Program options for the justice involved

Revised date

January 20, 2022

The Department of Corrections and city/county correctional agencies have a variety of confinement levels that the justice involved individual may be placed in. The following table is intended to help clarify how participation in a correctional program affects a person's eligibility for Medicaid.

Is the justice involved individual eligible for Medicaid?

Correctional type	Medicaid eligibility - Inpatient coverage only*	Medicaid eligibility - Full coverage
Electronic Home Monitoring (EHD/EHM) The justice involved individual resides in their home and is monitored electronically. The justice involved individual does not occupy a jail or prison bed while in this program.		X
Day jail / Day reporting The justice involved individual reports at various assigned times throughout a 24-hour period OR are placed on supervised work or community betterment programs during regular work hours. In either situation, the justice involved individual does not occupy a jail or prison bed while in the program.		X
Pretrial supervision / Probation Pretrial supervision staff monitor the justice involved individual who is released from custody by the court pending the outcome of their trial and they do not occupy a jail or prison bed		X
District Court probation District Court probation officers monitor the justice involved individual who is convicted of or are pending trial for misdemeanor charges. The justice involved individual does not occupy a jail or prison bed.		X
DOC community supervision Community Corrections Officers monitor the justice involved individual who is convicted of felony charges. The justice involved individual does not occupy a jail or prison bed.		X
Drug Court A court-ordered program in which the justice involved individual with drug-related charges voluntarily chooses to participate in chemical dependency treatment. The individual may have their charges dismissed if they successfully complete the program. The individual does not occupy a jail or prison bed.		X
Furloughs Individuals are sometimes furloughed by a city/county jail for various reasons. When medically furloughed the individual is typically not reported out of the facility so the suspension coding does not change in ProviderOne. To be eligible for a Medicaid payment the individual must receive inpatient hospitalization services lasting 24 hours or more and not return to the jail in the same day. Same-day furloughs for services are typically the responsibility of the jail or a payer other than Medicaid.	Depends
**Work Release in city/county facilities Justice involved individuals who are housed in a work release facility, jail, or corrections facility and are authorized to leave the facility for purposes of employment, education, court-ordered treatment or employment search. The justice involved individual does occupy a corrections bed while in this program. Most county work release programs operate under this model. For a complete list of approved city/county work release facilities, please refer to the list provided below this table. For DOC work release eligibility, please refer to Supervised Community Residential Facility/Halfway House / DOC Work Release.	X
Work crews / Community betterment This program is offered to select justice involved individuals. The program includes working in the community on various public or nonprofit programs. The individual does occupy a corrections bed while in this program. There may be exceptions for those not occupying a corrections bed while in this program.	X
**Supervised Community Residential facility/Halfway House / DOC work release The justice involved individual is housed in state or local corrections-related supervised community residential facility which allows for 'freedom of movement'* to: 1) work outside the facility in employment opportunities available to individuals who are not under justice system supervision, 2) use community resources at will (libraries, grocery stores, recreation, etc.) and 3) seek health care treatment in the broader community to the same or similar extent as other Medicaid enrollees. The residential facility may be public or privately operated. These facilities may have “house rules” where for example residents may be required to report during certain times and sign in and out. Similarly, they may be restricted from traveling to or frequenting locations associated with criminal activity. The majority of state operated (DOC) work release programs use this model. Please refer to the list of approved work release facilities.		X
Residential Reentry Centers (RCC) – Federal corrections facility A justice involved individual housed in a RCC does not have freedom of movement and is only authorized to leave the RCC through sign-out procedures for approved activities, such as seeking employment, working, counseling, visiting, or recreational purposes. During the approved activity, the inmate's location and movements are constantly monitored and RCC staff may visit or call them at any time.	No coverage - these are federal facilities and the cost of medical care is the responsibility of the Federal Government.	No coverage - these are federal facilities and the cost of medical care is the responsibility of the Federal Government.
Voluntary and temporary residence in a public institution This includes justice involved individuals who are residing in a public institution or detention center for a temporary period of time voluntarily after their case has been adjudicated and arrangements are being made for their transfer to a community residence. The justice involved individual must be free to leave and is voluntarily residing there pending other appropriate arrangements based on their needs.		X
Residents in a Mental Health Facility or IMD Individuals (justice involved and general public) who are between the ages of 22 and 64 and are a patient of an Institution for Mental Diseases (IMD) where there are over sixteen beds (e.g. Western State) for more than 15 days in a given month.	X

*Inpatient hospital events; must be admitted for 24 hours or more

**List of City/County Jail work release facilities that are approved living situations are Seattle/King County, Whatcom, and Thurston County.

***List of DOC work release facilities that are approved living situations are: Ahtanum View - Yakima County, Bellingham - Whatcom County, Bishop House - King County, Brownstone - Spokane County, Clark County - Clark County, Eleanor Chase House - Spokane County, Helen B Ratcliff - King County, Longview - Cowlitz County, Olympia - Thurston County, Peninsula - Kitsap County, Progress House - Pierce County, Reynolds - King County, Tri-Cities - Benton County. The only DOC facilities that are unapproved are: Lincoln and Rap Houses in Pierce County.

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