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County jail pursues Medicaid 1115 waiver for MAT and eyes facility expansion and reentry services
Summary
Warden Williams, Deputy Warden Nellis and Public Safety ASD Director Mari Martinez described a pilot 1115 Medicaid waiver (milestone 3) that could enable Medicaid billing for certain MAT and hepatitis services, noted rising MAT medication costs (Vivitrol) and explained a plan to reserve roughly $1.75 million in presumed bonding capacity to support a potential jail expansion to increase medical and behavioral health capacity.
Public Safety ASD Director Mari Martinez, Warden Williams and Deputy Warden Nellis presented the adult detention facility (ADF) budget and detailed an effort to capture Medicaid revenue through a pilot 1115 waiver for services tied to medication‑assisted treatment and behavioral health.
"With this waiver, we should be able, hopefully, to recuperate some of our largest costs in the medical system, meth and gel, specifically around MAT medications," Deputy Warden Nellis said, describing milestone 3 of the pilot and a forthcoming readiness walkthrough with the health care authority.
Martinez and corrections leadership said FY27 shows decreases tied to a matured bond and reductions in certain telecom line items, but increases in medical supplies and insurance. Martinez noted the prior use and exhaustion of opioid settlement funds for MAT medications and said the county budget shows a significant increase to continue medication assistance services in FY27. Manager Schafer also told the commission staff are recommending that approximately $1,750,000 be reserved for future presumed revenue bonding capacity to fund a significant expansion and remodel of the jail when required.
Commissioners pressed staff on how medical and reentry services are organized, telehealth for women and Project ECHO participation; corrections staff said telepsych and Project ECHO are in use and that reentry programming (including RISE and La Sala expansion plans) is underway. The ADF team also highlighted facility improvements such as new private outdoor spaces for a special management unit and relatively small fixed asset requests under $5,000 for operational safety.
What happens next: staff will continue to implement the pilot waiver steps, monitor possible Medicaid reimbursement, move forward with reentry coordination, and return with further detail on contracts and service line breakdowns.
