Advocate
We play an active role in advocating for public safety and public health reforms. Our expertise informs how we organize partners to influence budgetary and policy decisions, leading the conversation on reform at the city and state levels.
The little-known Medicaid Inmate Exclusion Policy (MIEP) prevents states from providing essential healthcare services to incarcerated individuals and creates significant risks of hospitalization and even death when individuals transition from jails or prisons back into the community. The Center for Medicaid and Medicare Services (CMS) released guidance in early 2023, inviting states to submit waiver applications that would allow them to utilize Medicaid resources to provide key services designed to address the ongoing opioids overdose epidemic and improve care for clients with severe mental illness.
P2PH and Legal Action Center have led efforts to improve and accelerate New York’s Medicaid Waiver application process, including organizing stakeholders to submit letters and provide testimony during the state and federal public comment periods in 2022. New York is currently working with local partners to develop a new Medicaid Reentry Waiver application that will align with CMS’ latest guidance and funding structures. P2PH and LAC continue to facilitate meetings with NYC partners and NY State to navigate the remaining hurdles to implementation and further accelerate the new application timelines.
CMS Guidance on Improving Care Transitions for Incarcerated Populations >
Manatt Health Issue Brief on CMS Guidance >
P2PH and LAC Comments to New York’s latest Medicaid Waiver application >
Daniel's Law Task Force
The Daniel's Law Task Force in New York City was established to address the response to mental health and substance use crises, aiming to shift the responsibility from police to trained mental health professionals and emergency medical workers. This initiative emerged in response to the tragic death of Daniel Prude, who died in 2020 during a mental health crisis when police intervened with fatal consequences.
Daniel's Law aims to establish a statewide crisis response system that deploys mental health professionals, peers with lived experience, and EMTs as the primary responders to mental health emergencies. The objective is to provide compassionate care rather than criminalize individuals in crisis, ensuring safer and more appropriate interventions.
The task force works with various stakeholders, including the NYC Department of Health and Mental Hygiene and the NYC Fire Department, to develop and improve these crisis response strategies. They also involve the public through regular virtual meetings and opportunities for public comment
Access to drug treatment services has long been tied to the criminal justice system, with many advocates decrying that “the front door to treatment is too often a jail cell.” With the advent of the Affordable Care Act (commonly referred to as “ObamaCare”), drug treatment services are now covered under Medicaid at the same level as physical health services, leading to wider access to care. Unfortunately, the scale and destruction of the still growing opioids epidemic have continued to outpace these recent policy and service enhancements, as reflected in the table below:
P2PH works with partners around New York City and State to address the overdose crisis by expanding Harm Reduction approaches throughout public health and public safety systems. Recent innovations include:
- OASAS funding for mobile syringe exchange and peer education programs
- Medicaid billings for Certified Recovery Peer Advocates (CRPAs),
- Medication for Opioid Use Disorder (MOUD) requirements in all NY jails and prisons
- Supporting long-standing harm reduction providers and their integration into Medicaid managed care
- Publishing an issue brief calling for the introduction of Safe Use Facilities to reduce opioids-related injuries and fatalities
- Participating in NYC Department of Homeless Services’ Harm Reduction Advisory Council
P2PH out the financial and operational argument to hire, train and retain peer navigators in clinical healthcare settings, criminal justice deflection programs and community violence reduction work. This effort was done in partnership with John Jay’s Navigator Certificate in Human Services and Community Justice, EAC CLEAR and the NYC Justice Peer Initiative.