Perhaps no other project area under the California Forward has achieved so much in a single year while also taking on so much more to start the next than the Partnership for Community Excellence. Sharon Aungst and Kathy Jett have been at the front of this effort for CA Fwd and took a few minutes to answer some quetsions about what was accomplished in 2014 and what lies ahead for next year.
What defined 2014 for the PCE?
This year began with the Partnership completing the last three regional convenings – getting Corrections and Health Care officials from counties all across California into the same room to discuss how to get as many newly eligible defendants and offenders enrolled into a vastly expanded version of Medi-Cal under President Obama’s Affordable Care Act.
How did the ACA expansion impact California jails?
The expansion of eligibility was massive. Originally, Medi-Cal was available only to those with children and below a certain income threshold. A vast majority of “justice-involved” individuals are generally childless adults with no health coverage whatsoever.
When enrollment for the newly expanded state Medi-Cal program (under ACA guidelines) began, pretty much anyone in the justice system, whether on parole or probation, could be enrolled as long as they were an adult aged 18-64 and making less than 138 percent of the Federal Poverty Level. Those in jail could be enrolled prior to release to assure they could access care and services once released.
Furthermore, inpatient stays for an inmate at a hospital or another off-site medical facility were set to be covered, as well as treatment or care that was received while in the community after release. And while addiction treatment through Drug Medi-Cal was previously reserved for pregnant women and opioid drug users only, it expanded to include all manner of residential recovery, detoxification, intensive outpatient and day treatment for those with substance use disorders.
And what was the impact of this expansion for counties and why was it so important to get health and corrections in the same room talking to one another?
A full 100 percent of all costs billed to Drug Medi-Cal or Medi-Cal for these newly eligible from 2014-2017 will be reimbursed by the Federal government. Between 2017 and 2020, this will gradually drop to 90 percent. This represents a massive savings to counties while at the same time diverting those from prison who never needed to be there in the first place.
And in a way, that final sentiment is what the Partnership’s big 2015 project is designed to do as well: empower counties to use data-driven decision-making to ensure the use of very limited and costly county jail beds only for those who need to be incarcerated and to use alternatives that can reduce recidivism and improve offenders and their families outcomes.
Explain in more detail the Partnership’s 2015 undertaking with the four counties and what role data and data-driven decision making is playing?
It’s a simple mantra: using data to make smart decisions leads to better outcomes. We are really trying to promote alternatives to jail as the only solution. The goal is to help counties go through a process of reviewing baseline data, such as what is happening to probation violators, and coaching them through a process of examining why they are doing things a certain way. Through this process they realize that more outreach and more understanding of exactly why someone absconded would lead to different ways of dealing with these offenders that could dramatically reduce recidivism instead of just revoking their probation and sending them to jail.
What does this process entail for getting the three chosen counties on board with using data in ways they never have?
We are working with 4 different counties and what we are seeing as the staff within each goes through the process of collecting and streamlining all of this data is that for the first time, they’re looking at aggregate data and using that as a magnifying glass or a mirror to look at their own practices. It’s really powerful when the practitioners start telling the story of their own transformation and what the next step would be to make changes and get better outcomes.