A forthcoming study from the Substance Abuse and Mental Health Services Administration (SAMHSA) and Mathematica Policy Research Inc. shows that specialized discharge planning efforts for inmates with mental illnesses in three Oklahoma prisons are having a positive impact on Medicaid enrollment after release.

Preliminary results from the study, which were presented at the 2008 SAMHSA/Center for Medicaid Services Conference on Medicaid and Mental Health Services/Substance Abuse Treatment, indicate that after discharge planning processes were implemented, individuals with serious mental illnesses were approximately three times more likely to be enrolled in Medicaid at discharge. In addition, preliminary analyses showed that 63 percent of inmates entering Oklahoma Department of Corrections (DOC) facilities were not enrolled in Medicaid, but were likely eligible for benefits. The full report should be available in April 2009 on the SAMHSA website.

In 2004, Mathematica obtained a contract from SAMHSA to work with Oklahoma to design, implement, and evaluate a program to ensure that adults with serious mental illnesses had health insurance coverage on the day they were discharged from correctional facilities. The program, which was collaboratively designed and administered by state officials from the DOC; the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS); the Oklahoma Department of Human Services (OKDHS), which processes Medicaid applications; and the Oklahoma Health Care Authority (OHCA), placed three discharge managers in three DOC facilities with mental health units.

These discharge managers identify potential enrollees 6-9 months before release and submit SSI/SSDI applications 120 days before release and Medicaid applications 60-45 days prior to release. These managers, along with DOC staff, have completed SSI/SSDI Outreach, Access, and Recovery (SOAR) training on how to fill out SSI/SSDI applications and were trained by DHS staff to fill out Medicaid applications.

To read more details about discharge planning processes employed in Oklahoma, click here.

In addition to increased Medicaid enrollment rates, officials involved in the initiative are optimistic about the long-term impacts of the initiative on recidivism. The DOC will be conducting a longitudinal study over the next few years to determine rates of re-incarceration for individuals who are enrolled in Medicaid when they leave prison. To read more about the impact of Medicaid enrollment on criminal justice outcomes for individuals leaving jails, click here.

The DOC also recently signed an agreement with the ODMHSAS to facilitate information exchange between the two agencies, recognizing that many individuals with serious mental illnesses in the DOC were former ODMHSAS consumers. In particular, the agreement requires ODMHSAS to develop a web interface that will enable credentialed DOC mental health professionals to match incoming inmate records with ODMHSAS records to determine if the person had previously received ODMHSAS-administered services.

The database will provide information about last mental health diagnosis, types and intensity of mental health and substance abuse services provided, employment status, and housing status—all of which can be used in discharge plans and potentially used in benefit applications. For more information on specialized discharge planning processes in Oklahoma or the DOC/ODMHSAS information sharing agreement, contact Bob Mann, Coordinator of Clinical Social Work Services at the DOC.

For more information on the Justice Center's project on enrolling more eligible individuals in federal benefits upon release from prison or jail, click here or contact Hope Glassberg.

The U.S. Department of Justice, Office of Justice Programs' Bureau of Justice Assistance (BJA) has named its 2008 grantees under the Justice and Mental Health Collaboration Program (JMHCP), which was authorized by the Mentally Ill Offender Treatment and Crime Reduction Act of 2004 (MIOTCRA).

The 2008 grantees span 23 communities from 18 different states and Guam. Of these, three communities received planning grants with a maximum award of $50,000 for 12 months, 10 received planning and implementation grants with a maximum award of $250,000 for 30 months, and 10 communities received implementation and expansion grants with a maximum award of $200,000 for 24 months. All grants required a joint application from a mental health agency and unit of government responsible for criminal and/or juvenile justice activities. View the full list of 2008 grantees.

The Council of State Governments Justice Center's Criminal Justice / Mental Health Consensus Project will provide technical assistance to the new grantees.

This is the third round of grantees funded through MIOTCRA. Through funds appropriated in FY 2007, BJA awarded 26 grants in 16 states under the JMHCP. In FY 2006, BJA awarded 27 grants in 19 states under the JMHCP. Read more about the 2006 and 2007 grantees on the Criminal Justice/Mental Health InfoNet.

On October 14, 2008, President Bush signed the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act, S. 2304. The bill, which reauthorizes the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA) for an additional five years at $50 million per year, passed the Senate by unanimous consent on September 26, and passed the House of Representatives on September 29. The reauthorization succeeded a full year before the program expired in a rare expression of support by Congress. The effort was led by Sens. Edward Kennedy (D-MA) and Pete Domenici (R-NM) and Reps. Bobby Scott (D-VA) and Jim Ramstad (R-MN).

The bill also expands training for law enforcement to identify and respond appropriately to individuals with mental illnesses and supports the development of law enforcement receiving centers to assess individuals in custody for mental health and substance abuse treatment needs. For more information about S. 2304, please view the fact sheet or contact Leah Kane. When funds are made available for the next round of JMHCP grants, information will be available on the Consensus Project website.

After percolating in Congress for years, the Mental Health Parity and Addiction Equity Act of 2008, H.R. 1424, championed by Sens. Paul Wellstone (D-MN) and Pete Domenici (R-NM), has finally passed both chambers of Congress and been signed into law by the president.

The act requires certain insurers, including some Medicaid managed care entities, to ensure that mental health coverage is comparable to benefits provided for physical health care. Specifically, the law prevents insurance companies from charging higher deductibles and co-payments for mental health services or using different visitation caps on mental health services. The act, which also increases coverage for substance use disorder services, has been considered in Congress in various forms over the last 15 years and was signed by the president in early October as a part of the Emergency Economic Stabilization Act, after previously passing both chambers of Congress.

The act will likely increase services available to individuals with behavioral health disorders released from jail or prison, many of whom may be eligible for Medicaid, and is anticipated to affect 36 million children and adults covered by managed-care Medicaid programs overall. Its passage represents an increasing recognition among policymakers of the seriousness of behavioral health disorders and, more important, the effectiveness of behavioral health treatment and possibilities for recovery.

Click here to view a fact sheet on the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 developed by the National Council for Community Behavioral Healthcare. To learn more about the Justice Centers project related to people with mental illnesses in the criminal justice system, click here or contact Hope Glassberg.

Reminder: On October 28, the National Council for Community Behavioral Healthcare and the CSG Justice Center are offering a free webinar on improving law enforcement encounters with people with mental illnesses. Click here for more information or to register.

Save the date: 11/4/08 - 11/6/08 2008 National CIT Conference in Atlanta, GA "Georgia on Your Mind - CIT in Your Heart."

Save the date: 11/8/08 - 11/12/08 IACP 115th Annual Conference and Exposition in San Diego, CA.

Seattle Post-Intelligencer (WA) - Seattle police unit reaches out to the mentally ill
10/12/08 - "With resources limited for the mentally ill, police often are the first to get called when someone is having a psychiatric meltdown. In a unique approach, the Seattle Police Department dedicated two officers to cases such as this one, hoping to prevent crises before they turn tragic."

WTVY News (AL) - Mental health seminar trains safety leaders
10/12/08 - "When it becomes a criminal situation, it's not always cut and dry what to do with the suspect. If the person taken into custody has a mental illness, there are special treatment options for them."

Standard Net (UT) - Acting out real life/Law enforcement officials stage scenarios featuring addicts, the mentally ill
10/11/08 - "The Crisis Intervention Training helps officers respond appropriately to dynamic situations involving mentally ill individuals, said Salt Lake City Police Detective Ron Bruno, program director for the weeklong event at the Swanson Tactical Training Center."

WOIA.com (TX) - Police form new unit focusing on the mentally ill
10/10/08 - "The San Antonio Police Department will soon get a new unit that will focus on crises involving people who are mentally ill. The new unit will pair officers with mental health professionals on a full-time basis."

Sacramento Bee (CA) - Officers learn how to confront people suffering a mental crisis
10/7/08 - "Authorities in Yolo and El Dorado counties are holding special training to help police officers learn how best to confront people caught up in a mental health crisis."

KNDO/KNDU (WA) - Richland police trained on how to deal with a mental health crisis
10/7/08 - "On Tuesday a group of nearly 30 Richland police officers got some training on how to help someone going through a mental health crisis."

Tampa Bay Online (FL) - Training prepares law enforcement for mentally ill
10/6/08 - Deputy Jason Deso indicates that his "experience and training with the Crisis Intervention Team allows him to recognize signs of mental illness and has prepared him to de-escalate a situation with words. Starting with a gentler approach can avoid exacerbating a hostile situation. The benefit: No one gets hurt."

Middletown Journal (OH) - Ohio Supreme Court justice pushes for mental health dockets
10/4/08 - "Ohio Supreme Court Justice Evelyn Lundberg Stratton has been a national and state advocate for mental health dockets for seven years. The justice spoke to the Fairfield Rotary Club on Friday, Oct. 3, about that advocacy, and how she received help from then-Akron Municipal Judge Elinor Stormer and Butler County Common Pleas Court Judge Michael Sage, two judges who had established a mental health docket in Ohio."

Salt Lake Tribune (UT) - Graduates of mental health court stay out of jail longer
9/22/08 - "Offenders sent to mental-health court stay out of trouble longer than mentally ill defendants prosecuted in traditional courtrooms, according to a new report. One year after leaving mental-health court, participants had cut their arrests and jail bookings in half, a study by the Utah Criminal Justice Center at the University of Utah found."