Evaluating Medicaid Access for Halfway House Residents: A Research Partnership with the Connecticut Department of Correction, 2013-2017 (ICPSR 37580)

Version Date: Mar 16, 2023

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Principal Investigator(s):
Emily Tiry, Urban Institute; Akiva Liberman, Urban Institute

https://doi.org/10.3886/ICPSR37580.v1

Version V1

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Summary

The goals of this study were to examine how providing Medicaid coverage for halfway house residents may affect care seeking, improve health care usage, and decrease criminal recidivism relative to providing health care through prison or jail medical facilities. To achieve these goals, we developed a researcher-practitioner partnership with the Connecticut Department of Correction (DOC) to implement a mixed-methods research design.

Qualitative data collection included focus groups with halfway house residents; interviews with halfway house staff, correctional health providers, correctional officers, and state-level DOC officials; and site observations of DOC medical facilities. Quantitative data collection included collection of administrative and recidivism data from DOC, coding of study participants' DOC medical charts to measure their baseline health status and health care usage in prison or jail, and collection of Medicaid enrollment and claims data from Connecticut's Department of Social Services (DSS) to measure Medicaid enrollment and health care usage in the community.

Citation

Tiry, Emily, and Liberman, Akiva. Evaluating Medicaid Access for Halfway House Residents: A Research Partnership with the Connecticut Department of Correction, 2013-2017. Inter-university Consortium for Political and Social Research [distributor], 2023-03-16. https://doi.org/10.3886/ICPSR37580.v1

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Funding

United States Department of Justice. Office of Justice Programs. National Institute of Justice (2014-IJ-CX-0015)

Subject Terms

Geographic Coverage

Smallest Geographic Unit

None

Restrictions

Access to these data is restricted. Users interested in obtaining these data must complete a Restricted Data Use Agreement, specify the reasons for the request, and obtain IRB approval or notice of exemption for their research.

Distributor(s)

Inter-university Consortium for Political and Social Research
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Time Period(s)

2013 -- 2015 (Study 1 and Study 2 (Quantitative Data)), 2016 -- 2017 (Qualitative Data)

Date of Collection

2014-04 -- 2014-05 (Study 1), 2015-04 -- 2015-05 (Study 2), 2016-10 (Focus Groups (Qualitative Data)), 2017-03 -- 2017-05 (Staff Interviews (Qualitative Data))

Data Collection Notes

  1. The qualitative data is not included in this release.

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Study Purpose

The goals of this study were to examine how providing Medicaid coverage for halfway house residents may affect care seeking, improve health care usage, and decrease criminal recidivism relative to providing health care through prison or jail medical facilities.

Study Design

The study design compared outcomes based on two separate comparisons. The first comparison was halfway house residents who were eligible to be enrolled in Medicaid under a pilot program implemented in April-May 2014 (n=147) compared to similarly situated halfway house residents one year prior to or one year after the pilot (n=233). The second comparison was halfway house residents in April-May 2015 who were eligible for Medicaid enrollment due to their legal custody status (n=287) compared to a contemporaneous group of halfway house residents who were not eligible for Medicaid because they had a different legal custody status (n=892).

Sample

The quantitative study was divided into two sub-studies with a combined study population of 1,436 halfway house residents.

Study 1 (n=380) was structured as an impact evaluation. The treatment group (n=147) consists of halfway house residents who were eligible to be enrolled in Medicaid under the 2014 pilot program. This pilot was conducted in two of Connecticut's five parole districts--one rural and one urban--during several weeks in April and May 2014. Residents enrolled through the pilot program were granted Medicaid coverage for a 12-month period, after which they would have to recertify their eligibility, just like any other Medicaid beneficiary. Consistent with an intent-to-treat design, treatment group status was assigned based on the opportunity for enrollment in Medicaid rather than actual enrollment. The comparison group (n=233) consisted of similarly situated community release halfway house residents who were living in halfway houses in the pilot parole districts during the same time of year one year prior to or one year after the pilot (i.e., 2013 and 2015).

Study 2 (n=1,179) was structured as an observational study. In this study, the treatment group (n=287) consists of halfway house residents throughout the state in April-May 2015 who were released under a status other than community release (e.g., parole). These residents were automatically eligible for Medicaid upon release due to their status and are typically enrolled in Medicaid as part of the discharge planning process. The comparison group (n=892) consists of a contemporaneous group of halfway house residents released under a community release status and therefore not eligible for Medicaid. Individuals eligible for community release typically have a sentence of less than two years and are within 18 months of their release date, whereas those eligible for parole typically have at least a two-year sentence.

Time Method

Longitudinal: Trend / Repeated Cross-section

Universe

Connecticut halfway house residents in April-May 2013, April-May 2014, and April-May 2015.

Unit(s) of Observation

Individual

Data Type(s)

Mode of Data Collection

Description of Variables

The data file is organized at the person level, with each observation representing one of 1,436 halfway house residents residing in Connecticut between 2013 and 2015 and the data have 207 variables. The data has a variable "study_id", which contains a unique, anonymized identifier for each participant. Halfway House Medicaid Data also contains additional demographic variables such as age, gender, and race of several Halfway House Residents in Connecticut. The data also included several date variables. Medical history, criminal history, and recidivism information is available for all participants.

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Original Release Date

2023-03-16

Version History

2023-03-16 ICPSR data undergo a confidentiality review and are altered when necessary to limit the risk of disclosure. ICPSR also routinely creates ready-to-go data files along with setups in the major statistical software formats as well as standard codebooks to accompany the data. In addition to these procedures, ICPSR performed the following processing steps for this data collection:

  • Checked for undocumented or out-of-range codes.

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Notes

  • The public-use data files in this collection are available for access by the general public. Access does not require affiliation with an ICPSR member institution.

  • One or more files in this data collection have special restrictions. Restricted data files are not available for direct download from the website; click on the Restricted Data button to learn more.