Rebuilding Lives. Strengthening Communities.

MAYORAL POLICY CAUCUS ON PRISONER REENTRY
54
Issue
Ensure timely access to Medicaid and SSI/SSDI benefits for eligible
individuals released from prison.
Recommendation
Incarcerated individuals with a serious mental
illness may have once received Medicaid 53 or federal
disability benefits, like Supplemental Security Income
(SSI) or Social Security Disability Income (SSDI). 54 Prior
to incarceration, they likely were not employed, and relied
on SSI or SSDI payments to cover housing or other living
expenses. The vast majority do not have access to private
health insurance and rely on Medicaid for health care
coverage, or have no insurance at all.
Few prisoners, however, are enrolled in these federal
assistance programs upon release. When they begin their
jail or prison terms, they often lose eligibility. And when
they are released, restoring that eligibility can be difficult.
If prisoners received SSI, SSDI, or Medicaid before
incarceration, they can reapply; if not, they can apply for
the first time. But the paperwork is cumbersome and
unfamiliar, and applications can take months to
process—months during which many formerly incarcerated
individuals lack money for medication, housing or
treatment.
As a result, access to these critical supports—typically
conditions of probation or parole—is severely limited,
presenting a significant obstacle to transitioning into the
community and maintaining continuity of care. “When
individuals with mental illness are released from jail or
prison without SSI, SSDI, or Medicaid benefits, they are
much more likely to end up in a homeless shelter, in the
emergency room, or back in jail or prison,” according to
Chris Koyanagi, Policy Director at the Bazelon Center for
Mental Health Law in Washington, D.C. 55
Generally, the length of time a person is in jail or prison
determines whether, or when, federal benefits will be
affected. 56
SSI payments continue until an individual has been in jail
or prison for a full calendar month—from the first of the
month through the last day. After one full calendar
month, the individual is “suspended” from SSI. The person
remains on the rolls, but does not receive payments.
During this period, the Social Security Administration
(SSA) presumes that the prisoner, while incarcerated,
remains disabled. However, when the individual is discharged,
SSA must be informed of the prisoner’s release,
and a form must be submitted with evidence that financial
hardship still exists. Although this process is relatively
simple, often it is more than mentally unstable individuals
leaving prison can accomplish on their own. Thus, these
individuals may go weeks or months without receiving the
benefits to which they are entitled, and all too often end
up homeless or back in jail or prison. 57
SSI benefits are terminated if an individual is incarcerated
for 12 full consecutive calendar months or more. An individual
whose eligibility has been terminated must file a
new application for SSI. The average prisoner in Illinois
prisons serves just over 19 months; 58 consequently, the
possibility that benefits will be terminated is quite high.
Once SSI benefits have been terminated, the reinstatement
process is considerably more involved than after suspension.
The individual must obtain documents detailing his
or her medical history, and receive a new assessment to
show a current disability under the eligibility standards.
SSA may then take at least three months to review the
application and issue a decision about reinstatement. In
cases where information is missing, the process may be
extended by six or nine months. 59 Again, the lack of
benefits during this period may force these mentally ill
individuals back on the streets and into the criminal
justice system.
Like SSI, SSDI payments continue for a short time while
an individual is incarcerated. An individual can receive
SSDI benefits until he or she has been convicted of a crime
and spent 30 days in jail or prison. Payments will be
“suspended” on the 31st day of confinement, whether or
not a full calendar month has passed. However, SSDI benefits
are never terminated for incarceration alone, no matter
how long the prison term. People who qualify for SSDI
remain eligible as long as they meet the federal definition
of disability. Cash payments can resume after release;
however SSA must receive verification that the person is
no longer in a correctional facility.
Jails and prisons have a financial incentive to inform SSA
that a person is confined; they receive federal payments
when they supply information resulting in suspension or
termination of SSI or SSDI benefits. 60 Unfortunately, correctional
institutions have no such incentive to advise SSA
when prisoners are released so benefits can be restored.