Trinity County Health and Human Services Agency (HHSA) presented a status update May 20 on jail‑health operations, describing recent service upgrades, new billing capabilities and planned pursuit of Medi‑Cal reimbursements under the state’s CalAIM initiative.

Liz Hamilton, HHSA director, told the Board that since the board directed that HHSA administer jail‑health financials in October, the county has added clinical capacity in the jail medical unit, secured an electronic health record (EHR) system tailored to correctional medicine, and set up time‑study processes that enable billing and cost recovery. Hamilton said staff recently completed an administrative review of medical billing and recovered roughly $270,000 in reimbursements that have paid for added clinical staffing (an additional physician assistant and an LVN) and operational improvements.

HHSA staff outlined three CalAIM‑related opportunities the county is pursuing:
- Enhanced Medi‑Cal billing for inmates while in custody (CalAIM allows billing for the first 28 days of incarceration and again for the 90 days prior to release in certain circumstances). County staff described plans to engage a vendor to handle the specialized billing required of Medi‑Cal for incarcerated populations.
- Intergovernmental Transfers (IGT) and Medi‑Cal Administrative Activities (MAA) reporting to recoup portions of staff time and eligible medical costs; staff said MAA will depend on accurate time‑study reporting by corrections and allied county staff.
- PathJI (Pathways for Justice‑Involved) implementation awards: Hamilton said the county had received multiple awards under PathJI (the transcript cited behavioral‑health funding slightly over $800,000, social‑services funding of about $102,000, and a $2,000,000 award for jail‑related services; probation separately was awarded about $2.5 million). She cautioned that many PathJI disbursements are phased and tied to reporting and implementation milestones.

Hamilton stressed these funds are performance‑based and reporting‑driven, and staff are coordinating across five internal teams to implement clinical upgrades, administrative billing and pre/post‑release service linkages. County Administrative Officer Trent Tuthill and Sheriff leadership participated in the presentation and thanked HHSA for support. The board and staff discussed timing considerations for initiating some reimbursements (for example, the IGT match that requires a general‑fund contribution up front but returns federal funds at a later rate). Tuthill noted the county expects some revenue realization in the second half of the next fiscal year when CalAIM and PathJI billing ramp up.

Supervisor comments praised staff collaboration; several supervisors highlighted the difficulty and importance of implementing time‑study practices with corrections staff and thanked HHSA community health staff for field work in the jail.

Ending
HHSA staff and the Sheriff’s Office will continue implementing EHR, time‑studies and billing workflows while coordinating the PathJI implementation schedule. The board did not take a final action during the update but was briefed on staffing additions, reimbursement estimates and program timelines.