Increasing numbers of people with a serious mental illness are filling U.S. prisons and jails. Some of these individuals were enrolled in federal benefits, including Medicaid, at the time of incarceration, and many are eligible to participate in these benefit programs upon release. Few, however, are actually enrolled when they return to the community, and, as a result, their access to medications and treatment – typically essential to compliance with conditions of release for someone with a mental illness – is severely limited. Corrections administrators and mental health professionals alike agree that this problem is one of the biggest obstacles to the successful transition of people with a mental illness from prison or jail to the community. In an indication of the importance of this issue, Congress passed legislation mandating a study to determine the correlation between receipt of benefits upon re-entry and recidivism.

Some of the state and local governments struggling with this problem have developed innovative solutions in response. Unfortunately there remain barriers to implementing programs that address this complex issue. At least four factors contribute to the problem

• A lack of awareness about this issue and its significance in key policymaking circles.
• Confusion among state and local government officials regarding federal regulations rules for terminating, suspending or reinstating federal benefits.
• The absence of a clear, coherent federal policy, which would help minimize confusion regarding relevant federal regulations.
• Inadequate coordination among corrections administrators, community corrections officials, and community mental health representatives (at the institutional and system levels) to ensure comprehensive transition planning for offenders with a mental illness.

To assist state and local government officials grappling with the problems described above, and to maximize the value of the local, state, and federal responses described above, the Council of State Governments (CSG), through the Consensus Project, will work to accomplish the following:

• Facilitate the coordination of research efforts
• Understand the federal rules
• Help states to streamline their processes

To accomplish these goals CSG will hold a meeting among officials from several states that have developed responses to this problem and representatives of key federal agencies (such as the Social Security Administration).

At the conclusion of these efforts CSG will develop a document detailing best practices on this issue. An appendix to the Consensus Project Report outlined some of the issues involved, and is linked below.