Hartford Foundation Submits Testimony in to support federal Medicaid demonstration waiver to implement a Justice Involved Re-entry Initiative.

The Hartford Foundation for Public Giving has submitted testimony to the legislature’s Appropriations and Human Services Committees in support of the Connecticut Department of Social Services’ proposed Substance Use Disorder Demonstration Waiver pursuant to Section 1115 of the Social Security Act for Connecticut’s Medicaid program and Children’s Health Insurance Program (CHIP) to the federal Centers for Medicare & Medicaid Services (CMS) to implement a Justice-Involved Population Re-entry Initiative (Re-entry Initiative). 

Data show that most justice-involved people, both nationally and in Connecticut, eventually return to their communities after serving time. We know they need access to reentry planning and support before release and continuing supports in the community to effectively reintegrate, including access to mental and physical health care services, stable housing, food and workforce training and job opportunities. Without addressing people’s mental and physical health needs while incarcerated and upon their release. Often people are looking forward to coming home but find it challenging given the stigma of incarceration and discrimination to make the transition. 

The 2024 State of Reentry Report, commissioned by Career Resources Inc. in collaboration reentry center and other leaders, highlights the barriers people face upon their release. Problem substance use and mental and physical health issues continue to present barriers and challenges to successful reintegration of returning citizens into Connecticut communities. Substance use for people incarcerated with sentences ending within six months, 93 percent reportedly had a substance use problem, with 48 percent reporting to have a serious or extremely serious substance abuse problem. Similarly, people incarcerated with an end of sentence date within six months, 37 percent reported having a moderate to severe mental health disorder. This initiative would be an invaluable tool to address the significant needs of youth and adults living with mental health and substance use challenges.

As part of the Hartford Foundation’s efforts to dismantle structural racism and advance equitable social and economic mobility for Black and Latine residents of Greater Hartford, the Hartford Foundation seeks to increase stable employment that advances careers for adults and youth in our region who are often left behind. The Foundation’s efforts focus on increasing training opportunities that lead to hiring and retaining residents with significant barriers to employment, including men and women returning from prison and jail and opportunity youth disconnected from school and work. 

For many years, the Hartford Foundation has been at the forefront of supporting nonprofits and their partners working with men and women incarcerated and preparing to return to Greater Hartford communities. We not only believe in second chances, but affording the education and other supports many youths and adults may not have received before becoming involved justice system involved. Many were not employed and struggling with substance abuse and urban trauma issues before they were Our grantmaking has included work with nonprofits focusing on juvenile reentry…to work supporting fathers and mothers in prison and their children to help them maintain positive interactions…to complementing federal reentry grants to cover populations or services not covered…to seeding and providing multi-year support of the Greater Hartford Reentry Welcome Center and newer programs directed by people who have experienced incarceration and successful reentry. 

The access to pre-release health, mental and behavioral health, housing, and case management services the proposal provides is essential to addressing persistent challenges around substance abuse and health we know are prominent within justice-involved populations. This is documented in the State of Reentry reports this year and over past two years, commissioned by Career Resources Inc., in collaborations with and other welcome center leaders, as well as the Foundation’s evaluations of the Greater Hartford Welcome Center.

As we have seen the number of people incarcerated reduced to half of what it was in previous years with increased focus on diversion programs and other efforts, we also understand that the people remaining often have more complex challenges in these areas need more support.

A longstanding best practice in reentry is providing a continuum of supports that begin before release and continue through services provided by community-based organizations. This we know needs to happen but has not been easily accomplished. The DSS proposal is critical in achieving these goals. 

The Foundation’s strategic work also included providing supports for basic human needs in our region, applying an equity lens to the systems and programs that address physical and mental health care, emergency shelter and homelessness diversion, and healthy food choices, and the digital divide.

Since 2007, the Hartford Foundation has funded critical reentry supports to help returning citizens succeed, including reentry planning pre-release, job readiness and industry training, housing, health, transportation and other basic needs, and job placement assistance. This has included support for the Reentry Welcome Center in Hartford led by Community Partners in Action, with additional funding from the City of Hartford and other state and federal resources and working with a broad referral network of service providers. Since 2015, the Foundation has also been supporting the BEST Chance reentry program coordinated by Capital Workforce Partners, with support from the Connecticut Department of Labor and other funding, and a network of training and other providers. Both programs also provide returning citizens with access to basic services and referrals to community-based food, shelter, health, and other programs. 

In Connecticut, there are five reentry welcome centers operating in Bridgeport, Hartford, New Haven, New London and Waterbury. An important change is that the DOC transports people to the welcome centers instead of dropping people off at locations with no direct support. This facilitates the continuity of care. The reentry center serving Greater Hartford coordinates closely with the CT Department of Correction reentry staff in assessing individual reentry supports needed. A continuing challenge is that sometimes people are released without adequate notice given that DOC staff may not always know when people will be released so the 90-day window for planning is not always available. 

In August 2021, the Hartford Foundation partnered with the City of Hartford, Dalio Education announced an initial 18-month investment of $9.85 million to support opportunity youth, who are individuals 16 – 24 who are currently disengaged from school or work, some of whom have been justice-involved. The funding was provided to COMPASS Youth Collaborative, Our Piece of the Pie, and Roca, Inc. to allow these organizations to provide individualized, trauma-informed, high-touch support to the young people they specialize in working with:

• COMPASS to expand its Peacebuilders programming model, increasing the number of violence interrupters in Hartford working to de-escalate conflict and build relationships with the hardest to reach youth.
• OPP to significantly increase the capacity of the Youth Service Corps, allowing it to serve 100 additional young people, on top of the approximately 250 young people they currently serve annually.  Former Hartford Mayor Luke Bronin led the creation of the Youth Service Corps in 2016 to give young people part-time jobs as well as one-on-one coaching and mentoring.
• Roca, a national youth-serving organization that is also working in Massachusetts and Maryland, came to Hartford to offer a program  specifically serving young women, including young mothers, who are victims of abuse and neglect. 

In 2023, the Foundation made an additional commitment to invest $4 million to support this work. All of these organizations should inform the work outlined in the legislation. In addition, the Foundation has supported the Center for Children’s Advocacy’s (CCA) work with youth pre-release and in the community. CCA is also part of the network of programs working with opportunity youth and has attended to developing supports for juvenile reentry.

The Hartford Foundation has supported this work for many years. We know that the programs with public-private funding are better able to address the layers of need and sustain the work. Adequate public support is essential if we are to address wraparound substance abuse counseling, and physical and mental health housing, needs data show are prevalent in youth and adult reentry populations. No one entity can do this work alone. The work requires strong partnerships. 

If approved and implemented, the Re-Entry Initiative would allow the state to utilize Medicaid and federal financial participation using Medicaid and CHIP funds for Connecticut’s incarcerated adults and youth detained in juvenile and community residential centers. These resources would be used to provide targeted and comprehensive benefits to ensure a continuum of care strategy that enables robust coordination, service provision, and community connections after release.

The Foundation applauds the comprehensive approach DSS has taken in developing this initiative that includes: 

Medicaid Coverage for eligible individuals in the state’s correctional system and juvenile facilities. Including individuals with behavioral health needs including mental health disorders and substance use disorders, certain other health conditions, and all detained youth.

A targeted Benefit Package for these individuals will include case management services, medication-assisted treatment for SUD, a 30-day supply of medications upon release, and certain other supportive services.

A Coverage Period of up to 90 Days immediately prior to the release of the individual from the correctional system.

Services to Address Health Related Social Needs for the justice-involved population transitioning from correctional centers and correctional institutions and juvenile facilities throughout the state.

The Foundation shares DSS’ goals of increasing coverage, continuity of coverage and appropriate service uptake through assessment of eligibility and availability of coverage for benefits in carceral settings prior to release. The Foundation has consistently advocated for the expansion of a broad range of supports to prepare people before leaving incarceration to support successful transition to the community. 

The Re-entry initiative also properly emphasizes the importance of improving coordination and communication not only between correctional systems and administrative services, but also community-based providers who can offer services while individuals are still incarcerated and post-release. Through our own investments, the Foundation has seen how providers who have staff with lived experience of incarceration are powerful trusted messengers who can effectively help returning citizens to access needed services upon release and set them on a path to success. 

With access to additional federal funding, this effort would help to improve the quality of care for incarcerated individuals and in the community to ensure a more seamless process to maximize the potential for successful re-entry. By taking a proactive, preventative approach, this initiative could significantly reduce the need for emergency care and hospitalization among recently released youth and adults.

The Hartford Foundation also applauds DSS’ intentions of addressing unmet needs related to a lack of adequate housing support. These conditions contribute to poor health for youth and adults transitioning from incarceration, without access to safe, stable, affordable housing individuals returning from incarceration simply cannot successfully transition into the community.

The 2024 State of Reentry Report also has continued to document that Black/African Americans and Hispanic/Latino Americans are disproportionately represented within Connecticut’s prison and jails relative to their population size in Connecticut, which underscores the need to address racial discrimination in access to housing opportunities. Department of Correction data in the report indicated that 16 percent of people in the study reported immediate housing instability. Reentry welcome center providers in Bridgeport, Hartford, New Haven, New London, and Waterbury reported higher housing insecurity. 

When individuals are released from incarceration and reentering the community, they often have no personal housing that they own or rent. People reentering are often reliant on family and friends to provide them with housing while they find a job and attend to other basic needs to make a successful transition. When that is not available and families or friends have limited resources, people reentering must rely on transitional housing or shelters that are provided by the state, town, or a nonprofit. The Foundation supports DSS’ request to use federal funding towards infrastructure investments to support the development of justice involved health related social needs services including housing. Reentry providers have identified securing stable housing as a significant persistent challenge.

The Foundation is eager to partner with legislators, government partners, advocates, and businesses to ensure that just involved youth and adults have the comprehensive and holistic supports they need to eliminate barriers to opportunities to reach their potential, thrive and contribute to Connecticut’s vitality.