Medication Grant Program

Chapter 15 of Kendra's Law provides grants for the cost of medications and other services. Many individuals who leave jails, prisons and hospitals receive only limited supplies of medication until they qualify for Medicaid. The Medication Grant program provides funding to counties to pay for the individual's mental health medications and services related to providing medication pending their Medicaid determination.

Frequently Asked Questions

Who is eligible for this program?

Individuals who qualify for this program are those released from jails/prisons and discharged from hospitals who require medications to treat mental illness. Each county determines who qualifies for the program. To be eligible for the program, individuals must file a Medicaid application prior to or within seven days of discharge or release.

How will the enrollment process work for an individual leaving jail?

For an individual leaving jail, they will likely have a transition manager (or another designated jail employee) to help complete a Medicaid application within seven days of release. The individual can then go to their local Department of Mental Hygiene to receive a Medication Grant Card. A Medication Grant enrollment form and a form indicating that the person qualifies for the Medication Grant Program must also be provided to the county.

In larger metropolitan jails, an individual working with a transition manager (or designated jail employee) can send their Medication Grant enrollment form to the local Department of Mental Hygiene before release. Once an individual receives a Medication Grant card, they can present that card at any one of over 3800 pharmacies across New York State.

How will the enrollment process work for an individual leaving the hospital?

The individual would work with the hospital discharge planner (or designated hospital employee) to complete a Medicaid application and Medication Grant enrollment form. Upon release from the hospital, the individual can present this form to the Local Department of Mental Hygiene to receive their Medication Grant card.

How does the enrollment process work for an individual leaving state prison?

Prison pre-release coordinators will send the Medicaid application to the county Department of Mental Hygiene where the individual will be residing. The prerelease coordinators will enroll the individual in the Medication Grant Program and issue their card on release.

What happens after the decision is made about Medicaid eligibility?

Once Medicaid eligibility is determined, the individual will be disenrolled from the Medication Grant program. For those people who are denied Medicaid coverage, counties are encouraged to aid in assuring a smooth transition to other funding streams to support the medication needs of these individuals.

What is the role of the County Department of Mental Hygiene?

The role of the County Department of Mental Hygiene is to administer the Medication Grant program. This includes:

• publicizing the program with the institutions and providers in the community
• working with local social service departments to ease the transition of these individuals into the community
• encouraging community support for targeted individuals to meet their medications needs

To help reduce the administrative burden to the county, the state OMH has contracted with a Pharmacy Benefits Manager (PBM).

How will these locally operated programs work?

Each participating county Department of Mental Hygiene will receive Medicaid applications and enrollment forms from qualified individuals leaving jail, prison and hospital settings. The counties send the enrollment form to the Pharmacy Benefit Manager (PBM). The PBM sends notification to the county. The county provides the individual with a medication grant card. The local Department of Mental Hygiene would then forward the Medicaid/Cash Assistance/Food Stamp Application to the local Department of Social Services.

After receiving the medication grant card, how will the individual know which pharmacies will participate in the program?

Upon receiving the medication grant card from the local Department of Mental Hygiene, an individual will receive a list of participating pharmacies in their area.

What is the cost of the program?

Once an individual has their medication grant card, there is no cost for medications related directly to their mental illness. There are also no co-payments for the medications.

Where can I get more information?

Additional information is available through your local department of mental hygiene