For decades, one rule shaped healthcare for incarcerated individuals: Medicaid coverage stopped at the prison wall.
That meant thousands of people left correctional facilities with little or no connection to healthcare, behavioral health services, housing support, or medications. Many reentered their communities already facing overwhelming barriers, often leading to emergency room visits, homelessness, or re-incarceration.
Today, that model is changing.
California is among the first states approved to provide certain Medi-Cal services to eligible youth and adults up to 90 days before their release from state prisons, county jails, and youth correctional facilities.
For community-based organizations (CBOs), this creates an unprecedented opportunity to improve health outcomes while helping individuals successfully reintegrate into their communities, but navigating Medi-Cal requirements, Managed Care Plan contracting, and operational readiness can be complex.
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Why the 90-Day Window Is So Important
Research consistently shows that the first few months following release are the most vulnerable period for justice-involved individuals.
Without coordinated support, people often face:
- Lack of access to medications
- Unstable housing
- Untreated mental health conditions
- Substance use challenges
- Difficulty accessing primary care
- Increased risk of hospitalization or re-incarceration
Rather than waiting until someone walks out the gate, California’s Justice-Involved (JI) Initiative allows providers to begin planning for a successful transition before release occurs.
This approach creates what is often called a “warm handoff”—connecting individuals with healthcare and community services while they are still incarcerated so support continues seamlessly upon release.
How Enhanced Care Management Supports Justice-Involved Individuals
A key component of the initiative is Enhanced Care Management (ECM) for the Justice-Involved population.
Under ECM, providers become the bridge between correctional facilities, healthcare systems, and community resources.
Services may include:
- Conducting comprehensive intake assessments
- Developing individualized care plans
Coordinating medical and behavioral health services - Connecting clients with housing and social supports
- Collaborating with probation officers, correctional staff, and social service agencies
- Ensuring continuity of care immediately upon release
The goal isn’t simply releasing someone from incarceration.
The goal is helping them successfully reintegrate into their community with the support needed to remain healthy, stable, and connected to care.
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Success Requires New Partnerships
Providing pre-release services requires more than clinical expertise.
Organizations must build strong working relationships with correctional facilities and understand the operational realities of secure environments.
Many providers refer to this as developing “in-reach” capabilities—bringing care coordination into correctional settings before release.
This requires collaboration, flexibility, and an understanding of correctional security protocols, communication processes, and data-sharing requirements.
Preparing Your Organization for Justice-Involved ECM
1. Verify Your Network Status
Ensure your organization is contracted as a Justice-Involved ECM provider with your local Managed Care Plan (MCP). Health plans are responsible for maintaining adequate provider networks to serve eligible members.
2. Hire Staff with Lived Experience
California guidance encourages organizations to employ Community Health Workers (CHWs) or Lead Care Managers (LCMs) who have lived experience with incarceration.
These team members often build trust more quickly, understand the unique challenges clients face, and improve engagement throughout the transition process.
3. Prepare for Secure Data Sharing
Successful care coordination depends on timely information sharing between correctional facilities, managed care plans, and community providers.
Evaluate your current systems to identify technology, privacy, and workflow gaps before implementation begins.
A Public Health Investment That Changes Lives
The Justice-Involved Initiative represents more than a new funding opportunity.
It reflects a shift in how California approaches public health, recognizing that successful reentry begins long before someone is released.
By intervening during the critical 90-day pre-release period, providers can reduce emergency department utilization, improve continuity of care, decrease recidivism, and help individuals build a healthier future.
For community-based organizations, this is an opportunity to play a pivotal role in transforming lives while strengthening the communities they serve.