When someone leaves jail in King County and across the country, they typically have no supplies of their medications or any connection to a medical provider. But that’s starting to change. New efforts at the federal, state, and local level aim to provide a lifeline from inside the jail to next steps outside.

CaSandra Adams spent a decade cycling in and out of local jails for crimes related to her opioid addiction. Adams said 90% of the time, she left jail with no means and nowhere to go.

“Just completely to the streets, in a town I didn’t know,” she said, with “clothes inappropriate to the weather, no ride, no money, no phone, no ID, no nothing. Just having to survive, figure it out.”

Adams said while in jail she’d sometimes have a moment of clarity where she really wanted to seek treatment and make a change. But at release there was no one to help her, except other people walking out the doors at the same time.

“We’d get into their boyfriend’s car and I’d be passed something,” she said. “And there I am, back in the same hamster wheel” of addiction.

Adams is now a peer advisor for King County’s jail reentry initiative, drawing on her experiences to design better options for people exiting jail. Most people in jail are low-income and qualify for Medicaid health coverage, but historically the program has excluded health care provided within jails and prisons. But now 22 states including Washington have qualified for a waiver; it allows Medicaid reimbursement for certain transition-related expenses in the 90 days before someone is released.

Megan Murphy, who manages this new initiative, said the waiver allows Jail Health staff to help people plan their transition back to life outside, rather than starting from zero the moment they’re released.

“We can leverage non-local dollars to pay for services in the jail,” she said. “This comes with a requirement for release planning for all eligible people in addition to that warm handoff to an appropriate service provider to continue those services.”

The new reimbursements cover things like case management, scheduling treatment for substance use disorder, and a 30-day supply of prescription medication and medical supplies as someone exits the jail.