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DHHS details Medicaid community reentry demonstration, 45‑day pre‑release work and 30‑day discharge supports
Summary
Medicaid director Henry Littman and associate commissioner Anne Landry told the committee the 1115 demonstration allows Medicaid to provide services in the 45 days before release and cover a 30‑day medication supply at discharge; officials said implementation begins in January and could reduce county and correctional costs over time.
Medicaid Director Henry Littman and Associate Commissioner Anne Landry briefed the Health, Human Services and Elderly Affairs oversight committee on Nov. 22 about the department’s community reentry demonstration and related Medicaid work in schools.
Littman said the 1115 waiver enables Medicaid to initiate mental‑health and substance‑use disorder supports beginning 45 days before an individual’s release from incarceration. The goal is to establish care relationships, allow managed‑care organizations to provide care management, and on discharge supply a 30‑day medication supply to reduce gaps that can lead to emergency‑room visits or recidivism. Littman said New Hampshire was among the earliest states to secure the waiver and expects to begin implementation in January for state facilities.
On youth reentry, Littman said there is a federally mandated focus on reintegrating eligible youth (18–21 and former foster youth up to 26) with covered screening and diagnostic services during the 30 days before release and 30 days of post‑release care management.
Committee members pressed for fiscal details. Littman said the program should reduce net costs over time by avoiding higher downstream expenses (ER visits, boarding) and that federal funding will offset some program costs; he also noted a required independent evaluation under the waiver with interim and five‑year reports.
On a separate but related topic, Littman described the Medicaid‑in‑schools rules: parents must sign the initial plan of care and any plan changes to bill Medicaid; the parent is the case head and has rights to billing and service information. Committee members raised concerns about privacy and cases in which youths age into adult privacy protections while still in school; Littman responded that parental rights and billing access remain structured into the program though he acknowledged edge cases may require attention.
No formal committee action was taken; members requested more fiscal details and follow‑up information on implementation and county coordination.
