I have served as an Integration Consultant for NC InCK, based out of the NC Division of Juvenile Justice and Delinquency Prevention (DJJDP), since November 1, 2021. As I prepare to move on from this work, I have been reflecting on the impact NC InCK has made on juvenile justice-involved youth, families, and communities.
One goal of all InCK programs is to holistically assess and address ways to prevent out-of-home placements of youth. This certainly applies to youth involved with the Juvenile Justice system and why it is a focus for NC InCK.
Through policy studies, workgroup efforts, and intern research, our NC InCK team has found multiple areas of potential influence for these vulnerable youth.
1. Medicaid Suspension and Reinstatement
When a youth is committed to a Youth Development Center (YDC), their Medicaid is suspended until no more than 24 hours pre-release. However, the current process for reinstatement after release is completely manual which often leads to a gap in Medicaid coverage. In collaboration with our NC Medicaid team, we concluded an automatic reinstatement process would help solve this problem. Through further research, we learned of the opportunity to change the pre-release timeframe for reinstatement of coverage. Our workgroup developed talking points, shared resources, and educated DJJDP and Medicaid staff on how the current policy has had a negative impact on youth in need of pre-release services, specifically for mental and/or behavioral health.
2. Resources for Adolescents and Young Adults, Focusing on Juvenile Justice Involvement
Not all care managers are trained to work with adolescents and young adults or aware of the complex needs of this population. To support care managers, we created an extensive, though not exhaustive, guide of resources and supports for adolescents and young adults involved with the Juvenile Justice system and the NC InCK care model. This guide includes information about physical, behavioral, mental, and sexual health as well as education, employment, finances, housing, nutrition, and support. It also shares ideas and tips for care managers to discuss goals and the transition from adolescence to adulthood with the youth and/or family.
3. Juvenile Court Counselor (JCC) Community Referrals
When Medicaid launched Tailored Care Management (TCM) in December 2022, the landscape of Juvenile Justice and Medicaid changed significantly. Most juvenile justice involved youth transitioned to TCM, making them ineligible for NC InCK care management. However, NC InCK saw an opportunity to engage more youth in the model earlier and began training Juvenile Court Counselors (JCCs) on how to make direct referrals for NC InCK care management. These training sessions began in May 2023 and have resulted in nearly 40 referrals so far. Though some of those referred were TCM-eligible, several decided to receive support from NC InCK Family Navigators. Juvenile Court Counselors have expressed their support and positive experience with the direct referral process.
4. Connecting with Juvenile Justice Behavioral Health (JJBH) Partnerships
Each NC InCK county has an established Juvenile Justice Behavioral Health (JJBH) partnership intended to address mental health and substance use needs of youth and families involved with DJJDP. We connected with the Alliance JJBH team on July 17, 2023, and continue to participate in meetings regularly. Through this, we created a process for JJBH partners to refer youth to NC InCK care management leveraging the existing referral path for JCCs. We hope to continue to expand these efforts through additional partnerships in the coming months.
Moving Forward: Hope for Improved Medicaid Coverage and Services
I am confident that NC InCK and DJJDP will continue to build on these achievements, furthering their commitment to provide appropriate services for supporting Juvenile Justice-involved youth. It is my hope that Medicaid will make federal policy changes to allow all vulnerable youth uninterrupted access to Medicaid services while in YDC commitment. It is my dream that, by providing holistic, equal, comprehensive Medicaid services to youth, North Carolina will see a reduction in juvenile crime and delinquency, youth with intellectual or developmental disabilities (I/DD) and behavioral health needs will not be subjected to the juvenile justice system, and families will prosper as they receive the care and services they need to thrive.
I am deeply grateful for the opportunity to work with NC InCK and DJJDP and will carry my experience in my heart always. May we all keep up the InCKredible work!
Author:
Judy Lawrence: has been innovative and inspiring in her role with DJJDP and NC InCK since November 2021. Her work with Chief Court Counselors and staff has ensured that the needs of youth are addressed by collaborative communications across child and family-serving agencies. Ms. Lawrence’s leadership within the NC InCK structure, and her leadership to connect and strengthen a collaboration between DJJDP and NC Division of Health Benefits to respond to the CMS Section 1115 Waiver which, among other benefits, will enable Medicaid funds to be utilized by youth during the end of their stay in YDCs.
Ms. Lawrence has worked with the State of North Carolina since February 2007, holding leadership roles with NC DHHS, the Administrative Office of the Courts, and DJJDP. She has led several projects for TANF and SNAP programs, administered a District Guardian ad Litem program, and managed the national Work Support Strategies and SNAP Collaborative initiatives. She has most recently transitioned to the position of Medicaid Senior Program Manager for NC Advanced Medical Home. Prior to her work with North Carolina government systems, Ms. Lawrence was a Social Work Supervisor with the Alamance County Department of Social Services in North Carolina, and worked with social services agencies in West Virginia, Florida, and Ohio.
Ms. Lawrence earned her Bachelor of Science degree in Family Studies and Human Services from Ohio University in 1998 and achieved her Lean Process Improvement certification from NC State University in 2017. In her non-work life, she enjoys reading, swimming, baking, and spending time with her handsome hubby and kittos.