California will soon become the first state in the nation to offer health insurance to income-eligible individuals who are incarcerated - starting 90 days prior to their release. The feds just agreed to match funds spent on Medi-Cal or CHIP for people leaving jail, prison or juvenile correctional facilities.

Hagar Dickman, senior attorney at the nonprofit Justice in Aging, said it is in everyone's interest to set justice-involved people up for success.

"The idea is to ensure that people are connected with services prior to their release, and individuals with mental-health needs and substance-abuse disorder also can have their medication given to them prior to the release," Dickman said.

Previously the feds would only reimburse the state's Medi-Cal expenses for people upon their release. In addition, the state passed a law last fall put people's Medi-Cal into suspension instead of terminating it while incarcerated. Now their status will be reactivated without them having to reapply.

This is not just a health initiative, it's an equity initiative - since a disproportionate number of people of color face incarceration, Dickman said. And it puts people on stronger footing as they re-enter society.

"This is really an important way to combat the significant effects of mental illness, mental health issues, and substance abuse in the jails particularly in light of both high rates of homelessness and also suicide and overdose as people are released," she said.

The move is part of the larger project called Cal AIM
which will modernize Medi-Cal - and allow it to cover things like housing supports, since secure housing is considered a social determinant of health.

Maryland has one of the highest percentages in the nation of people in prison who began serving time when they were juveniles.

A new report from Human Rights for Kids included survey results from more than 120 people in Maryland who have been in prison since childhood. It found nearly 70% had experienced six or more Adverse Childhood Experiences, the major upheavals in a child's life affecting their development, from abuse and neglect to incarcerated relatives and domestic violence.

Nate Balis, director of the Juvenile Justice Strategy Group at the Annie E. Casey Foundation, said one concern is children in Maryland are automatically tried as adults if they're accused of any of more than 30 crimes.

"Because it's based on offense -- and not based on the individual circumstances of the offense itself, or of a young person's history, or of even considering the trauma that young people have experienced -- it means that just because of the offense, we are charging young people as adults," Balis explained.

The report showed 6% of Maryland's incarcerated population has been in prison since childhood. The numbers also include immense racial disparities, with more than 90% being people of color. The report recommended all cases involving a child start in juvenile court and courts be required to take Adverse Childhood Experiences into account during sentencing.

Balis also noted compared to adults, young people are more capable of change, which he argued should mean more effort is made to keep them out of the adult system.

"We want to do everything we can to steer them away from the system," Balis urged. "To prevent them from future offending, to fill their lives with good things, to keep them away from the justice system. Not to pull them deeper into the system and even into the adult criminal justice system, when we could serve them effectively in the juvenile justice system."

Other recommendations include prohibiting the use of solitary confinement for children and not housing children in adult jails and prisons.

Changes in federal law will permit West Virginia and other states to use Medicaid dollars to pay for health care services for incarcerated youths beginning Jan. 1.

In addition to helping kids get physical and dental health care, the new rules should give them needed resources to address mental and behavioral health challenges stemming from childhood trauma.

Elizabeth Crouch, associate professor of health services policy and management at the University of South Carolina, said mitigating adverse childhood experiences is a growing part of efforts to keep rural children out of the juvenile justice system and detention.

"A fifth of rural children are diagnosed with developmental behavioral mental health disorders," Crouch pointed out. "Rural children are more likely to be diagnosed with developmental behavioral disorders, such as ADHD, than their urban counterparts."

About 45% of West Virginia children experience adverse childhood experiences, a rate five points higher than the national average. The Medicaid coverage for youth in detention includes physical, dental and behavioral health screenings and case management services.

States are also taking into account neurocognitive research showing teen brains do not fully develop until the mid-20s. Crouch noted arrests of young people have dropped by more than 80% since the mid-1990s, as a greater understanding of childhood trauma has increased the number of alternatives to detention. Still, she acknowledged the challenges for rural kids are formidable.

"What we have found is that rural children have been disproportionately living in homes affected by current substance use or mental illness," Crouch explained. "Rural children have experienced much higher rates of opioid use."

Despite declining arrests and detention rates, young people of color are still far more likely than white youth to be held in juvenile facilities, according to The Sentencing Project.

The New York Police Department's new commissioner must address the agency's dwindling public trust as her tenure begins.

Jessica Tisch became the agency's top official after former commissioner Edward Caban resigned amid federal investigations. Past surveys show moderate trust in the department but a new survey of heavily policed neighborhoods paints a different picture.

Brett Stoudt, associate director of the Public Science Project, said it found people in such neighborhoods want crime handled differently.

"A significant number of these residents do not desire more investments in policing but instead desire approaches to public safety that invest in a broad set of supports and services, and institutions," Stoudt explained. "The kind that more fundamentally address the root causes of violence."

Other findings show people are fearful of their neighborhood's expanded police presence. Along with this, some said they have experienced physical or sexual violence from police officers. Stoudt noted this kind of policing mostly affects minorities in the city. The New York Civil Liberties Union finds Black people are 20% of the city's population, but were 60% of people police stopped in 2023.

Recommendations to fix the issues include increasing transparency for the department, firing officers who abuse their position for power and stopping the spread of misinformation from the agency.

Ileana Méndez-Peñate, program director for the group Communities United for Police Reform, said other recommendations aim to reduce the department's omnipresent role in some areas.

"The other policy recommendation related to that is the real need to invest in the fundamental needs of New Yorkers," Méndez-Peñate emphasized. "I talked about housing and education but also youth programs and services and quality city infrastructure through security. These are some of the top concerns."

There could be challenges to enacting the survey's solutions. One is the charter revisions passed on Election Day, since one of them gives the department more power. She added another challenge is financing, since the millions of dollars the city spends on the police department do not address the root causes of certain issues.


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