Page 3

TEAMKY Demonstration

Approval Period: January 1, 2025 through December 31, 2029

Page 2 of 155 criteria as described in Section VII of the STCs. This expenditure authority is contingent upon compliance with Section VII of the STCs, as well as all other applicable STCs.

5. HRSN Services Infrastructure. Expenditures for allowable HRSN administrative and infrastructure costs not otherwise covered under section 1903 of the Act, as described in section VII of the STCs.

6. Pre-Release Services. Expenditures for pre-release services, as described in section VIII of the STCs, furnished to individuals who meet qualifying criteria in STC 42 for up to 60 days immediately prior to the expected date of release from a correctional facility that is participating in the reentry demonstration initiative under this demonstration.

7. Pre-Release Administrative Costs. Expenditures for allowable administrative costs, supports, transitional non-service expenditures, infrastructure and interventions, as described in STC 51. These expenditures may not be recognized as medical assistance under section 1905(a) and may not otherwise qualify for federal matching funds under section 1903, to the extent such activities are authorized as part of the Reentry Demonstration Initiative.

Title XIX Requirements Not Applicable to the Medicaid Expenditure Authority for Pre- Release Services:

Amount, Duration, and Scope of Services and Comparability Section 1902(a)(10)(B)

To enable the state to provide only a limited set of pre-release services, as specified in these STCs, to qualifying individuals that is different than the services available to all other individuals outside of correctional facility settings in the same eligibility groups authorized under the state plan or demonstration authority.

Freedom of Choice

Section 1902(a)(23)(A)

To enable the state to require qualifying individuals to receive pre-release services, as authorized under this demonstration, through only certain providers.

Comparability; Amount, Duration and Scope; Section 1902(a)(10)(b) Provision of Medical Assistance and Section 1902(a)(17) To the extent necessary to allow the state to offer HRSN services and to vary the amount, duration, and scope of HRSN services covered for a subset of beneficiaries, depending on beneficiary needs as determined by the application of qualifying criteria, as specified in Section VII of the STCs.

Title XXI Expenditure Authority: