Program options for the justice involved

Revised date

Justice involved individuals may be held in various settings, including Department of Corrections prisons, city or county jails, and juvenile detention or rehabilitation facilities. The following table clarifies how an individual's specific correctional status affects their eligibility for Apple Health (Medicaid).

Is the justice involved individual eligible for Medicaid?

Correctional type:
Juvenile Rehabilitation (JR) facilities		 Inpatient coverage* Reentry services (including CAA) 90 days pre-release Reentry services (including CAA) Post-release CAA-related services only 30 days pre-release CAA-related services only Post-release Full coverage
JR institution Yes Yes (transfer to community facility or release equals full benefits) Yes     No
JR community facilities           Yes
Electronic home monitoring (community transition services - CTS - JR definition
A juvenile resides in their home and is monitored electronically for movement. They do not occupy a bed in a carceral facility while in this program.		           Yes

*Inpatient hospital events; must be admitted for 24 hours or more

Correctional Type:
Juvenile Detention (JD) facilities		 Inpatient coverage* Reentry services (including CAA) 90 days pre-release Reentry services (including CAA) Post-release CAA-related services only 30 days pre-release CAA-related services only Post-release Full coverage
JD pre-trial (section 5122 of CAA of 2023)           Yes
JD post-trial (5121)/Reentry Initiative (RI) Yes Yes Yes     No
JD post-trial 5121 (none participating in RI) Yes     Yes Yes No
JD electronic home monitoring
Incarcerated juvenile resides in their home and is monitored electronically for movement. They do not occupy a juvenile detention bed while in this program.		           Yes

JD pre-trial release/supervision/probation

Pre-trial supervision staff monitor a juvenile who is released from custody by the court pending the outcome of their trial and they do not occupy a juvenile detention bed.

           Yes

Juvenile Probation Reporting and Evidence Based Treatment Programs (EBPs):

  • Washington State Aggression Replacement Training (WSART) 
  • Functional Family Therapy (FFT) 
  • Multi-Systemic Therapy (MST) 
  • Family Integrated Transitions (FIT) 
  • Coordination of Services (COS)
  • Education and Employment Training (EET)

In either situation, the juvenile does not occupy a juvenile detention bed while in the program.

           Yes
District court probation
District court probation officers monitor a juvenile who is convicted of or pending trial for misdemeanor charges. The juvenile does not occupy a juvenile detention bed.		           Yes
JD community supervision (probation)
Community corrections officers monitor a juvenile who is convicted of felony charges. The juvenile does not occupy a juvenile detention bed.		           Yes

JD drug court
A court-ordered program in which the juvenile with drug-related charges voluntarily chooses to participate in chemical dependency treatment and counseling. The juvenile may have their charges dismissed if they successfully complete the program. The juvenile does not occupy a juvenile detention bed.

           Yes

*Inpatient hospital events; must be admitted for 24 hours or more

Correctional Type: Jails/Prisons Inpatient coverage* Reentry services (including CAA) 90 days pre-release Reentry services (including CAA) Post-release CAA-related services only 30 days pre-release CAA-related services only Post-release Full coverage

Electronic home monitoring/graduated reentry (DOC)
An incarcerated individual resides in their home and is monitored electronically for movement. They do not occupy a bed in a carceral facility while in this program.

           Yes

Day jail/day reporting 
Incarcerated individual reports at various assigned times throughout a 24 hour period or are placed on supervised work or community betterment programs during regular work hours. In either situation, the incarcerated individual does not occupy a jail or prison bed while in the program.

           Yes

Pre-trial supervision/probation
Pre-trial supervision staff monitor an incarcerated individual who is released from custody by the court pending the outcome of their trial and they do not occupy a jail or prison bed.

           Yes
District court probation
District court probation officers monitor the incarcerated individual who is convicted of or pending trial for misdemeanor charges. The incarcerated individual does not occupy a jail or prison bed.		           Yes

Community supervision
Community corrections officers monitor an incarcerated individual who is convicted of felony charges. They do not occupy a jail or prison bed.

           Yes
Drug court
A court-ordered program in which an incarcerated individual with drug-related charges voluntarily chooses to participate in chemical dependency treatment and counseling. The incarcerated individual may have their charges dismissed if they successfully complete the program. The incarcerated individual does not occupy a jail or prison bed.		           Yes
Furloughs
Individuals are sometimes furloughed by a city/county jail for various reasons. When medical furlough is reported, ProviderOne updates the suspension.
To be eligible for Medicaid payment the individual must receive inpatient hospitalization services lasting 24 hours or more or receive medical services other than inpatient hospitalization outside of the first 24 hour window of the furlough. Furlough under 24 hours is the responsibility of the facility or a payer other than Medicaid.		 Yes         Yes (if over 24 hours)
Work release in city/county facilities
Incarcerated individuals who are housed in a work release facility, jail, or corrections facility and are authorized to leave the facility for purposes of employment, education, court-ordered treatment or employment search. The incarcerated individual does occupy a corrections bed while in this program. Most county work release programs operate under this model.		 Yes         No
Work crews/community betterment
Offered to select incarcerated individuals. This program includes working in the community on various public or non-profit programs. The incarcerated individual does occupy a corrections bed while in this program.		 Yes Yes (based on ERD)       No

*Inpatient hospital events; must be admitted for 24 hours or more

Correctional Type Inpatient coverage* Full coverage

Supervised community residential facility/WA State DOC reentry center/Halfway house/DOC work release
An incarcerated individual is housed in a state or local corrections-related supervised community residential facility with "freedom of movement" to:

  • work outside the facility in employment opportunities available to individuals who are not under justice system supervision
  • use community resources at will (libraries, grocery stores, recreation, etc.) and 
  • seek health care treatment in the broader community to the same or similar extent as other Medicaid enrollees

The residential facility may be public or privately operated. These facilities may have "house rules" where for example residents may be required to report during certain times and sign in and out. Similarly, they may be restricted from travelling to or frequenting locations associated with criminal activity. The majority of state operated (DOC) work release programs use this model. 

   Yes

Residential Re-entry Centers (RCC) - Federal corrections facility 
An incarcerated individual housed in a RCC does not have freedom of movement and is only authorized to leave the RCC through sign out procedures for approved activities, such as seeking employment, working, counseling, visiting, or recreational purposes. During the approved activity, the inmate's location and movements are constantly monitored and RCC staff may visit or call them at any time.

 No No
Voluntary and temporary residence in a public institution
An incarcerated individual who is residing in a public institution or detention center for a temporary period of time voluntarily after their case has been adjudicated and arrangements are being made for their transfer to a community residence. The individual must be free to leave, but is voluntarily residing there pending other appropriate arrangements based on their needs.		   Yes

Residents in a mental health facility or IMD
Individuals (justice involved and general public) who are between the ages of 22 and 64 and are a patient of an Institution for Mental Diseases (IMD) where there are over sixteen beds (e.g. Western State) for more than 15 days in a given month.

 Yes No

*Inpatient hospital events; must be admitted for 24 hours or more

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