Medicaid Support for Justice Involved Youth Returning Home

Background

This webpage provides information about new requirements under the federal Consolidated Appropriations Act (CAA, 2023) (P.L. 117-328), which went into effect on Jan. 1, 2025.

Under Section 5121 of the CAA, states are required to ensure the following services are provided to eligible justice-involved youth who are enrolled in Medicaid or CHIP and incarcerated post-adjudication, meaning an official judgment was made (e.g., youth who are incarcerated after conviction):

Screening and diagnostic services in the 30 days prior to release (or no later than one-week post release); and
Targeted case management in the 30 days prior to release and for at least 30 days post-release (referred to as Reentry Care Management in North Carolina).

NC Medicaid is committed to meeting the federal requirements to help justice-involved youth successfully transition back into the community upon reentry with the health supports and services they need. NC Medicaid, in coordination with the Department of Public Safety (DPS), Division of Juvenile Justice and Delinquency Prevention (DJJDP), plans to phase in the implementation of CAA-required services beginning with the state-operated Youth Development Centers (YDCs) in fall of 2026.

Eligible Populations

CAA 5121 applies to certain Medicaid members who are:

Enrolled in NC Medicaid;
Under 21 years of age or between the ages of 18 and 26 under the mandatory former foster care eligibility group; and,
Being held in a correctional facility post-adjudication (e.g., youth who are incarcerated after conviction).

Eligible Facilities

North Carolina will be instituting a phased roll-out of CAA 5121 requirements, beginning with screening and diagnostic services in the five state operated YDCs, which house approximately half of post-adjudication youth beginning July 1, 2026.

Reentry care management will begin Nov. 1, 2026. NC Medicaid is coordinating with other stakeholders to determine the feasibility of phasing in these services to other facilities that house post-adjudicated youth (e.g., state prisons, county jails, and tribal jails).

Screening and Diagnostic Services

Beginning within 30 days before release (or no later than one week, or as soon as practicable after release from the facility), NC Medicaid will cover the following screening and diagnostic services, consistent with Health Check requirements.

Table: Screening and Diagnostic Service Definitions

Covered Service	Medicaid Eligible Youth Under the Age of 21	Eligible Youth Ages 21 and Over
Screening	Services include: Comprehensive health, developmental history and unclothed physical examination; Appropriate vision, hearing and lab testing; Dental screening services; Behavioral health screenings; and Assessment if the individual is up to date with immunizations in accordance with the Advisory Committee on Immunization Practices (and if not, provide the appropriate immunizations)	Services include: Those screenings that are medically necessary to determine existence of a physical or behavioral health illness or condition Age appropriate screenings per the American Academy of Pediatrics / Bright Futures Periodicity Schedule Blood pressure Weight
Diagnosis	Diagnostic services must be rendered when a screening service indicates the need for further evaluation and when such diagnostic services are otherwise medically necessary.

Covered Service

Medicaid Eligible Youth
Under the Age of 21

Eligible Youth
Ages 21 and Over

Screening

Services include:

Comprehensive health, developmental history and unclothed physical examination;
Appropriate vision, hearing and lab testing;
Dental screening services;
Behavioral health screenings; and
Assessment if the individual is up to date with immunizations in accordance with the Advisory Committee on Immunization Practices (and if not, provide the appropriate immunizations)

Services include:

Those screenings that are medically necessary to determine existence of a physical or behavioral health illness or condition
Age appropriate screenings per the American Academy of Pediatrics / Bright Futures Periodicity Schedule
Blood pressure
Weight

Diagnosis

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

Reentry Care Management

Eligible youth can receive Reentry Care Management beginning up to 30 days before release. North Carolina Medicaid plans to provide care management support for up to one year following release beginning on Nov. 1, 2026.

A care manager can:

Identify health care, behavioral health, educational and social support needs
Develop a personalized plan for services and support
Connect youth and families to community resources
Schedule appointments and coordinate services
Follow up after release to help ensure services are received

Why These Services Matter

Returning to the community is an important transition. These services help youth and families:

Access needed health care and behavioral health services
Connect with community-based supports
Prepare for educational and social service needs
Create a plan for ongoing success after release

What Families Should Know

To receive these services, a youth must be enrolled in Medicaid. If your child is not currently enrolled, assistance may be avaiable to help with the Medicaid application process.

Applying for Medicaid

To apply, please visit the How To Apply for NC Medicaid webpage.

Questions and Additional Information

For more information about CAA 5121, please visit: Justice Involved Care Management
For questions about these services, please contact: Medicaid.NCEngagement@dhhs.nc.gov