01/27/2014 by Paul Olalde

SoCal counties face differing issues on enrolling offenders in expanded Medi-Cal

At yet another iteration of California Forward’s Affordable Care Act (ACA) themed convenings across the state, it was representatives from San Diego, Orange and Imperial counties who were focused on improving enrollment into expanded Medi-Cal programs.

These counties in particular have had some issues getting the right hand to talk to the left hand.

“There has been trouble blending the Criminal Justice side with treatment side to get treatment funded by the Federal government under AB 109,” said Ron Lane the Deputy Chief Administrative Officer for San Diego County. 

Some released inmates in San Diego County have run in to a dead end with the online Medi-Cal application when they are asked for proof of incarceration.

County-issued proof of incarceration documents have been used in some cases but these documents further complicate the application process for an offender population already failing to register because of an inability to navigate the marketplace. It would be more efficient to have incarceration information in the system upon an individual’s release.

Alameda County has entertained the idea of enrolling individuals at booking. Even if enrollment was not completed at booking, the information gathered can initiate the process of determining coverage eligibility during pretrial.

Conventional criminal justice practices are being tweaked to leverage the ACA and provide more services. San Diego has explored the potential of specialized arrest teams composed of both social workers and police as a way of preventing or minimizing incarceration.

Orange and Imperial counties worked together during a small group breakout session and came back with a desire to identify the most expensive offender population in recurring costs and needs due to habitual incarceration and target them for enrollment first.

Split sentencing is another incarceration alternative gaining momentum, but the counties’ District Attorney Offices and Courts workgroup expressed a need for statistics and culture change regarding the success of specific alternative sentencing programs before they will be considered effective substitutes for jail time by county judges.  

Much like the rest of the state, there has been trouble with inmate identification forms. A proposed resolution was the generation of non-real identification cards to help keep track of inmate applications and eligibility. They would not be actual legal forms of identification but would use a photo of the inmate and some general information such as social security number and date of birth to assist in tracking them and their Medi-Cal application throughout processing in pre-trial. This would also give them something to hand over to the probation department post-release.

All parties also expressed the need for their departments to seek out collaboration with each other and actively pursue opportunities to share information in hopes of reducing overlapping jurisdictions and minimizing gaps in coverage.

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