The Clark County Jail will be able to bill Medicaid for specific inmate services for the first time starting in July 2025. The Washington State Health Care Authority will give the county a maximum of $2.5 million to implement the services.
On Tuesday, the Clark County Council approved Jail Services’ participation in the Reentry Demonstration Initiative under the Medicaid Transformation Project.
This means the jail will be one of the first in the state to bill Medicaid for specific inmate services, including case management, medications for alcohol and opioid use disorder, and a 30-day supply of medications and medical supplies in-hand upon release.
“So much of the population needs medical care, and we’re absolutely responsible for medical care of our inmates,” council Chair Gary Medvigy said.
Officials said billing Medicaid will save the county — which already provides some medical services to inmates — money and reduce recidivism rates.
Historically, people either lose their Medicaid or lose access to services funded by Medicaid while incarcerated. This has serious implications for inmates with substance use disorders, mental illness and high medical needs, according to officials.
“I won’t very often say this word from the dais, but the system as it currently exists is absolutely stupid,” Councilor Glen Yung said.
The Social Security Act prohibits use of federal funds and services, including Medicaid, for medical care provided to inmates. Prior to 2016 in Washington, people had to reapply for coverage after they were released, and many had struggled to access the medical care they needed before being incarcerated.
“They go in with health care, with health coverage, and they exit without it,” Yung said.
In 2016, Washington passed a bill allowing the suspension, rather than the termination, of Medicaid for inmates. In 2021, Washington passed bills allowing the Health Care Authority to seek federal funding to provide pre-release medical services.
Last year, the federal Center for Medicaid Services entered into an agreement with the state Health Care Authority to implement the Medicaid Transformation Project, which allows specific services for inmates within 90 days of release. The average length of stay in Clark County’s jail is 27 days, according to jail officials.
The funding from the Health Care Authority will go toward hiring staff, reentry planning and creating the information technology infrastructure necessary for these services, such as recordkeeping and access to virtual health care.
About 80 percent to 90 percent of people in jails throughout the United States are eligible for Medicaid, according to a 2020 study published in the National Library of Medicine. However, only an estimated 30 percent of people coming into the Clark County Jail have active Medicaid enrollment.
“Often when people are cycling in and out of our legal system, they’re not always keeping compliant with their insurance,” said Anna Lookingbill, jail transition manager. “They’re not always making sure that the things that they need for their care are in place. So a significant piece is not only the ability to provide and bill for services but to navigate that complex eligibility network.”
