Study of Jail Detainees, Mental Health Services, and Medicaid Policy (Pinellas County, FL AND KING COUNTY, WASHINGTON) - Morrissey, Steadman, Cuellar

Mentally ill offenders seem to suffer a double blow -- being jailed for minor offenses, and then losing their Medicaid coverage upon release from jail. The Network undertook a study to determine if loss of Medicaid was indeed occurring and whether the result was less mental health care after release. The study was situated in two locations—Pinellas County, Florida (1999-2002) and King County, Washington (1995-1998). It tracked the Medicaid status of mentally ill individuals who were detained in the county jail and, after release, the use of mental health services in their communities. Despite widely held beliefs to the contrary, disenrollment from Medicaid did not occur routinely for all mentally ill detainees. Rather, the major determinant of Medicaid disenrollment was the length-of-stay in jail. Mentally ill individuals who stayed less than 30 days were rarely disenrolled from Medicaid. That group was the largest share of detainees enrolled in Medicaid. Preliminary findings suggested that Medicaid enrollees, upon entry to jail in both counties, had a much greater likelihood of receiving any services in the 90-days after release -- and they received more services -- than those who were not enrolled in Medicaid upon jail entry. Differences between counties in the rates of post-release service use and service intensity seemed to relate to Medicaid policy design and to types of administrative data that were collected. The Florida component of the project was in collaboration with the Florida Mental Health Institute and the Pinellas County Data Collaborative. The Washington component was in collaboration with several county and state agencies.

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Last modified: June 1, 2006
©2006 MacArthur Foundation Network on Mental Health Policy Research
Last Revised: June 2006