A bipartisan bill in the Wisconsin Legislature would launch a pilot project to provide health care and substance abuse recovery services to incarcerated people before and after release.(Photo by Caspar Benson/Getty Images)

“When people don’t receive support, they tend to go back to what they knew,” Tom Denk, who was released from state prison in 2022, told the Wisconsin Examiner.

In an email, Denk said that he has experienced incarceration for a substance use issue and has had many friends who have had similar experiences. 

“One of my best friends was in prison with me,” Denk said. “It was his tenth time in prison — all for substance use issues. However, after he was released, this last time, he died from an overdose.”

Denk said he would like to see wrap-around services extended to include all prisoners. However, he supports a bipartisan effort in the Wisconsin Legislature to request a specific type of waiver of federal Medicaid law for a state demonstration project to provide eligible incarcerated people with up to 90 days of prerelease health care coverage. The coverage would include case management services, medication-assisted treatment for all types of substance use disorders and a 30-day supply of prescription medications to help people continue to overcome addictions after release. There are 19 other states that have approved waivers, while nine, including D.C., are pending. 

In 2023, the Biden administration put out guidance encouraging states to test strategies to support the re-entry of incarcerated people into communities, according to the health policy research organization KFF.

While Medicaid is prohibited from paying for non-inpatient services provided during incarceration, states can apply for a partial waiver of that policy.

A bill in the Wisconsin Legislature, AB 604, would require the Wisconsin Department of Health Services to request the waiver from the federal government. It will receive a hearing Tuesday afternoon in the Assembly Committee on Mental Health and Substance Abuse Prevention. Its senate counterpart, SB 598, has been referred to the Committee on Health.  

In a press release, Sen. Sarah Keyeski (D-Lodi) said the bill would offer a way to reduce state and local health care costs for individuals with substance use disorders who are already eligible for Medicaid and are incarcerated in state prisons or county jails. She said it would also enhance access to care after release. 

“If we can initiate treatment for more individuals struggling with substance use disorders while they are incarcerated, we can both improve health outcomes once they are released back into their communities and lower rates of recidivism,” Keyeski said. 

Denk said that upon release, he had to search for a new provider, which “got more and more difficult to do.” He said that “case management would help with this issue — and reduce stressors that cause people to use substances.”

Support from lawmakers of both parties, activists 

Sen. Jesse James (R-Thorp) and Rep. Clint Moses (R-Menomonie) are among the bipartisan group of lawmakers who introduced or cosponsored AB 604.

James is the chair of the Senate Committee on Mental Health, Substance Abuse Prevention, and Children and Families, while Moses is chair of the Assembly Committee on Health, Aging and Long-Term Care. Sen. Howard Marklein, co-chair of the Joint Committee on Finance, is another cosponsor. 

“This bill is about saving lives and giving people coming out of the criminal justice system the best chance of recovery and reintegration into their communities,” James said in an emailed statement. 

The statement cited a North Carolina study of opioid overdose death rates between 2000 and 2015, which concluded that people released from prison are highly vulnerable to opioids and need urgent prevention measures. 

“When treatment begins pre-release and is maintained throughout reentry, we will see meaningful improvement in health outcomes,” James said.

Moses said in a statement that the bill will help give incarcerated individuals a positive start in a transitional phase in their lives, and would also reduce costs for local governments. 

The criminal justice reform advocacy groups EX-Incarcarated People Organizing (EXPO) and WISDOM expressed support for the legislation in statements to the Examiner. 

“For too long, people leaving incarceration have faced dangerous gaps in healthcare coverage — especially those living with substance use disorders,” EXPO stated. 

The legislation “recognizes what we see every day in our work,” according to the organization, “that people returning home are far more likely to succeed when their health and basic needs are supported from the start.”

In an email to the Examiner, Mark Rice of WISDOM said that many formerly and currently incarcerated people are struggling with poverty, mental illness and addiction. He said that “far too many people” detained in prisons and jails are needlessly dying and suffering due to health issues that could be fixed through increased access to care during and after incarceration.

“The system must be fundamentally transformed so that health is prioritized over punishment,” Rice said. 

Under the bill, the Department of Health Services would submit the request for a waiver by Jan. 1, 2027.