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NACo-NSA Joint Task Force: Inmate Health Care and Recidivism

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Watch: How the Medicaid Inmate Exclusion is Impacting Local Justice Systems

About the Task Force

Convened in March 2019, the National Association of Counties (NACo) and National Sherriff’s Association (NSA) joint task force is made up of NACo and NSA members representing county leaders, law enforcement, judges, prosecutors, public defenders, behavioral health and veterans’ services, will explore the impacts of the national mental and behavioral health crisis and the Medicaid Inmate Exclusion Policy (MIEP), which strips federal health and veterans benefits from individuals upon admission to jail – not upon conviction – leading to increased recidivism.

About NACo

The National Association of Counties (NACo) strengthens America’s counties, including nearly 40,000 county elected officials and 3.6 million county employees. Founded in 1935, NACo unites county officials to advocate for county government priorities in federal policymaking; promote exemplary county policies and practices; nurture leadership skills and expand knowledge networks; optimize county and taxpayer resources and cost savings; and enrich the public’s understanding of county government.

About NSA

The National Sheriffs’ Association is one of the largest associations of law enforcement professionals in the U.S., representing more than 3,000 elected Sheriffs across the nation, and with a total membership of more than 20,000. NSA is a non-profit organization dedicated to raising the level of professionalism among Sheriffs, their deputies, and others in the field of law enforcement, public safety, and criminal justice. Throughout its 78-year history, NSA has also served as an information resource for all law enforcement, as well as state governments and the federal government.

Task Force Members

Co-Chair: Hon. Nancy Sharpe Commissioner, Arapahoe County, Colo.
Co-Chair: Hon. Greg Champagne Sheriff, St. Charles Parish, La.
Delrice Adams Executive Director, Cook County, Ill. Justice Advisory Council
Hon. Michael Adkinson Sheriff, Walton County, Fla.
Hon. Claudia Balducci Councilmember, King County, Wash.
Hon. Kathryn Barger Supervisor, Los Angeles County, Calif.
Hon. Roy Charles Brooks Commissioner, Tarrant County, Texas
Hon. Brett Clark Sheriff, Hendricks County, Ind.
Hon. Jerry Clayton Sheriff, Washtenaw County, Mich.
Hon. Thomas Dart Sheriff, Cook County, Ill.
Hon. Jerry Demings Mayor, Orange County, Fla.
Hon. John Flynn District Attorney, Erie County, N.Y.; Member of the Board of Directors, National District Attorneys Association
Hon. Daron Hall Sheriff, Davidson County, Tenn.
Hon. Michael Heldman Sheriff, Hancock County, Ohio
Hon. David Hudson Judge, Sebastian County, Ark.
Hon. Clay Jenkins Judge, Dallas County, Texas
Hon. Peter J. Koutoujian Sheriff, Middlesex County, Mass.
Hon. Steven Leifman Associate Administrative Judge, Eleventh Judicial Circuit of Florida, Miami-Dade County, Fla.
Nick Macchione Director, Health and Human Services Agency, San Diego County, Calif.
Hon. John McMahon Sheriff, San Bernardino County, Calif.
Hon. Gabriel Morgan, Sr. Sheriff, Newport News, Va.
Hon. Christopher Moss County Executive, Chemung County, N.Y.
Hon. Eric Severson Sheriff, Waukesha County, Wis.
Hon. Helen Stone Commissioner, Chatham County, Ga.
Hon. Tim Svenson Sheriff, Yamhill County, Ore.
Hon. Janet Thompson Commissioner, Boone County, Mo.
Hon. Errol Toulon, Jr. Sheriff, Suffolk County, N.Y.
Hon. Jenny Wilson Mayor, Salt Lake County, Utah
Edward Zackery Director, Veterans Service Office, Medina County, Ohio


Public Advocacy

NACo 2018-2019 2nd Vice President, Boone County, Ky. Judge Gary Moore discusses the joint task force

Key Talking Points

  • Counties nationwide annually invest $176 billion in community health systems and justice and public safety services, including the entire cost of medical care for all arrested and detained individuals
  • Counties are required by federal law to provide adequate health care for approximately 10.6 million individuals who pass through 3,100 local jails each year with an average length of stay of 25 days
  • Medicaid is the single largest source of funding for behavioral health services in the United States, and the number of inmates who are eligible for health coverage has increased as more states have accepted Medicaid expansion
  • More than 95 percent of prisoners eventually return to the community, bringing their health conditions with them. However, in many states, federal benefits are completely terminated instead of being suspended, and it can take months for former inmates to reenroll and regain their benefits following reentry
  • Having access to federal health benefits while awaiting trial and presumed innocent aligns with an individual’s constitutional rights
  • Access to federal health benefits for non-convicted individuals would allow for improved coordination of care, and also decrease short-term costs to local taxpayers and long-term costs to the federal government
  • Providing access to federal health benefits for those awaiting trial and verdict decisions would help counties break the cycle of recidivism caused or exacerbated by untreated mental illness and/or substance use disorders, thereby improving public safety

Legislation We're Tracking

Medicaid Reentry Act

H.R. 1329

Sponsored by Reps. Paul Tonko (D-N.Y.) and Michael Turner (R-Ohio), this bipartisan legislation would restore Medicaid benefits to inmates for the 30-day period prior to their release from a public institution, such as a jail.

Restoring the Partnership for County Health Care Costs Act

H.R. 1345

Sponsored by Rep. Alcee Hastings (D-Fla.), this legislation would remove limitations on Medicaid, Medicare, Supplemental Security Income (SSI) and Children’s Health Insurance Program (CHIP) benefits for pre-trial inmates of jails, detention centers and prisons.


Task Force Resources



Related News

Related Resources


  • Associate Legislative Director – Health  
    (202) 942-4246
  • Associate Legislative Director – Justice and Public Safety  
    (202) 942-4217
  • Director of National Center for Jail Operations, National Sheriffs' Association  

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