Santa Clara County Among 1st in California to Enroll Incarcerated People in Medi-Cal Before Release

Santa Clara County officials are leading the way on a new state initiative to provide Medi-Cal benefits to people incarcerated in county lockups as they prepare to reenter society, part of an effort to improve health outcomes in underserved communities.

The new program, known as the Justice-Involved Reentry Initiative, is one part of the state’s push to better streamline and integrate Medi-Cal with other social and health services across California. Through the reentry program, people in jails and youth correctional facilities can now enroll in Medi-Cal 90 days before their release.

All counties in California must implement the program by October 2025, but Santa Clara County, along with Inyo and Yuba counties, were among the first to gain approval from the state to begin the work.

During the 90-day period, county health agencies, which oversee care for incarcerated people, can work with those preparing for reentry to develop plans for uninterrupted medical care and mental health support.

“This means that gains that were made while in custody through mental health services, drug addiction treatment and support for chronic health conditions will not be lost when people leave custody,” county Board of Supervisors President Susan Ellenberg said during a news conference on Tuesday, to mark the county enrolling more than 100 people in the program.

“In short, this initiative will make these residents healthier and our entire community safer.”

Ellenberg said about 70% of people in county correctional facilities, a disproportionate number of whom are people of color, are struggling with chronic health issues, mental illness or substance-use disorders.

“Very often, the triggering behavior or action that lands them in custody was one of those health-related issues or social determinants of health,” she said in an interview. “So being able to address those while they’re in custody is really significant, but only will have a lasting effect if we continue it.”

Program participants are also offered case management support for up to one year after their release to help navigate the complex web of available government, private market and nonprofit-provided services.

“The medical system, behavioral health systems, as well as connecting them to other services like housing, food, transportation, other things that you need, the fundamentals to be able to manage your health well,” Michelle de la Calle, director of system integration for Santa Clara Valley Healthcare, said in an interview.

Dr. Clifford Wang, the interim director of custody health services for the county, said people leaving county facilities would be given a supply of their medications in hand, as well as any needed medical equipment, such as walkers, canes or wheelchairs.

“Once you leave custody, you’re thinking about, ‘where am I going to live, where am I going to get my next meal,’ and you may not pick up your prescriptions,” Wang said. “So it’s a bridge, and it’s lessening the burden on them. One less thing they might have to worry about when they get out in the immediate sense.”

People who are trying to rebuild their lives face many challenges “including housing instability, homelessness and barriers to gainful employment,” said Ky Le, a deputy county executive.

Le said this latest initiative will augment the work the county has already done to provide reentry resource centers, employment programs and peer counseling services.

Ellenberg said she’s happy Santa Clara County is “at the vanguard again” for programs and initiatives that help “build a carceral system that is as least traumatizing as possible, as most rehabilitative as possible.”

“I look forward to learning about the lives that will be improved as a result of this program,” she said.