Case Study: California’s Human-Centered Transformation of Medi-Cal’s Justice-Involved Pre-Release Services

From Vision to Reality

When California launched the Justice-Involved (JI) Reentry Initiative under CalAIM, the mission was ambitious yet clear: bridge the healthcare gap for individuals transitioning from correctional settings to community life. California’s correctional network is vast spanning more than 300 local and state facilities and serving an incarcerated population that remains at higher risk for poor health outcomes, injury, and death than the general public. They also face disproportionate risks of trauma, violence, overdose, and suicide. The California Department of Health Care Services (DHCS) sought to extend Medi-Cal coverage up to 90 days before release, ensuring that justice-involved individuals could access the care, services, and support essential to a successful return to their communities. This groundbreaking effort marked the first time state positioned correctional facilities served as Medi-Cal providers—empowering them to deliver and bill for a targeted set of pre-release services, including enhanced reentry care management.

DHCS has partnered with IBM for many years to manage the California Medi-Cal Management Information System (CAMMIS). CA-MMIS is a suite of over 90 sub-systems designed to manage critical Medi-Cal processes in support of delivering no-cost and low-cost healthcare services to more than one-third of the state’s population. As the JI initiative introduced new needs for technology solutions, the partners collaborated to design and implement JI program capabilities within CA-MMIS. The resulting Justice-Involved Provider Portal serves as the primary interface for correctional facilities and community-based partners to manage JI eligibility and enrollment for incarcerated Medi-Cal members.

Turning Insight into Innovation

The first cohort of county correctional facilities went live on October 1, 2024. DHCS began a series of workgroups to support these early adopters and encourage shared learning with other counties as they prepared to implement the JI program. Through these conversations, a new reality emerged. “We were tracking hundreds of clients in Excel...” said one Yuba eligibility technician. “Now, that time goes back to working with people instead of spreadsheets.”
These JI Provider Portal users were not like traditional healthcare providers. Their environments, staffing models, processes, and technology systems were fundamentally different. What worked well for traditional clinical providers did not always translate seamlessly inside correctional settings. Through Human Centered Design research, it became clear that not all counties are alike. There would need to be solutions for archetypes like Los Angeles County that have high volumes and high complexity. The JI Provider Portal succeeded in extending Medi-Cal’s reach, but the users’ unique operational context called for further evolution. DHCS and IBM recognized this moment not as a setback, but as an opportunity to listen more deeply, learn from experience, and design with renewed focus on the people delivering and receiving care.


Together, DHCS and IBM launched a new wave of Human-Centered Design (HCD) research to understand how to better serve the justice-involved community. The research included field interviews, job shadowing, and onsite observations across multiple facilities to see firsthand how staff interacted with the technology. This deep engagement and data-centric analysis revealed opportunities to simplify high-volume tasks, improve transparency, and streamline communication between correctional facilities and Medi-Cal systems.

The design team applied these insights directly into system architecture and interfaces—reducing the number of clicks and screens required for high-volume processing and building upload templates that mirror the spreadsheets counties were already using. By designing around the JI clients and program staff’s end-to-end journey, not against it, the portal became an integrated part of the workflow rather than another layer on top of it.

Evolving Capabilities with Purpose

The result was a select set of enhancements focused on the highest-impact needs identified by and observed with users themselves. Through collaboration and empathy, DHCS and IBM identified where simple enhancements could make the biggest difference.

• Introduced in September 2025, the Multiple Member Screening capability allows correctional facilities to inquire, activate, or terminate up to 200 members at a time using a standardized upload file. Each record now returns a clear status—Accepted, Pending, or Error— along with a downloadable response file that supports quick correction and resubmission. This change eliminated hours of repetitive data entry and significantly increased processing efficiency. The feature was designed to match real-world workflows, allowing users to focus on supporting patients rather than managing transactions.
• In October 2025, DHCS released the Download Screening History feature, expanding transparency and operational control for correctional facilities. Through this function, users can export screening histories for single or multiple members, apply filters for status, user, or coverage period, and track time-sensitive data such as Days Remaining before release. This enhancement provided critical visibility into caseloads, enabling proactive coordination and better alignment with reentry timelines.
• DHCS and IBM are now developing a secure Application Programming Interface (API) solution that allows county and facility systems to communicate directly with CAMMIS. This integration layer will automate data exchange for eligibility, screening, and claims information—reducing human intervention in repetitive processes. With hundreds of daily intakes across multiple health and custody systems, LA’s pilot API will automate eligibility validation and support real-time status updates across correctional health, DPSS, and Medi-Cal systems.

These updates resolved nearly all of the 78 user-logged pain points, including the most common issues—manual data entry, tracking outside of the system, and copying data into multiple systems—reducing redundant entry by up to 80 percent in high-volume counties. Today, the California Department of Corrections and Rehabilitation and 10 California counties are delivering JI Pre-Release Services, and benefits have been activated for over 42,000 individuals.

Learning Forward: Building Systems That Evolve

Through each stage of transformation, the Justice-Involved Initiative has remained true to its purpose: connecting people to care through systems designed with empathy and purpose. The evolution from initial deployment to ongoing innovation demonstrates California’s leadership in building technology that adapts to its users and grows with their needs, investing where design can make the most difference for those who serve and those who are served.

Through continuous readiness assessments, DHCS ensures that every county can sustain operational and clinical coordination. Governance structures now include quarterly readiness reviews, oversight dashboards, and technical assistance pathways that make improvement systemic, not episodic.

The Justice-Involved Initiative is more than a technology success story—it is proof that when government and industry collaborate around human experience, innovation becomes continuous. California’s journey stands as a model for other states seeking to blend data, empathy, and design into public service systems that truly work for everyone.