Criminal Justice 101 and the Affordable Care Act. Prepared by: Colorado Criminal Justice Reform Coalition

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1 Criminal Justice 101 and the Affordable Care Act Prepared by: Colorado Criminal Justice Reform Coalition

2 Who we are CCJRC and CCLP have partnered to help Colorado seize this historic opportunity to connect justice involved populations with needed health care coverage and services. We coordinate a stakeholder group specifically focused on this population and the ACA. Advances the health, economic security and wellbeing of low-income Coloradans through research, education, advocacy and litigation. Advocates for criminal justice reforms and serves as a resource for people involved in the criminal justice system. 2

3 Opportunities offered by the ACA Over 100,000 justice involved individuals in Colorado on any given day. Estimated 70% - 90% of justice involved individuals are uninsured. Justice involved people have substantially higher rates of medical, psychiatric, and addiction problems as compared to the general public. 3

4 The ACA is a Game Changer The ACA has the potential to: Improve the health of justice involved people Improve public safety Improve the effectiveness of drug policy Improve the utilization of public dollars 4

5 Criminal Justice 101 5

6 Criminal Justice System There isn t a single criminal justice system broad categories are: court system law enforcement corrections There are many different ways that people can be justice involved which can impact whether they are eligible for Medicaid or tax subsidies through the private marketplace. 6

7 Criminal Justice System Components Court System Courts Probation District Attorney Defense Attorneys The court system in Colorado is divided into 22 independent Judicial Districts. Each has courts that will hear different kinds of cases, i.e. criminal, civil, family law, etc. Some operate specialty courts like drug court or veterans court. Each Judicial District has an independent Probation Office and a Chief Probation Officer. Probation Officers are officers of the court. Each judicial district has an elected District Attorney who is responsible for filing and prosecuting criminal cases. Colorado has a unified state Public Defender s Office that represents indigent clients. The Public Defender has numerous offices across the state. There are also defense attorneys in private practice across the state. 7

8 8

9 Criminal Justice System Components Law Enforcement State Police Local Police Jails are operated by the local county, generally the county Sheriff s Department. There are 56 jails in Colorado. Some counties do not operate their own jail but have an agreement with another county jail. Sheriff Jail People can be in jail for many different reasons. Each jail will have someone who is responsible for inmate medical care. 9

10 Criminal Justice System Components Corrections Colorado Dept. of Corrections (State Prisons) Parole Community Corrections The Colorado Dept of Corrections (DOC) manages, supervises and operates the 19 state prisons and contracts with 4 private owned prisons. Most people released from prison will be required to serve a period of supervision, called parole after they are released. Parole officers work for the Dept of Corrections, not the court. There are numerous parole offices across the state. The state also contracts with community corrections programs, aka halfway houses in numerous (but not all) judicial districts. There are currently 33 community corrections programs in Colorado. 10

11 Colorado Prison Facilities 11

12 Criminal Justice Involvement BOND When people are first arrested for an offense, they may be released from jail on bond awaiting trial or other disposition of the criminal case. People on bond are living in the community and they have not been convicted (or yet sentenced) for a criminal offense. Depending on the jurisdiction and circumstances, people may be supervised by pretrial services while on bond. PROBATION Probation is a sentence option for people convicted of either misdemeanor or felony offenses where the person is living in the community and under supervision of a probation officer with court oversight. 12

13 Criminal Justice Involvement JAIL People can be in jail for a number of different reasons. It is a very fluid population and people may not be in jail for a very long time. Pre-trial detainees - people that are in jail who have not been convicted of a criminal offense and have not (yet) made bond. These individuals may be supervised by pretrial services. Convicted serving jail sentence people who have been convicted and sentenced to serve a period of time in jail. Immigration hold/detainer people can be in jail because Immigration Control Enforcement (ICE) or other law enforcement agency/court has placed a hold or detainer on a person because of another pending legal action. 13

14 Criminal Justice Involvement PRISON BOND People When people in prison are have first been arrested convicted for an offense, a felony they and may sentenced be released to serve from a jail period on bond of awaiting time in prison. trial or other disposition of the criminal case. People on bond are living in the community and they have not been convicted (or yet sentenced) for a criminal offense. Depending on the jurisdiction and circumstances, people may be supervised by pretrial services while on bond. PAROLE PROBATION Parole Probation is a period is a sentence of supervision option for following people release convicted from of either state prison. misdemeanor People on or felony parole offenses are still under where the the jurisdiction person living of the in state the community Dept of Corrections and under and are supervision supervised of a by probation a parole officer. with They court are considered oversight. parolees not inmates. 14

15 Eligibility and Enrollment of Justice Involved Populations 15

16 Eligibility Depends on CJ Status Most justice involved individuals will be eligible for coverage. Two Tiered Test: Clients are NOT eligible for coverage if BOTH: they are an inmate of a public institution (i.e., under the control of state, county, federal government or municipality), AND they can be charged criminally with escape if they leave the institution without authorization. 16

17 Eligibility during Pretrial Phase Pretrial Status Eligible for Medicaid? Eligible for Coverage? Marketplace Eligible for Tax Credits? - On bond or diversion pending disposition Yes Yes Yes - In jail pending disposition No* Yes** Yes * The jail or prison facility is responsible for all health care services provided in-house. Medicaid can reimburse for medical care provided to an incarcerated person admitted as an inpatient in a hospital for at least 24 hours. ** Private insurance may pay for inpatient or outpatient services received while someone is in jail pretrial as long as the person continues to pay premiums and receives treatment in-network. 17

18 Eligibility while serving a sentence Serving Sentence Eligible for Medicaid? Eligible for Coverage? Marketplace** Eligible for Tax Credits? In County Jail No* No No In Prison No* No No Probation Yes Yes Yes Parole Yes Yes Yes * The jail or prison facility is responsible for all health care services provided in-house. Medicaid can reimburse for medical care provided to an incarcerated person admitted as an inpatient in a hospital for at least 24 hours, including individuals residing in a Community Corrections facility. **Marketplace enrollment must be discontinued within 30 days of being sentenced to a period of incarceration. 18

19 Eligibility in Community Corrections ( halfway house ) Community Corrections Eligible for Medicaid? Eligible for Coverage? Marketplace Eligible for Tax Credits? - - Residential diversion clients No?? - - Residential transition clients No?? - - Condition of parole No?? - - SB 252 beds (parole revoked) No No No - - Non-residential diversion clients Yes Yes Yes - - Non-residential transition clients (ISP-I) Yes Yes Yes - - Condition of misd probation (SB13-250)* Yes Yes Yes * The court can order a defendant convicted of a misdemeanor drug offense to complete treatment in a residential treatment program provided in a community corrections facility. These people are not subject to prosecution for escape if they leave the facility. 19

20 Things to remember Justice involved people may have never had health insurance or a primary care provider. Justice involved people may have restrictions and requirements that they have to comply with that could affect the delivery of health services. Justice involved people may be under a significant amount of stress that can be adversely affecting their health. Justice involved people have all the privacy rights of other patients. 20

21 Resources on Take Care - Health Matters Website Take Care Health Matters Professional Guide Tell us Your Story Webinars Sign up for a training Much more 21

22 Questions? More info? Terri Hurst, CCJRC Policy Coordinator 22

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