​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​CalAIM Justice-Involved Initiative

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Justice-Involved individuals - people who are now, or have spent time, in jails, youth correctional facilities, or prisons - are at higher risk for injury and death than the general public. They face disproportionate risk of violence, overdose, and suicide.1

  • Incarcerated individuals in California jails under active care for mental health issues rose by 63 percent over the last decade.2
  • 66 percent Californians in jail or prison have high or moderate need for substance use disorder treatment.3
  • Overdose is the leading cause of death for people recently released from incarceration, and individuals in California jails or prisons have a drug overdose death rate of more than three times the total national prison rate.
  • ​In California, nearly​ 29 percent of incarcerated​ men are Black, while Black men make up only 5.6 percent of the state's total population. 
Through its Justice Involved initiative, California is taking significant steps to address poor health outcomes in this population. The state is establishing Medi-Cal enrollment processes, providing targeted Medi-Cal services to eligible individuals while they are incarcerated immediately prior to their release, and ensuring continuity of coverage and services after incarceration as part of re-entry planning.​


California Obtains Federal Approval to Expand Medicaid Services for Justice-Involved Individuals 

​Full press release​

On January 26, 2023, California became the first state in the nation approved​ to offer a targeted set of Medicaid services to youth and adults in state prisons, county jails, and youth correctional facilities for up to 90 days prior to release. Through a federal Medicaid 1115 demonstration waiver announced by the Centers for Medicare & Medicaid Services (CMS), DHCS will partner with state agencies, counties, and community-based organizations to establish a coordinated community reentry process that will assist people leaving incarceration connect to the physical and behavioral health services they need prior to release. 

The goals of the Medi-Cal Justice-Involved initiative include increasing and continuing Medi-Cal coverage; improving coordination and communication among correctional systems, Medicaid systems, and community-based providers; and providing appropriate health care interventions at earlier opportunities. This should result in reduced gaps in care, improved health outcomes, and prevention of unnecessary admissions to inpatient hospitals, psychiatric hospitals, nursing homes, and emergency departments, and reduce overdose, suicide, homelessness, and recidivism. The initiative will help California address the unique and considerable health care needs of justice-involved individuals, improve health outcomes, deliver care more efficiently, and advance health equity across the state. 

In addition, the waiver authorizes $410 million for Providing Access and Transforming Health, Justice-Involved Capacity Building grants to support collaborative planning, and IT investments intended to support implementation of pre-release and reentry planning. 

For more information, please review this fact sheet​.  

Justice Involved Stakeholder Toolkit​

Improving the Health of Justice-Involved Adults & Youth

The Medi-Cal Justice-Involved initiative ensures continuity of coverage through Medi-Cal pre-release enrollment strategies and provides key services to support a successful re-entry into the community. The initiative builds on existing requirements implemented across jails, youth correctional facilities, and prisons that:

  • Ensure all eligible individuals are enrolled in Medi-Cal prior to release from county jails and youth correctional facilities.
  • Provide targeted Medi-Cal health  care services to youth and eligible adults in the 90 days prior to release to prepare them to return to the community and reduce gaps in care. Eligible adults include those who have a mental health diagnosis or suspected diagnosis, a substance use disorder or suspected diagnosis, a chronic clinical condition, a traumatic brain injury,  intellectual or development disability; or are pregnant or postpartum, including behavioral health. All youth in youth correctional facilities are eligible; no clinical criteria is required. 
  • Provide “warm handoffs" to health care providers to ensure that individuals who require behavioral and other health care services, medications, and other medical supplies (e.g., a wheelchair), have what they need upon re-entry.
  • Offer intensive, community-based care coordination for individuals at re-entry, including through Enhanced Care Management (ECM), when eligible.
  • Make Community Supports (e.g., housing supports or food supports) available upon re-entry if offered by their managed care plan.
To implement these aims, Medi-Cal provides funding to build statewide capacity for workforce, technology changes, and data sharing that support justice-involved initiatives.

Download the factsheet about the Medi-Cal initiative to improve the health of justice-involved individuals​.​

Download an issue brief on strategies for conducting pre-release Medi-Cal enrollment in county jails and youth correctional facilities.

Providing Access and Transforming Health Initiative (PATH)

CalAIM PATH Initiative to support the Justice-Involved Initiative​​

PATH is a five-year, $1.85 billion initiative to build up the capacity and infrastructure of on-the-ground partners to successfully participate in the Medi-Cal delivery system and implement ECM, Community Supports, and Justice Involved services.

Justice-Involved (JI) Capacity Building Program​

PATH provides funding to support the implementation of statewide justice-involved initiatives, such as pre-release Medi-Cal enrollment and suspension processes, and the delivery of Medi-Cal services in the 90 days prior to release. This includes: 

  • Collaborative planning: PATH funding supports correctional agencies, county social services department, county behavioral health agencies, managed care plans, and others so they can jointly design, modify, and launch new processes to increase enrollment in Medi-Cal and ensure access to care for justice-involved youths and adults.
  • Capacity and Infrastructure: PATH funding supports correctional agencies, institutions, and other justice-involved stakeholders as they implement pre-release Medi-Cal enrollment and suspension processes.

PATH JI Round 1​​

PATH JI Round 1 is a planning grant funding opportunity that provides small planning grants to correctional agencies (or an entity applying on behalf of a correctional agency) to support collaborative planning with county departments of social services and other enrollment implementation partners to identify processes, protocols, and IT modifications that are necessary to support implementation of pre-release enrollment and suspension processes. The application period for PATH Round 1 closed on July 31st, 2022.

PATH JI Round 2​​

PATH JI Round 2 is an implementation grant funding opportunity that provides larger application-based grants to support entities as they implement the processes, protocols, and IT system modifications that were identified during the Round 1 planning phases. While entities do not need to participate in Round 1 in order to apply for funding in Round 2, the Round 1 planning grant funds provide an opportunity to support the development of a comprehensive application for Round 2 funding. The application deadline for Justice-Involved Round 2 funding has been extended to March 31, 2023. The application will be taken offline until January 25, 2023, to allow time for the needed modifications to the operational criteria. If you are currently working on an application,  please wait until the application updates are circulated to submit.

​​Note: This link will take you to our PATH partner website. 

The 'PATH Justice Involved Capacity Building Round Two Guidance Memo' is currently being updated and will be available for review upon completion. 

Please email justice-involved@ca-path.com with any questions about the application process.​​

​Key Documents

Informational Webinars​​

CalAIM Justice-Involved Advisory Group​

CalAIM Justice-Involved Advisory Group Scope

The DHCS CalAIM Justice-Involved Advisory Group is a broad-based body to solicit stakeholder input on policy and implementation matters regarding the CalAIM Justice-Involved initiative.  The Justice-Involved Advisory Group convenes a diverse and visible stakeholder advisory group of leaders and representatives from key sectors, including counties, prisons, jails, providers, consumers, health plans, and policy organizations. The Justice-Involved Advisory Group offers regular input on key policy and implementation issues to support the launch and ongoing success of the CalAIM​ Justice-Involved initiative. The Advisory Group will meet from October 2021 to July 2023 on a regular basis (e.g., monthly) for two hours either virtually or in Sacramento. While participation in the CalAIM Justice-Involved Advisory Group is limited to Advisory Group members, DHCS welcomes the public to attend the Advisory Group meetings.

To receive relevant updates on Justice-Involved Advisory Group meetings, sign up for the DHCS Stakeholder Announcements.

Justice-Involved Advisory Group Meeting Information

Upcoming Meetings

  • Date and time: To Be Announced.

Past Meetings and Materials​

Questions and Comments

Contact DHCS with any questions or comments on the CalAIM Justice-Involved initiative at CalAIMJusticeAdvisoryGroup@dhcs.ca.gov.​​

Last modified date: 1/30/2023 8:52 AM