Starting January 1, 2025, states are required to provide screening and diagnostic services and targeted case management to Medicaid- and Children’s Health Insurance Program (CHIP)-eligible youth and young adults prior to and after their release from correctional facilities. This requirement is part of Section 5121 in the Consolidated Appropriations Act of 2023 (P.L. 117-328), which was signed into law on December 29, 2022, and applies to state prisons, local jails, tribal jails and prisons, and juvenile detention and youth correctional facilities.
Under the new federal law and recent Centers for Medicare & Medicaid Services (CMS) guidance, screening and diagnostic services include immunizations, physical health, dental, and behavioral health services (including treatment for substance use disorders) and must be provided within 30 days before release or no later than one week after release. Each state Medicaid Agency will determine the specific services covered.
Targeted case management services include a comprehensive assessment, the development of a person-centered care plan, referral to appropriate health and other services, and monitoring and follow-up activities. Section 5121 requires such case management services to be provided within 30 days of release and for at least 30 days in the community.
The expansion of Medicaid and CHIP coverage in correctional facilities under Section 5121 will help facilitate smoother transitions for justice-involved youth back into the community by ensuring continuity of care and access to necessary health services, especially for those with substance use disorders. These measures align with efforts to improve health outcomes and reduce recidivism by addressing health needs, removing barriers to care, and promoting a comprehensive support system upon release.
Below are services resources to support readiness efforts by states and correctional leaders:
Getting Ready: Key Elements for the Implementation of Section 5121
Section 5121 Brief Operational Checklist for Post-Adjudicated Youth
Section 5121 of the Consolidated Appropriations Act of 2023 FAQs for Jails
Section 5121 of the Consolidated Appropriations Act of 2023 FAQs for DOCs
Sections 5121 and 5122 of the Consolidated Appropriations Act, 2023