The Maine Department of Health and Human Services (DHHS) mission is to promote health, safety, resilience, and opportunity for Maine people.
The Office of MaineCare Services (OMS) is working to improve access to health care for people who are incarcerated and strengthen their connections to community-based care when they return to the community. People leaving jail or prison may experience barriers to accessing primary care, behavioral health care, medications, and substance use disorder treatment. Connecting people with health care before release can support continuity of care during this critical transition.
MaineCare's Justice Initiatives include several related efforts to improve health care access and transitions from incarceration to the community.
1115 Reentry Initiative
- About
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The Centers for Medicare & Medicaid Services (CMS) has approved Maine's Section 1115 Reentry initiative as part of Maine's Whole Person Care Section 1115 Demonstration. This authority allows MaineCare to cover a targeted set of health care services for eligible individuals before they are released from jail or prison. The 1115 Reentry Initiative includes requirements for juveniles as defined in the Consolidated Appropriations Act (CAA) – Juvenile Justice.
The initiative is designed to connect individuals with needed health care before release and strengthen connections with community-based providers. The goals of the 1115 Reentry Initiative are to:
Improve
- Continuity of care
- Health outcomes
Reduce
- Mortality
- Reincarceration
- Unnecessary emergency department visits
- Avoidable hospitalizations
OMS is working closely with the Maine Department of Corrections (MDOC), the Maine Sheriffs Association, county jails, and other partners to prepare for implementation. Services are expected to begin in July 2028 and will be implemented statewide through a phased approach.
The Reentry initiative is one component of Maine's broader Whole Person Care Section 1115 Demonstration. The demonstration also includes efforts to strengthen the behavioral health continuum of care, improve transitions from institutions to the community, expand access to traditional healing practices, and address Health-Related Social Needs (HRSN).
Learn more about Maine's Whole Person Care Waiver application.
- County Informed Approach
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Maine is developing a county-informed approach for correctional facilities to participate in this demonstration. Because each county has unique characteristics and resources, Maine will work with each county and regional jail and prison to develop a plan for services provided by a carceral healthcare provider, an in-reach provider, or a combination of both.
Facility Highlights
- Individual county's unique historic overview and population demographics, including attractions, economy, healthcare, and manufacturing industries.
- Community services as impactful partners that serve an important role in supporting new clients access to care.
- Services available – medical, mental health crisis, and substance use support.
- Types of pharmacies and prescription services available to individuals.
- Peer recovery centers or recovery coaches available in the county.
- Community resources available, including housing, food, public transportation and other basic needs.
- Crisis and after-hours support systems existing in the county.
- Faith-based and culturally specific, or community-led organizations in the community.
Maine County Profile Data Sheets
In support of the county-informed approach, we developed profiles to provide a high-level overview of available resources and serve as a system platform of care for collecting shared data profiles for each carceral facility within the MDOC and county jail facilities.
County Community & Facility Profiles MDOC Profiles Androscoggin Aroostook Cumberland Franklin Hancock Kennebec Knox Lincoln Oxford Penobscot Mountain View Correctional Facility Piscataquis Sagadahoc Somerset Waldo Maine Coastal Region Reentry Center Washington Downeast Correctional Facility York
Other MaineCare Justice Initiatives
- Consolidated Appropriations Act (CAA) – Juvenile Justice
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The Consolidated Appropriations Act of 2023 established federal Medicaid and CHIP requirements for eligible youth who are incarcerated. These requirements are separate from Maine's Section 1115 Reentry authority and are being piloted at Long Creek Youth Development Center. The CAA requirements will be subsumed by the Section 1115 reentry waiver implementation.
The requirements are intended to improve access to health care, strengthen pre-release planning and care coordination, and support connections to community-based services following release.
Learn more about federal Medicaid and CHIP requirements for incarcerated youth.
- Post-Incarceration Incentive Payment Pilot
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MaineCare piloted the Post-Incarceration Incentive Payment to encourage timely follow-up after release from jail or prison. The pilot focused on the critical two days after release, when individuals may face heightened health risks.
The pilot aimed to improve care transitions by supporting timely connections between MaineCare members and community-based providers that can help sustain continuity of care. The pilot was successful and was then included in the 1115 Whole Person Waiver request.
Learn more about the Post-Incarceration Incentive Payment Pilot.
Justice Initiatives History
Since 2023, MaineCare has advanced several related Justice Initiatives for the purposes of improving incarcerated people’s access to health care and strengthening their transitions to community-based care. These efforts include the Post-Incarceration Incentive Payment Pilot of 2023, implementation of federal juvenile justice requirements under the Consolidated Appropriations Act of 2023, and Maine's Section 1115 Reentry initiative of 2023 included in the Whole Person Care Waiver application of 2025.
- Post Incarceration Incentive Payment Pilot
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In December of 2023, OMS announced the Post Incarceration Incentive Payment Pilot, which utilized funding received from the American Rescue Plan Act of 2021, under Section 9817. In August of 2024, over 46 organizations had qualified for the pilot. The pilot successfully ran from December 2023 until March 2026.
- Consolidated Appropriations Act (CAA) – Juvenile Justice
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Congress passed the CAA in 2023, which expanded access to Medicaid for incarcerated juveniles. The CAA aimed to improve pre-release planning with a specific focus on improving care coordination for the critical re-entry period.
- Section 5112 Requirement under CAA, 2023 - CMS' State Health Official letter (SHO #23-004) providing states with guidance on implementing continuous eligibility for juveniles in Medicaid and CHIP.
- 1115 Re-Entry Waiver
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In 2023, the Maine State Legislature passed H.P. 764 – L.D. 1204 requiring MaineCare to apply for the 1115 Re-entry Waiver by April 2025. See the list below for more information.
- Section 1115 of the Social Security Act (42 U.S.C § 1315) | April 17, 2023 - CMS’ State Medicaid Director Letter (SMD #23-003) issuing guidance for designing section 1115 demonstration projects.
- Maine Bill No.1204 H.P 764 – LD 1204 | March 21, 2023 - An act to improve the health of Maine residents by closing coverage gaps in the MaineCare Program for incarcerated persons.
- MaineCare's Notice of Agency 1115 Waiver Renewal Application | March 21, 2025 - OMS’ 1115 waiver renewal application and public comment materials.
- The Department of Health and Human Services Introduces Maine's Whole Person Care Waiver | March 28, 2025 - Maine’s DHHS blog post about the basics of the 1115 waiver application and why DHHS applied for it.
- Section 1115 Demonstrations - Information about section 1115 demonstrations on CMS’ Medicaid page.
- Whole Person Care Waiver
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In June of 2025, OMS applied to CMS for Maine’s Whole Person Care Waiver. All three of the 2023 Justice Initiatives were rolled into this application. The waiver proposed to broaden the focus of Maine’s existing 1115 waiver, the Maine Substance Use Disorder (SUD)Care Initiative by strengthening the behavioral health continuum of care, improving transitions from institutions to the community, expand access to traditional healing practices, and improving health outcomes through addressing Health-Related Social Needs (HRSN).
In October of 2026, DHHS announced CMS’ approval of the Whole Person Care Waiver application.
