton, Urban
Justice Center and NY Lawyers for the Public Interest. The city's subsequent
appeal was denied.
The city has balked at providing discharge planning services for inmates
being released from jails such as the one at Rikers Island. Instead, the
city drops these individuals at a toll plaza in the middle of the night
with $1.50 and a two subway tokens. People who took medication while incarcerated
are released without a supply to carry them until they can obtain and
fill a prescription. No one ensures that they have access to public benefits.
If they received SSI and Medicaid before incarceration, they can reapply,
or, if not, they can apply for the first time. But the paperwork is cumbersome
and unfamiliar, and the applications take months to process-months during
which many former inmates have no money for housing or medication. As
the judge wrote in his initial decision, the release of prisoners without
needed treatment planning risks "a return to the cycle of likely harm
to themselves and/or others" and their resulting rearrest.
Discharge planning, properly accomplished, would provide case managers
to assist inmates in qualifying for disability benefits and Medicaid
immediately
upon their release. It would also link them with community resources
for housing and mental health and rehabilitation services. Yet many
jail administrators
are unaware of what is entailed and how discharge planning can be achieved.
For example, jails can enter into pre-release agreements with the Social
Security Administrations and receive assistance from their local Social
Security offices to help inmates qualify for SSI benefits immediately
upon release.1 Finding
the Key explains these and other approaches. Its text can be downloaded
from this site. Another booklet is in accessible language for consumers
and their families: Arrested?
What Happens to Your Benefits
If You Go to Jail or Prison?—A Guide to Federal Rules on SSI, SSDI, Medicaid,
Medicare and Veterans Benefits for Adults with Disabilities (March 2004)
In upholding the Brad H. decision, the appeals court also accepted an
amicus brief by the Bazelon Center, the National
Alliance for the Mentally Ill (NAMI), the American Orthopsychiatric Association
and 11 New York organizations and coalitions. The law firm Gibson, Dunn
& Crutcher donated their time to write the brief on behalf of the above
organizations. The brief extensively documents the importance of discharge
planning to assure continuity of services and spells out how jails can
implement the requirement-already mandated by New York State law-consistent
with standards developed by the major professional organizations.
Notes
1. The Social Security Administration has
a “prerelease procedure” designed to “promote deinstitutionalization
by assuring eligible individuals timely SSI payments when they reenter
the community.”See the Social Security Administrations Program Operations
Manual System (“POMS”) (available online at the SSA website,
http://policy.ssa.gov/poms.nsf/aboutpoms
at POMS SI 00520.900-930, and Section 1631(m) of the Social Security Act,
42 U.S.C. § 1383(m). [This link takes you to POMS home page, then
you must click Table of Contents and keep clicking to get SI 00520.900
through .930]
For examples of Pre-Release Agreements, see POMS SI 00520.930, Exhibit
2.
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