Date of Conferral

7-19-2024

Date of Award

7-19-2024

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Rabeh Hijazi

Abstract

Incarcerated individuals in the United States have a high disease burden. Moreover, most of them are released from incarceration without health coverage. The problem is that most incarcerated people in Maryland return to the community from incarceration without health coverage and cannot access health care. The purpose of this qualitative study was to understand how Medicaid enrollment staff and managers of the Medicaid program perceive the experiences and challenges of justice-involved individuals in navigating the Medicaid system in Maryland. The study was grounded in the behavioral model for vulnerable populations. The main research question aimed at understanding how the enrollment staff and managers of the Medicaid program perceive the experiences and challenges of justice-involved individuals in navigating the Medicaid system in Maryland. This study used semi structured interviews to collect data from 11 enrollment staff and managers. Data were coded and analyzed following a 4-step thematic analysis process. Findings in the study included having Medicaid enrollment as a component of discharge planning and the need to streamline Medicaid eligibility and expand coverage. A major limitation in the study was the small sample size that limited generalizability. Justice-involved individuals should be educated about Medicaid during Intake orientation to facilitate enrollment. The study results point to the importance of Medicaid as a source of access to health services when justice-involved-individuals leave incarceration. Providing health care access to returning justice-involved individuals can produce positive social change through structural change that reduces health inequities in the U.S.

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