Community-based mental health providers are reluctant to provide services to people with criminal records for numerous reasons.  Near or at the top of this list of reasons is this population's inability to pay for treatment.  State and county government officials attempting to control the explosive growth of health care expenditures routinely warn providers about delivering services to individuals who ultimately do not qualify for federal benefits; providers will not receive back-payments for the delivery of these services.  Given the crushing demand that they are attempting to accommodate, providers are understandably hesitant to deliver services to a person who does not have health insurance and whose eligibility for public benefits is not immediately apparent.

Corrections administrators and health officials can take several steps to facilitate inmates' participation in federal benefit programs. (see Appendix C: Explanation of Federal Benefit Programs) First, state officials should require corrections staff to distribute to inmates information and application forms for all relevant federal and state benefit programs, including Medicaid; federal SSI and SSDI benefits; Temporary Assistance to Needy Families (TANF); food stamps; veterans programs; and state general assistance.  Staff should provide additional assistance, and in general pay particular attention, to subsets of the inmate population with mental illness who are especially likely to qualify for benefit programs, including those who meet the following criteria: 1) received federal benefits at the time of incarceration; 2) have very low incomes, particularly those under age 21; 3) are veterans; or 3) are parents of children under 18 and likely to be custodial parents upon release.

Second, appropriate authorities should establish a process through which the state Medicaid agency will accept applications from inmates while they are still in custody and will process these applications in a timely manner to ensure that those found potentially eligible are then able obtain access to the benefits immediately upon release.  Corrections administrators must appreciate the difficulty in timing a person's participation in benefit programs.  Accordingly, corrections officials should inform local social security offices and the state Medicaid agency as early as possible of the exact date of release of inmates who qualify, or may qualify, for benefits.

In establishing this process, corrections administrators should work with local mental health authorities to arrive at an agreement regarding diagnoses of people who are disabled and therefore may be eligible for SSI (and, by extension, Medicaid).  Corrections administrators should also assist inmates in applying for state identification cards, which will be provided upon the inmate's release.  Without such proof of identification, it is nearly impossible for a person to avail him or herself of many benefits or services.