faq – Agencies

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More health choices for client success

The frequently asked questions (FAQs) are arranged by topic. To use the FAQs below, you can choose to view all topics, or specific topics such as eligibility, find a criminal justice professional, find a provider, health records, marketplace-exchange and Medicaid.

How can I help my client determine if they are eligible for Medicaid?

For justice involved individuals, Medicaid eligibility is dependent on three factors: income, household size, and criminal justice status. If your client is single and earns less than about $1300/month and is not considered an “inmate” residing overnight in jail or prison; they may be eligible for Medicaid. Review the Take Care – Health Matters eligibility page for specifics.

You can help your client determine if they are eligible and help them enroll in Medicaid through numerous avenues. You may also contact your local county Department of Human Services or local medical assistance/application assistance sites to schedule an appointment. You may also contact one of your local Health Coverage Guides to schedule an appointment.

You may also determine a client’s eligibility online by going to the Colorado PEAK website and apply for Medicaid. For more information on eligibility and enrollment resources and information please visit the Colorado.gov/health website.

What is Connect for Health Colorado?

Connect for Health Colorado is Colorado’s health insurance marketplace. Health Insurance Marketplaces (aka Marketplace) were established by the Affordable Care Act and serve as a resource for individuals to purchase private health insurance. Connect for Health Colorado is an online resource where you can shop for a variety of private health insurance plans that will best meet your health needs. Depending on one’s income, household size, and criminal justice status, individuals may receive financial assistance through a tax subsidy to help with purchasing private health insurance through the Connect for Health. Private health insurance plans are available for individuals, families and small businesses and must offer coverage for what are called 10 essential health benefits.

Are there resources to help me enroll my client in Medicaid?

You can help your client determine if they are eligible and help them enroll in Medicaid through numerous avenues. You may contact your local county Department of Human Services or local medical assistance/application assistance sites to schedule an appointment. You may also contact one of your local Health Coverage Guides to schedule an appointment. You may also determine a client’s eligibility online by going to the Colorado PEAK website and apply for Medicaid. For more information on eligibility and enrollment resources and information please visit the Colorado.gov/health website.

My client believes they are already enrolled in Medicaid. How do I help them find out if they already have coverage?

You may go to the Colorado PEAK website to see if your client is already enrolled in Medicaid. Individuals who applied to Medicaid using a paper application may have to create a Username and Password on the Colorado PEAK website. If your client believes they already have a Username and Password, but has forgotten it, they will need to reset their log in information to be able to access their account. You may also call the Medicaid Customer Service line at 1-800-221-3943 to find out if your client is already enrolled in Medicaid. Your client will need to provide their date of birth and the last 4 digits of their social security number.

My client has Medicaid. Now what?

For behavioral health (substance use disorder and mental health) services:

Every individual enrolled in Medicaid is automatically assigned to a Behavioral Health Organization (BHO). BHOs are responsible for providing medically necessary behavioral health services to Medicaid clients. Depending on what county your client lives in will determine which BHO your client is assigned to. If your client needs behavioral health services, please contact the appropriate BHO who will assist your client in finding a behavioral health provider within your community.

For physical health services:

Individuals enrolled in Medicaid can choose from a variety of health plans to best meet their physical health needs. The Accountable Care Collaborative (ACC) is Medicaid’s primary health care plan and it is encouraged that all new Medicaid enrollees choose to be part of the ACC Program. The ACC Program will connect your client to one of seven Regional Care Collaborative Organizations (RCCO) depending on which county your client lives in. RCCOs will help your client find a primary care provider and coordinate health care, including dental care, and other social service supports that may help your client achieve success in the community. Your client will need to call HealthColorado to choose to be enrolled in the ACC Program or may contact the appropriate RCCO [PDF] to discuss how the ACC Program may be able to help and assist your client in accessing health care services.

How do I help my client find a Medicaid provider?

It’s easiest to help your client connect with the appropriate RCCO [PDF] to find a Medicaid provider. You can also go to Find a Provider  on the Colorado Department of Health Care Policy and Finance website or the Colorado Consumer Health Initiative’s Blue Guide Colorado and search for a provider by using a variety of search fields.

My client has Medicaid, but is going to be incarcerated in jail for a few weeks. Will she still have Medicaid when she is released?

Technically, people become ineligible for Medicaid as soon as they are incarcerated regardless of the length of time. However, on a practical level, if someone is incarcerated for a relatively short period of time, their Medicaid may not be officially terminated. If Medicaid is terminated, then your client would need to reapply.

Colorado currently does not currently have the ability to “suspend” someone’s Medicaid benefits when they are incarcerated for a short period. This means that justice involved individuals may “churn” between being eligible and ineligible for Medicaid when incarcerated and released. If your client is unsure if her Medicaid benefits have been terminated, she can call the Medicaid Customer Service line at 1-800-221-3943 to find out. She will need to provide their date of birth and the last 4 digits of their social security number.

How do I get a health record from a criminal justice agency?

For people who received health care while in jail, you will need to contact the jail and find out who is the custodian of medical records. Each jail may have its own protocols and fees. If you have a patient that was released from the Colorado Department of Corrections (DOC), you may contact the Denver Reception Diagnostic Center Inactive Medical Records Office. The telephone number is 303-307-2302 and the fax number is 303-307-2227. You will need to fax over a signed release from your patient. Unless you request otherwise, the DOC will provide a year’s worth of medical records and there is no charge.

Who are the contacts that health care providers need to know within the criminal justice system?

Please refer to the Take Care – Health Matters Professional Guide to find your local county jail, parole office, and Chief Probation Officer in your community.

My patient is justice involved. What should I be aware of that might impact the delivery of health services?

For some patients, the fact that they are justice involved won’t impact the delivery of health services or be something that you even need to be aware of. In some circumstances, it will be very important to understand restrictions that may be placed on them due to their justice involvement. For example, people living in a halfway house have to get permission to leave the halfway house, even to go to the doctor. They will be expected to have the doctor sign a form or otherwise verify that they were at the doctor’s office at a specific time. They may be only able to be away from the doctor’s office for a short period of time. It may also be important for a health care provider to know that a patient that is justice involved is likely to be under a lot of stress or feel overwhelmed with complying with all the requirements of criminal justice supervision. Creating open communication with your patient when it is relevant to know about their justice involvement is the key to navigating this complexity.

As a health care provider, am I expected to provide certain information back to a client’s probation or parole officer?

Justice involved patients have all the same rights to privacy as any other patient and you must receive written permission from your patient to discuss their health status or care with any criminal justice professional. It would be unusual that a medical provider would be expected to provide health-related information to a patient’s probation or parole officer.

However, if you are providing mental health or substance abuse treatment to a patient that is justice involved, it is almost guaranteed that you will be expected to provide information back to a patient’s probation or parole officer. The majority of people that are justice involved are in need of substance abuse and mental health treatment. Getting treatment is very likely to be a mandatory condition of criminal justice supervision. Probation and parole officers will expect that you provide certain information to them so that they can determine whether a patient is complying with terms and conditions of supervision. Talking with your client and the criminal justice supervising officer will be important so that there is real clarity around what information is expected to be shared, what information will be shared, and what permission must be obtained from the patient prior to sharing.