Health Care in the Juvenile Justice System: Recommendations to Increase Medicaid's Role

adolescent-substance-abuse-treatment_Medicaid-survey-reportCould juvenile justice agencies and Medicaid agencies work together to make sure teens in the juvenile justice system get evidence-based care when it comes to treatment for substance abuse, mental health issues, and medical care?
Could they improve the continuity of health care for youth leaving the justice system for the community? 

The answer to both questions appears to be a resounding, "Yes!"
At least that's what I take from a compact summary of a survey published in August 2010 by the National Academy for State Health Policy and funded by the MacArthur Foundation.
The summary is titled -- take a breath -- Service Delivery Policies: Findings from a Survey of Juvenile Justice and Medicaid Policies Affecting Children in the Juvenile Justice System. Survey findings include (I'm quoting):

1. Findings regarding how states pay for services for youth involved in the juvenile justice system, including:

  • Evidence-based practices, and
  • Settings in which Medicaid-funded services are allowed.

2. Findings regarding how states ensure that youth receive continuous care as they transition from the juvenile justice system to the community, including:

  • Policies around discharge planning;
  • Health records transfer;
  • Medication supply; and
  • Appointments with health care providers. 

The survey's authors note that juvenile justice agencies need clearer guidance from Medicaid on when they can fund treatment for youth in their care -- the issue being a federal prohibition for funding services for "inmates of a public institution." Furthermore, state Medicaid agencies sometimes have trouble funding evidence-based practices because they often include elements that don't fit current guidelines; the report suggested a couple of ways to address this to improve coverage for youth.
Based on the survey, it also appears that youth covered by Medicaid who are transitioning from the juvenile justice system to the community experience significant gaps in care, such as lack of prescribed medication, or health records that aren't transferred. However, there are steps juvenile justice agencies and Medicaid agencies can take to address this.
For example, juvenile justice agencies can beef up their policies and practices to help kids stay connected to needed health care. Medicaid agencies, for their part, could "explicitly allow juvenile justice agency personnel to assist children leaving an institution to apply for Medicaid and offer training to juvenile justice personnel to enable them to provide effective assistance."
There's more, too. I highly recommend that you download the summary and share it with planners in your juvenile justice system, and the folks at your state's Medicaid agency.  (Hat tip to Lore Joplin.)

Updated: February 08 2018