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Stephanie Collins, Ph.D., LMHC Assistant Deputy Commissioner MA Department of Correction October 30, 2017
Stephanie Collins, Ph.D., LMHC Assistant Deputy Commissioner MA - - PowerPoint PPT Presentation
Stephanie Collins, Ph.D., LMHC Assistant Deputy Commissioner MA - - PowerPoint PPT Presentation
Stephanie Collins, Ph.D., LMHC Assistant Deputy Commissioner MA Department of Correction October 30, 2017 Examine the issues impacting ex-offender Examine the issues impacting ex-offender reentry into the community reentry into the
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MA DOC Institution Overview Medical Services Medicaid Reentry Program MA DOC Community Linkages
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MA Department of Correction Census Sites Largest Sites Smallest Site Number of admissions annually Number of releases annually
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Comprehensive Services Contract Contracted comprehensive medical, mental
health and dental services
- “Medical services shall include medical, laboratory,
pharmaceutical, hospitalization, and inpatient care which shall include primary, secondary, and tertiary levels,
- utpatient, medical clinic care, physician specialty care,
telemedicine and all other health care services.”
Fully at risk, capitated contract
- The Contractor shall be solely responsible for making all
decisions with respect to the type, timing and level of services needed by inmates.
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FY 2017 ( July 1, 2016 – June 30, 2017)
- 8,262 Medical Trips
- 1,219 Emergency Medical Trips
- 552,000 Onsite Clinical Visits
49,000 MD/ANP 503,000 RN/LPN 29,000 Dental 832 seen for reentry and discharge planning 1,788 seen for aftercare appointments 1,085 discharged with active MassHealth/39 without 279 referred for medication assisted treatment
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Infectious disease medications top cost drivers were for HIV and Hepatitis C:
1.
Harvoni
2.
Viekira XR
3.
Atripla
4.
Epclusa The top cost drivers (for Non HIV or Hepatitis C medications) for medical costs were:
1.
Adalimumab
2.
Etanercept
3.
Truvada The top drivers for order volume were:
1.
Ibuprofen
2.
APAP
3.
Clonidine The top cost drivers for psychiatric medications include:
1.
Amitriptyline
2.
Chlorpromazine
3.
Perphenazine
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Vendor services as providers for clinical
services in MA
- MPCH
- Spectrum
MassHealth Fellowships and Grants Volunteer Services
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Offender enrollment in correct program Separate systems
- Inpatient Only Medicaid
- Community Medicaid
- Neither process is automated, applications and
changes are completed through a paper process
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Must complete a Medicaid application in
facility
Completed by vendor medical staff Enrolled prior to first inpatient stay which
exceeds 24 hours
Medicaid does not assume eligibility Only covers costs for services during the stay
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Must complete a Medicaid application in
facility 30 days prior to return to community
Completed with a Correctional Program
Officer
Not automatically enrolled. Application alerts
MassHealth that “Inpatient Only” status is changing to Community status
Not assumed eligibility Does not always start immediately upon
release
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Provide continuity of medical and mental health care for offenders returning to the community
Make appointments
Provide medications
Provide the offender with list of resources Increase chances at recovery and successful reintegration Housing Vocational opportunities
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MATRI
- Medication Assisted Treatment Reentry Initiative
Housing Vocational Programs Employment Cultural Programs (Churches, Organizations) Parole SSI/SSDI
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Court Systems
- No medical services
- No access to care
- No prior clinical information
Parole/Probation
- Responsibility for successful reentry fall to Parolee
Community Providers
- Lack of mental health resources
- Community Providers will not schedule appointments
before Medicaid is activated
DOC
No electronic health record Cannot provide treatment/medications beyond
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