States Can Use Policy Actions to Mitigate Risk and Spread of Coronavirus in Jails and Prisons

As more coronavirus cases and deaths are confirmed in jails and prisons, states can utilize programs and other policy actions to mitigate the risk and spread of the disease within facilities and the broader communities in which they are located, according to a new issue brief from KFF.

More than two million individuals are incarcerated in prison or jail each year, while millions more move into and out of incarceration over the course of the year and others regularly interact with the correctional system, including staff, health care workers, vendors and visitors. Given the close quarters, the coronavirus may spread easily among people in correctional facilities and extend into nearby communities.

As of April 14, 2020, there were 694 confirmed coronavirus cases in federal prisons, including 446 incarcerated individuals and 248 staff, as well as 14 reported deaths among inmates. Reports indicated that there were many more coronavirus cases in state and local correctional systems. People in jails and prisons also are at increased risk for serious illness from coronavirus due to high rates of underlying health problems.

Correctional systems can take a range of actions to mitigate the spread of the coronavirus include reducing admissions, increasing the number of people released from jails and prisons, and reducing visits and other unnecessary contacts within facilities and for people under community supervision. Some examples:

• All 50 states have implemented some form of restriction on visitation to correctional facilities, with 15 states suspending all visitation and 37 states suspending all visitation except for legal visits.
• California is preparing to expedite the release of up to 3,500 inmates from state prisons who have less than 60 days left on their sentence and were convicted of non-violent offenses.
• Los Angeles County released approximately 1,700 inmates from local jails, or roughly 10 percent of the inmate population. All had been convicted of non-violent crimes and had less than 30 days left on their sentences.
• The Iowa Department of Corrections has expedited the release of 700 inmates who were previously determined to be eligible for parole. Other states, including Illinois, Colorado, and North Dakota, have taken steps to expedite or ease restrictions for granting parole.

States can also use Medicaid to enhance coronavirus response efforts for the justice-involved population. Medicaid facilitates access to care for eligible individuals moving into and out of justice the system, particularly in states that have adopted the ACA Medicaid expansion. However, Medicaid reimbursement for incarcerated individuals is limited to inpatient care provided in facilities subject to certain requirements. Medicaid coverage among incarcerated individuals will be increasingly important if hospital care needs grow among incarcerated individuals due to the COVID-19 crisis.

At least 40 states already facilitate access to Medicaid by suspending inmates’ Medicaid coverage rather than terminating it when they are incarcerated, allowing them to get coverage immediately upon release and facilitating access to reimbursement if they receive inpatient care while incarcerated. States also can seek waivers to expand the services and facilities for which federal Medicaid reimbursement is available for incarcerated individuals. In Illinois and California, for example, officials have asked the Centers for Medicare and Medicaid Services to allow the states to claim reimbursement for Medicaid services provided in jails and prisons for COVID-19-relatedservices.

The full analysis, COVID-19 Response for the Justice-Involved Population, provides an overview of the COVID-19-related health risks for the justice-involved population, discusses the role Medicaid can play in response efforts for justice-involved individuals, and identifies other steps states and localities can take to mitigate risk and spread of COVID-19 for this population.

For other KFF data and analyses related to coronavirus and the COVID-19 pandemic, visit kff.org.