FOR THE FIRST TIME, CALIFORNIA TO PROVIDE MEDI-CAL SERVICES FOR PEOPLE RETURNING HOME AFTER INCARCERATION
SACRAMENTO — In a major step for health equity in California, the Department of Health Care Services (DHCS) announced that three California counties—
Inyo, Santa Clara, and Yuba—were approved as of October 1 to begin delivering a targeted set of Medi-Cal services to people returning to communities after incarceration. All California counties are required to implement this initiative before October 1, 2026.
The Justice-Involved Reentry Initiative provides crucial medical and behavioral health services for Medi-Cal eligible adults and youth in state prisons, county jails, and youth correctional facilities in the 90 days before their release. This initiative will help stabilize chronic and significant clinical health conditions, including mental illness and substance use disorders, and will facilitate a coordinated reentry to support smoother transitions and improve public health and safety. Further, the Justice-Involved Reentry Initiative will close equity gaps and improve health outcomes for people who are or have been incarcerated. Equity is a key driver of the initiative as Black, Indigenous, and People of Color (BIPOC) individuals are over-represented in California prisons and jails.
“These transformative services will have a lasting impact on people returning to their communities by ensuring they receive the care they need," said
DHCS Director Michelle Baass. “By providing access to vital health care services, this initiative helps people maintain their health during a critical time in their lives and reduces the likelihood of future emergency room visits or hospitalizations."
California is the first state in the nation to receive federal approval and implement this historic initiative. Until California received approval, states were not permitted to use federal Medicaid funding in state prisons, county jails, and youth correctional facilities to support individuals who are preparing to reenter the community. In accordance with recent state legislation, all California counties are required to implement this initiative before October 1, 2026, and will be phased in each quarter.
ABOUT THE PROGRAM: Pre-release services will focus on comprehensive care management and include physical and behavioral health consultations, lab and radiology services, medications and services for mental health and substance use disorders, community health worker services, and medications and durable medical equipment provided to the individual at the time of release.
The Justice-Involved Reentry Initiative is focused on ensuring Medi-Cal members have continuity of coverage and are supported to access key services to help them successfully return to their communities. Medi-Cal members who receive pre-release services in prison, jail, or a youth correctional facility will receive a comprehensive care transition plan to coordinate the medical, behavioral, and social services that will support them in the critical days and weeks following release.
Further, all participating members are eligible to receive
Enhanced Care Management (ECM) from their Medi-Cal managed care plan upon release. Together, the targeted set of pre-release services and the continuity of services and care coordination following release will improve health outcomes for Medi-Cal members throughout this important transition and further advance California's health equity goals.
“This initiative is a key part of the state's plan to set a new standard for what person-centered and equity-focused care looks like for all Californians," said
State Medicaid Director Tyler Sadwith. “This is about more than health care—it's about giving people the support they need to successfully reintegrate and rebuild their lives with dignity and a real path to a stable future."
WHY THIS IS IMPORTANT: More than 350,000 adults and youth enter or are released from California prisons and jails annually, and at least 80 percent of those are eligible for Medi-Cal. Individuals who have been incarcerated are largely people of color and have considerable health care needs but are often without care and medications upon release. People who have been incarcerated are particularly at risk for poor health outcomes, experiencing disproportionately higher rates of physical and behavioral health diagnoses and a higher risk for injury and death as a result of violence, overdose, and suicide than those who have never been incarcerated.
Individuals who are
incarcerated with a behavioral health disorder are more likely than those without a disorder to have been homeless in the year prior to their incarceration, less likely to have been employed prior to their arrest, and more likely to report a history of physical or sexual abuse. From 2009 to 2019, the proportion of incarcerated people in California jails with an active mental health case rose 63 percent; in 2019, 15,500 out of 80,000 individuals in jail custody had an
active mental health case.
Improving adverse health outcomes for previously incarcerated people is also a vital health equity issue. People from racial and ethnic minority groups are disproportionately incarcerated, often for mental health- and substance use disorder-related offenses. For example, 29 percent of the state's male prison population is Black, despite only making up 6 percent of the state's male population.
“For the first time ever, Medi-Cal will cover the cost of these services, connecting individuals with physical and behavioral health services during the critical period leading up to their release," said
Autumn Boylan, Deputy Director of DHCS' Office of Strategic Partnerships. “With their Medi-Cal card in hand, they can step back into California communities with one less thing to worry about as they focus on securing housing, finding employment, and rebuilding personal relationships."
"We're truly excited about expanding services and eligibility for individuals returning from incarceration to the community," said
Dr. Phuong Luu, Health Officer and Justice-Involved Reentry Lead for Yuba County Jail and Tri-County Detention Center. “By offering comprehensive, coordinated coverage for both mental and physical health, we're not just addressing immediate needs—we're investing in long-term well-being and community stability."
SUPPORTING ACCESS TO PRE-RELEASE SERVICES: All Medi-Cal members who are eligible for pre-release services will receive reentry support from an ECM care manager, both while the individual is still in custody and for a period of up to 12 months after the individual is released from the prison, jail, or youth correctional facility. The ECM care manager will provide person-centered, wraparound care management services to ensure the individual is able to timely access all necessary medical and behavioral health services, and will build trust with the individual and understanding of the individual's health needs, coordinating vital support services and developing a community transition plan.