New Federal Law Aims to Improve Health Care for Formerly Incarcerated Youth

Valentino Valdez, 27, faced significant challenges upon his release from a Texas prison in 2019 at age 21. Despite being provided with basic essentials like a birth certificate, Social Security card, a T-shirt, and khaki pants, he lacked access to health insurance, mental health medications, and medical care. This oversight left him vulnerable, leading to a crisis three years later when he was hospitalized due to suicidal thoughts.

The Impact of Lack of Health Care Services

Valdez’s experiences are not uncommon. Many individuals like him have cycled through juvenile detention, foster care placements, and state prisons without adequate mental health treatment. This lack of support can exacerbate existing issues and make reintegration into society difficult, increasing the likelihood of readmissions to correctional facilities.

“It’s not until you’re put in, like, everyday situations and you respond adversely and maladaptive,” Valdez said, “you kind of realize that what you went through had an effect on you.”

For years, formerly incarcerated individuals have struggled to access health care services independently, often facing gaps in coverage that can affect their physical and mental well-being. This issue is particularly pronounced among those eligible for Medicaid or the Children’s Health Insurance Program (CHIP).

A New Federal Law to Address the Gaps

A recent federal law seeks to address these challenges by requiring all states to provide medical and dental screenings to Medicaid- and CHIP-eligible youths 30 days before or immediately after their release from correctional facilities. Additionally, youths must continue to receive case management services for 30 days post-release.

This legislation represents a significant change, as Medicaid has historically been prohibited from covering health services for incarcerated individuals. The new law, enacted in January 2023 as part of a spending bill signed by President Joe Biden, aims to improve health outcomes and reduce recidivism among this vulnerable group.

“This could change the trajectory of their lives,” said Alycia Castillo, associate director of policy for the Texas Civil Rights Project. “Without that treatment, many young people leaving custody struggle to reintegrate into schools or jobs, become dysregulated, and end up cycling in and out of detention facilities.”

The Implementation Challenge

While the law represents a step forward, its effective implementation requires significant changes to the nation’s correctional health care systems. These facilities must align their health care practices with state Medicaid and CHIP programs, creating a seamless transition for individuals as they leave custody.

“It’s not going to be flipping a switch,” said Vikki Wachino, founder and executive director of the Health and Reentry Project. “These connection points have never been made before.”

Addressing Unmet Needs

The federal Bureau of Justice Statistics estimates that about a fifth of the country’s prison population spent time in foster care. According to the Sentencing Project, Black youths are nearly five times as likely as white youths to be placed in juvenile facilities, highlighting the systemic disparities within the justice system.

Studies show that providing treatment for these health needs after release can significantly reduce the likelihood of reentry into the juvenile justice system. “Oftentimes what pulls kids and families into these systems is unmet needs,” explained Joseph Ribsam, director of child welfare and juvenile justice policy at the Annie E. Casey Foundation.

Efforts to improve health care access for formerly incarcerated individuals can help break this cycle, making it more likely for them to reintegrate successfully into their communities.

Implementation Hurdles

Despite the clear need for change, implementing the law will face numerous challenges. Many state and local facilities lack the infrastructure to bill Medicaid or CHIP, share records with health care providers, and ensure continuous care for released individuals.

For example, Georgia’s juvenile justice system doesn’t have a robust billing system in place, and South Dakota faces difficulties in maintaining Medicaid and CHIP coverage during incarceration.

These obstacles highlight the significant technical and bureaucratic hurdles that must be overcome to ensure the law is enforced effectively.

The Human Cost

Valdez’s journey underscores the human cost of inadequate health care for those reentering society. Taken custody of at age 8 due to his mother’s inability to care for him, he faced a series of traumatic experiences in foster care and the juvenile justice system. His mental health declined, exacerbated by the lack of proper treatment and support.

“I felt like an animal,” he recounted, describing the harsh conditions and inadequate care he received.

The U.S. Department of Justice released a report in August 2023 finding unconstitutional conditions in five Texas juvenile justice facilities, including exposure to excessive force and prolonged isolation, failure to protect children from sexual abuse, and inadequate mental health services.

Valdez’s trauma and subsequent struggles illustrate the broader issue of systemic failures in providing necessary mental health care to those in state custody.

A Path Forward

Despite the challenges, the new law presents a significant opportunity for states to improve health outcomes for formerly incarcerated individuals. By addressing critical health care needs, states may reduce emergency care costs and decrease recidivism rates.

“Any state that is dragging its feet is missing an opportunity here,” said Wachino, emphasizing the importance of prioritizing this aspect of the health system.

Conclusion

The new federal law represents a crucial step towards better health care for formerly incarcerated youth. By requiring health screenings and continuous care, states can help individuals like Valentino Valdez reintegrate more successfully into their communities, reducing the risk of reoffending and improving overall well-being.

As implementation efforts proceed, it is essential that states and federal agencies collaborate to address the technical and bureaucratic hurdles involved. By doing so, they can ensure that this law fulfills its promise of improving the lives of those who have paid their debt to society.