Kentucky is readying a request for a Medicaid expansion waiver that will allow prisoners to qualify for free addiction treatment while behind bars.
With Kentucky ranking fourth for drug overdose deaths, opioids like fentanyl continuing to wreak havoc, and methamphetamine use still a serious problem across the state of Kentucky, this proposal is welcome.
It’s hard to get accurate data about the rate of prisoners with SUDs (substance use disorders) in US jails, but some estimates show 65% of inmates have an active SUD. If even a fraction of these prisoners can kickstart recovery before they’re released, the rewards are incalculable.
How has this proposal been received, then?
What Do Mental Health Advocates and Prison Reform Strategists Think of This Medicaid Expansion Proposal?
Mental health advocates and prison reformers both feel this Medicaid waiver proposal is a positive move, but they also feel it could be more robust. There is also a prevailing sentiment that this waiver could trigger unintended consequences.
Marcie Timmerman of Mental Health America of Kentucky voiced serious concerns that some people might view this potentially free treatment as a reason to jail someone. Whether that’s a family member reporting a family member for a crime, or a lawyer suggesting a client plead guilty to get addiction treatment in jail.
Another issue is the way the proposal is structured so the primary diagnosis must be substance use disorder. With dual diagnosis, though, often a mental health condition is the primary diagnosis. This is not a minor issue, either. There are 9.2 million adult Americans with a dual diagnosis. Advocates call for tweaking of this area of the proposal to prevent people falling out of recovery.
Amanda Hall, Policy Strategist at the ACLU Kentucky, believes that the waiver for Medicaid is a positive move that will help remove barrier to treatment for marginalized members of society.
Hall herself benefited from a community-based addiction treatment when in jail for charges related to drug use, so she speaks from experience, and she feels the treatment was responsible for the turnaround in her life after release. It’s on life after incarceration that Hall feels the focus should sharpen to prevent people from relapsing and restarting the vicious cycle of addiction and prison.
When Will This Proposed Medicaid Expansion Begin?
The period for submitting comments concerning the proposal finished on Friday, but an element of uncertainty remains due to the recent election.
A change in administration will change who approves the waiver at the Center for Medicare & Medicaid Services. We’ll keep you updated.
Why is it So Important to Address Addiction in Prisons?
We know from decades of research that offering comprehensive substance use treatment to jailed offenders helps to reduce both drug use and crime after the inmate is released. Inadequate treatment, by contrast, is a contributor to more overdoses and deaths, something Kentucky could do without.
To make this treatment as effective as possible, it should begin in prison and then be sustained post-release through participating in community treatment programs like those at Landmark Recovery of Lexington.
What To Do Next
We genuinely care about helping anyone addicted to drink or drugs reclaim their lives. We welcome this proposal and any others that help shift us toward a genuinely rehabilitative model of addiction treatment.
If you need help getting back on track, call our admissions team today at 888-448-0302.