Consolidated Appropriations Act of 2023: Medicaid and CHIP Services for Eligible Juveniles

Section 5121 of the CAA, 2023 applies to eligible juveniles who meet Medicaid or CHIP eligibility criteria and are nearing release from a public institution following adjudication.

This includes youth who are:

• Enrolled in Medicaid, Healthy Michigan Plan, or MIChild.
• Eligible for Medicaid or CHIP coverage.
• In a qualifying public institution or juvenile justice setting.
• Within the required pre-release or post-release timeframe.

Specific eligibility and operational requirements are described in the policy bulletin and operations guide.

Section 5121 of the CAA, 2023 requires the provision of screening and diagnostic services as well as targeted case management during the period surrounding release from a public institution.

Screening services include:

• Comprehensive health assessment, developmental history, and unclothed physical examination.
• Appropriate vision, hearing, and lab testing including lead toxicity.
• Dental screening services.
• Behavioral health screenings.
• Assessment of whether the individual is up to date with immunizations in accordance with the Advisory Committee on Immunization Practices (ACIP) (and if not, provision of the appropriate immunizations). 

Diagnostic services must be rendered when a screening service indicates the need for further evaluation and when such diagnostic services are otherwise medically necessary.

Screening and diagnostic services are to be provided in the 30 days prior to release from an eligible facility unless the individual was screened for and/or received diagnostic services upon intake or during the incarceration period and within a clinically appropriate time period (e.g., last 12 months); and the previously administered screening and diagnostic services meet the state’s established screening and diagnostic standards.

Targeted Case Management (TCM) services assist eligible individuals in gaining access to physical, behavioral health, educational and other needed services. At a minimum, TCM services include:

• Comprehensive assessment with periodic reassessment.
• Development and maintenance of a person-centered care plan.
• Referrals and related activities.
• Monitoring and follow-up activities.

Michigan is approaching CAA, 2023 implementation through coordinated policy, operations, and stakeholder engagement activities. MDHHS is working with juvenile justice facilities, Medicaid providers, managed care partners, community-based organizations, and other stakeholders to support operational readiness and continuity of care for eligible youth.

Michigan's approach includes:

• Publishing Medicaid policy guidance.
• Developing an operations guide and implementation tools.
• Supporting facility readiness and workflow planning.
• Providing training, webinars and technical assistance.
• Aligning CAA implementation with broader reentry and care transition efforts.
• Supporting consistent communication across Medicaid, juvenile justice, behavioral health, dental and community partners.

Guiding Principles:

• Youth-centered and family-informed.
• Equitable access to care and services.
• Continuity of care.
• Alignment with Medicaid Policy and federal requirements.
• Operationally feasible for facilities and providers.

Relationship to Other Michigan Reentry Work

Michigan is also engaged in broader Medicaid reentry planning and implementation activities. CAA Section 5121 is specific to required Medicaid and CHIP services for eligible juveniles during the period surrounding release from a public institution. Related reentry initiatives may have different populations, services, authorities, timelines, or operational requirements.

Upcoming Trainings
Information on upcoming trainings will be provided here as they are scheduled.

Past Webinars
Webinar materials will be shared here as they become available

• CMS CAA 2023 Sections 5121 and 5122 Juvenile Justice Page
• CMS State Health Official Letter
• CMS Frequently Asked Questions
• Michigan Medicaid Provider Manual
• Michigan Medicaid Provider Enrollment Resources
• Related Michigan Reentry Services Information