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State outlines new 1115 community reentry benefit for incarcerated adults and youth
Summary
The New Hampshire Department of Health and Human Services told a House committee it has begun implementing a new Medicaid 1115 waiver reentry benefit that provides up to 45 days of pre‑release care coordination and a 30‑day medication supply to sentenced individuals leaving state prisons and county facilities.
The New Hampshire Department of Health and Human Services told the House Health and Human Services Oversight Committee on April 25 that the state has begun rolling out a new Medicaid 1115 waiver component for community reentry, aimed at connecting people who are sentenced in state prisons and county facilities to health care and social supports before and after release.
Associate Commissioner Anne Landry said the waiver’s adult reentry benefit provides up to 45 days of covered services prior to release, and that Centers for Medicare & Medicaid Services (CMS) will cover up to a 30‑day supply of medications at discharge. “What we’re really trying to do here is prepare people to successfully come into the community and not have recidivism because of medical concerns,” Landry said.
The nut graf: New Hampshire received approval for the reentry component of its broader 1115 demonstration July 16, 2024, and is implementing a phased rollout that started in state correctional facilities. Officials said the aim is to reduce downstream costs (emergency care, incarceration) by ensuring people have an identified provider, prescriptions, insurance cards and care coordination when they leave custody.
Landry told committee members that the waiver is a five‑year demonstration that must meet a budget‑neutrality requirement. The state prioritized a 45‑day adult benefit focused on behavioral health and substance use disorder connections, and a separate youth reentry benefit (required by federal law) with more intensive case management and screening; the youth program includes services starting 30 days prior to release and continuing post‑release.
Officials described early implementation figures: at the Department of Corrections level the state had 30 individuals enrolled in the adult reentry component (10 released, 20 awaiting release), while the youth program had five enrollments with one youth released so far. During the 45‑day pre‑release period the state works with managed care organizations and DOC care coordinators to arrange community mental health center connections, primary care, and prescription fills so people “walk out the door” with an insurance card, discharge prescription, and assigned provider, Landry said.
Committee members asked about metrics and cost tracking. Representative Pearson emphasized the importance of independent evaluation and data for persuading legislators that the program saves money. Landry said the 1115 demonstration requires an independent evaluator and an evaluation plan, which the department will share with the committee in a future update.
On expansion and next steps, Landry said the state is starting with state facilities to build implementation experience, then intends to add counties in phases, likely beginning with larger or ready counties and pairing them with smaller ones to test variations in capacity and readiness. She said the department has sought federal grant funding to accelerate county rollout and noted workforce and hiring freezes limit how quickly the state can scale implementation.
Funding and logistics: Landry said CMS federal match for covered services helps shift some costs away from state funds, and the department expects some near‑term investments (telemedicine equipment, care manager time) but projects avoided emergency and inpatient costs will offset that investment. Landry and members cited examples of early success — individuals who obtained housing, employment and continued treatment after release — and said transportation benefits in Medicaid have helped people reach appointments.
Committee members raised practical questions about program length and scope and asked for periodic reporting on outcomes and cost savings. Landry reiterated the department’s plan to provide evaluation metrics and highlighted the program’s coordination with the Department of Corrections and managed care organizations.
Ending: The department asked the committee to monitor rollout and to expect follow‑up briefings with evaluation details as the demonstration matures.
