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2. Curriculum and Community Partnerships State policy innovators should develop neces sary curriculum and community partnerships (such as in-reach engagements by PRSS pro fessionals) for 6 to 12 months of prerelease programming. RSAT’s curriculum can serve as a template and policy leaders in other states can adapt that template to the local culture and processes. 3. Immediate Connection to Health Care System Administrators of RSAT-like programs should ensure an immediate connection to the healthcare system, coupled with PRSS services, at the time of inmate’s release. 4. Broadly Offer Medications for Opioid Use Disorder Services Behind the Walls Given the high prevalence of opioid use disorder (OUD) among inmates, it is important to offer medications for OUD to all inmates in need, rec ognizing its effectiveness in supporting recovery from OUD. 5. 1115 Waivers Per the Figure, the RSAT program saved Arizona $6,667 per RSAT graduate per year. With the average Medicaid spending in Arizona per adult per year at $3,831 and with the federal Medicaid cost for all states), the ROI on state taxpayer dollars is profound if an RSAT-like program is paid for by Medicaid dollars.7 Re entry 1115 waivers that are based on the RSAT model could be a boon for vulnerable Medicaid beneficiaries and a huge saver of state and fed eral taxpayer dollars. Conclusions Arizona’s RSAT Program stands as a testament to the transformative power of a holistic and community driven reentry approach. By learning from its success, sharing best practices, and advocating for policy changes, we can pave the way for a more effective and compassionate reentry system nationwide. At a macro level, providing expanded coverage and addressing the complex needs of this unique population will yield government paying over 64% of that (the federal government pays at least 50% of

better health outcomes, reduced recidivism and drive down health care costs over the long-term. Managed care organizations play a crucial role in this process, as they are at the forefront of managing health care ser vices to individuals transitioning from incarceration to the community. With the robust ROI data, investing in programs like RSAT not only benefits criminal justice– involved individuals, but also society at large. CT REFERENCES Kinner SA, Wang EA. The case for improving the health of ex-prisoners. Am J Public Health . 2014;104(8):1352-1355. doi:10.2105/ AJPH.2014.301883 Howard J, Solan M, Neptune J, Mellgren L, Dubenitz J, Avery K. The importance of Medicaid coverage for criminal justice involved individuals reentering their communities. Office of the Assistant Secretary for Planning and Evaluation. April 2016. Accessed February 20, 2024. https://aspe.hhs.gov/sites/default/files/migrated_legacy_files/146076/ MedicaidJustice.pdf State waivers list. Medicaid.gov. Accessed February 20, 2024. https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and waiver-list/index.html Recidivism rate by state. Wisevoter. Accessed February 12, 2024. https://wisevoter.com/state-rankings/recidivism-rates-by-state/#arizona FY 2020 operating per capita cost report. Arizona Department of Corrections, Rehabilitation, and Reentry. June 28, 2021. Accessed February 5, 2024. https://corrections.az.gov/sites/default/files/documents/reports/ adcrr-percapcostreport_fy2020-final.pdf HEDIS measures: initiation and engagement of substance use disorder treatment (IET). National Committee for Quality Assurance. Accessed February 5, 2024. https://www.ncqa.org/hedis/measures/initiation-and engagement-of-alcohol-and-other-drug-abuse-or-dependence-treatment/ Federal medical assistance percentage (FMAP) for Medicaid and Multiplier. KFF. Accessed March 14, 2024. https://www.kff.org/medicaid/ state-indicator/federal-matching-rate-and-multiplier

Sara Ratner, JD is President of Government Programs at Nomi Health.

Zach Zobel is the Director of Healthcare SaaS Strategy for Nomi Health Analytics.

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