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Sheriff's reentry program enrolls people in Medicaid, reports medication-cost and taxpayer savings
Summary
The Clallam County sheriff's clinical services described a reentry program that enrolls people entering custody in Medicaid, provides 30-day medication supplies at release, coordinates telehealth and community navigators, and reported roughly $320,000 in reimbursements and large reductions in county medication spending.
Madison Gallant, who leads the sheriff's clinical services, told the Board of Health April 21 that a reentry program launched July 1 under an 1115-type waiver (presented as an "11/15 waiver" in the record) enrolls detainees in Medicaid, connects them with behavioral and primary care, and supplies 30 days of medication at release to reduce gaps in care and overdose risk.
Gallant described an intake process with two points of contact where staff assess medical, dental and social needs and create individualized care plans. The program arranges warm handoffs to community "trusted helpers" assigned by partners such as Olympic Community Health and schedules post-release telehealth appointments when possible. Staff package medications for immediate release and, when needed, arrange transportation to treatment facilities.
Gallant reported approximate fiscal impacts: about $320,000 in billing/reimbursements from July to March and a notable reduction in county medication expenditures (the transcript gives a year-to-date comparison that staff described as an 89% decrease in county medication spending: from $57,000 last year to about $6,000 year-to-date after the program's start). Staff cautioned that billing capture is imperfect while the program scales and that delays and denials occur because of coding and workflow limitations.
The presenter highlighted clinical outcomes and referrals: staff have connected people to treatment for HIV, hepatitis C, cancer care and chronic conditions (one example cited was Crohn's medication). From the program's tracking period staff reported 150 adults opted into reentry services versus 34 who opted out, and about 185 referrals to behavioral-health partners with 51 individuals documented as receiving post-release follow-up care.
Board members and staff discussed data-tracking, HIPAA constraints and the need for better software and possibly a medical biller to improve reimbursement capture, and they noted barriers such as short-release windows (many detainees are released within 24 hours) and lack of phones or addresses. The board encouraged continued partnership building and software solutions to improve longitudinal tracking and outcomes measurement.
