An Act to Reduce Recidivism by Improving Access to Benefits for Individuals
with Psychiatric Disabilities upon Release from Incarceration
Commentary on Article VI
Even when the state adopts all of the policies and processes set forth
in Articles III-V to facilitate and expedite access to benefits, some
inmates may nevertheless end up released and in the community without
benefits. This might result from their being released earlier than expected
because of the progress of their legal cases, or from processing delays
by SSA, errors in identifying potentially eligible inmates and completing
applications, or other unanticipated circumstances.
This article creates
bridge programs to keep such individuals from falling through the cracks.
The bridge programs are available to released inmates
who have applied for federal benefits but whose applications are still
pending. Released inmates qualify for the bridge programs if their
applications for federal benefits were filed during incarceration or
within three
months of their release. The bridge programs provide temporary health
care coverage and income benefits during the period that federal benefit
applications are pending. Without bridge programs, many released inmates
will lack access to health care coverage and income support and be
at risk of decomposition and re-offending.1
VI. B. Temporary Medicaid
Regardless whether the inmate has ever before been a Medicaid recipient,
states have the flexibility under federal law to place potentially
eligible individuals in their Medicaid program, pending full review
of eligibility. Initially, the cost of Medicaid services must be borne
by the state, but once an individual’s Medicaid eligibility is
confirmed, the state may seek reimbursement from the federal government
for services rendered before the eligibility determination.2 Reimbursement
will be made in accord with the state’s match arrangement.3
Allowing for quick access imposes some financial risk on the state because
some individuals enrolled in the temporary Medicaid program may ultimately
be found ineligible for Medicaid. However, the state incurs a greater
risk from the recidivism that often results when released inmates do
not have access to appropriate mental health services.4
VI. C. Temporary Income Support
Many inmates with psychiatric disorders depend on SSI or SSDI to secure
stable housing. Without stable housing, released inmates are at risk
of decomposition and re-offending. As the Council of State Governments
Consensus Project notes, “[a]dequate housing is the linchpin
of successful reentry for offenders with mental illness.”5
When SSI or SSDI cash benefits are not immediately available, temporary
income support should be provided to assist released inmates in securing
housing and other necessities.
Temporary income support may be provided by putting individuals on state
General Assistance in states that have such a program, or through a new
program. The model law directs that payments be equal to the basic SSI
payment in the state. A less costly, but considerably less effective,
alterative would be to make payments equal to the General Assistance
rate.
To the extent permitted by federal law, states may recoup support
payments made to released inmates from SSI and SSDI back benefits. Under
the model
law, to be eligible for the temporary income support program, an individual
must have applied for SSI or SSDI. Once the individual’s eligibility
for SSI or SSDI is established, the individual will receive back benefits
for the time following release during which the individual’s SSI
or SSDI application was pending.
The state may arrange with recipients
of temporary income payments to be reimbursed from any SSI and SSDI
back benefits the recipient receives.6
Notes
1. See Nelson, M., Deess, P., and Allen, C. The First
Month Out, Post-Incarceration Experiences in New York City (New York,
New York: Vera Institute of Justice,
1999).
2. 42 U.S.C. § 1396a(a)(34), 42 C.F.R. § 435.914.
3.
In all states, the federal government pays at least 50% of the cost of
the Medicaid program. The actual proportion of costs paid by the federal
government depends on the economic well-being of the state’s population:
the poorer the state, the higher the proportion of costs paid by the
federal government. In the poorest states, the federal government pays
approximately 75% of the cost of Medicaid services. POMS SI 01715.001
B (“The Federal government pays 50 percent of Medicaid administrative
costs and between 50 and 83 percent of program costs following a statutory
cost-sharing formula.”) “POMS” refers to the Social
Security Administration’s Program Operations Manual System, available
online at SSA’s website, http://policy.ssa.gov/poms.nsf.
4. See discussion of costs in the commentaries on Articles
I and X.
5. Council of State Governments, Criminal Justice/Mental
Health Consensus Project (June 2002) at p. 167. Also, “housing
is crucial for helping individuals with mental illness maintain stability
and avoid
involvement
in the criminal justice system.” Id. at p. 110.
6. We are unaware
of any federal law that would bar such an arrangement. See Washington
State Dept. of Social and Health Services v. Guardianship
Estate of Keffeler, — U.S. —, 123 S.Ct. 1017 (2003) (state
may recoup foster care expenditures from children’s SSI and SSDI
benefits).
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