Research Report

Collaboration Reentry July 17, 2026

Medications-in-Hand: Early Learnings from Medicaid Reentry Waiver Implementation in California

Providing 30 days of medications at release is a core requirement of California’s CalAIM Justice-Involved Initiative—and one of its most operationally challenging components. While the policy goal is straightforward, implementation in jail settings requires counties to navigate unpredictable release dates, pharmacy operations, medication-specific clinical considerations, and coordination across multiple partners. Drawing on interviews with leaders from 11 California counties, focus groups with community-based organizations and people with lived experience, and a statewide county survey, this report captures the early lessons emerging from implementation across California. It highlights practical strategies counties are using to address planned and unplanned releases, strengthen pharmacy workflows, improve cross-system coordination, and support continuity of care after release. Rather than prescribing a single model, the report shares real-world experiences from counties that are testing, adapting, and refining their approaches—offering practical ideas for jurisdictions preparing to launch or strengthen their own medications-in-hand programs.

Research Report

Collaboration Reentry July 1, 2026

Beyond Health Metrics: A Framework for Measuring Criminal Justice Outcomes in Medicaid Reentry Waiver Implementation

The Medicaid 1115 reentry waivers represent a meaningful shift in how states and counties support people leaving incarceration by improving continuity of care during the critical reentry period. As of June 2026, the Centers for Medicare & Medicaid Services (CMS) approved reentry waivers for 19 states, with eight additional states and the District of Columbia awaiting approval. As demonstration projects, these waivers create an important opportunity to understand how this policy shift affects both health and criminal justice outcomes.

Although state Medicaid agencies will collect extensive information on health services and outcomes, there is no comparable framework for measuring whether these investments improve criminal justice outcomes. Without that information, jurisdictions cannot fully understand the impact of the reentry waivers. When health and behavioral health needs go unaddressed, individuals are more likely to experience instability that Introduction contributes to repeated justice system involvement.

This report describes criminal justice outcomes that local and state jurisdictions can monitor to understand the broader impacts of this policy shift. Investing in the measurement of both health and criminal justice outcomes will help jurisdictions tell a more complete story of the reentry waivers’ impact.

This document is intended for criminal justice professionals, researchers, county administrators, state policymakers, and cross-system collaborators implementing or considering Medicaid reentry waivers. While reentry waivers may apply to both jails and prisons, this paper focuses primarily on county jails and reflects Justice System Partners’ (JSP) work supporting California counties since 2019 through the MacArthur Foundation’s Safety and Justice Challenge (SJC) California Network. The measures described in this paper provide jurisdictions with a practical starting point for evaluating the criminal justice impacts of Medicaid reentry waivers using data that many agencies already collect.

Changemakers Reflect on the Safety and Justice Challenge and Their Vision for the Future

By: Kimberly Richards, Lore Joplin

Collaboration Community Engagement November 20, 2025

Since 2015, the John D. and Catherine T. MacArthur Foundation’s Safety and Justice Challenge (SJC) has worked to safely reduce the nation’s overreliance on jails, creating tangible benefits for individuals, families, and communities. America’s local jails are complex systems, holding over 660,000 people daily, with more than 7.6 million cycling through annually. Transforming these systems requires coordination and collaboration across traditionally adversarial stakeholders who each have their own priorities and professional cultures.

Our new report, “What It Takes to Change the Way America Thinks About and Uses Jails,” highlights distinguishing traits of effective leaders on the front lines of reform. Drawing on ten years of quarterly jail data across 26 SJC communities and interviews with 25 leaders, including 11 national SJC advisors and 14 local leaders, we identified seven essential knowledges, skills, and abilities (KSAs) and five key insights that drive successful system improvement.

To complement the report findings, this blog post explores the influence of individuals on system transformation, directly informed by the reflections and aspirations of impactful leaders.

Finding Common Ground in the Safety and Justice Challenge

For the changemakers, SJC offered a crucial platform to shift long-held professional practices and build trust across boundaries. It created space for stakeholders who did not always agree–including law enforcement, court actors, advocates, community representatives, and others–to find ways to collaboratively focus on reducing unnecessary jail use and improving public safety.

For some, being part of SJC became one of the most energizing and pivotal points of their careers. One interviewee indicated that she had experienced years of frustration trying to make changes within rigid systems, often finding that strategies never fully materialized. However, she found that SJC proved collaboration across systems was possible and could lead to meaningful change for people and their communities. Local reform efforts that at one point felt isolated began to feel connected to something larger–a coordinated effort within a national network of peers working together towards a shared goal.

SJC’s structure helped to make this collaboration possible. In many communities, there were no existing cross-system forums, such as Criminal Justice Coordinating Councils, to bring partners together around common goals. Participating in SJC provided a rare opportunity to help traditionally siloed agencies work together on shared objectives, building trust along the way. Some changemakers described how conversations that previously only happened in formal meetings began to occur more informally as genuine partnership developed and people became more comfortable connecting directly with each other.

Many interviewees reflected that the essence of collaboration altered the way they viewed their own work. The experiences through SJC helped people think more broadly about their role in the justice system, seeing themselves less as a representative of a single agency and more as a contributor to a larger ecosystem.

The SJC network created a supportive community where leaders exchanged strategies, learned from similar challenges in other cities and counties, and gained the validation necessary to sustain long-term reform efforts. It reminded everyone involved that lasting change depends not only on great strategies and strong data, but also on relationships that make progress possible.

Wielding the Magic Wand for Future Changemakers

When asked what they would give to emerging leaders if they had a magic wand, the changemakers revealed a powerful, aspirational vision, granting courage to individual leaders, and commitment from the systems around them.

Many changemakers wished for stronger institutional support that would eliminate the endless battle to justify reform and provide the foundation to consistently take bold action. They imagined agencies and communities that embrace change rather than resist it, making curiosity to new ideas the default setting. Some spoke to the need for institutions to demonstrate bravery by taking calculated risks, absorbing criticism well, and standing firm in the face of opposition so the individuals driving reform do not bear that burden alone.

Others focused on the practical foundations of change, envisioning justice systems with the infrastructure, staffing, and resources needed to deliver meaningful improvements. They would grant emerging leaders facilities designed to promote safety and care with the support necessary to sustain progress. They also would like to see comprehensive data systems, believing strong data infrastructure is a legacy that breaks down silos and facilitates informed decision-making.

Some leaders focused on the tools and perspectives emerging changemakers need in order to navigate complex political and social landscapes, particularly around public perception and inclusion. Many emphasized the importance of honest storytelling, making sure reform is portrayed accurately and not defined or hindered by moments of fear and misinformation.

Beyond policy and practice, changemakers wished for future leaders to hold onto empathy, resilience, and grace – for themselves and for the people they serve.

These wishes for future leaders offer reflection on their personal experiences and a collective vision about the next chapter in system transformation – a vision of courageous institutions, informed communities, strong data and infrastructure, and leaders who approach their work with compassion and conviction.

The Roadmap for Transformation

Altogether, these reflections demonstrate not only what SJC accomplished, but also what it made possible. Across counties and roles, changemakers described how the initiative changed their approach to their work and showed collaboration as not only necessary, but achievable. The relationships, shared learnings, and trust developed through SJC – both within counties and across the nation – proved that progress happens when a network of partners strive toward a common purpose. The hopes expressed for future generations of changemakers are a reminder that change does not end when a grant cycle closes or a program sunsets. It lives on in the skills, values, and connections that people carry on throughout their work.

As the Safety and Justice Challenge comes to a close, the lessons shared here and expressed in more detail in our new report serve as gratitude and guidance for the ongoing transformation supported by the people and partnerships continuing to move it forward.

Here is a link to the report.

Special thanks to the key changemakers, site coordinators, and CUNY ISLG for their participation in this project.

Research Report

Collaboration Community Engagement Crime Incarceration Trends November 12, 2025

What It Takes to Change the Way America Thinks About and Uses Jails

Kristy Danford, Kimberly Richards, Lore Joplin

America’s local jails hold over 660,000 people daily, with over 7.6 million cycling through annually.1

Transforming these complex systems requires coordination and collaboration across traditionally adversarial stakeholders including sheriffs, police departments, judges, prosecutors, defenders, government administrators, behavioral health and health care providers, community organizations, and advocates.

While many publications document effective interventions, less attention has been paid to the leadership and infrastructure necessary to implement and sustain these transformations.

This report examines key leadership approaches to implementing and sustaining criminal justice system improvements, specifically focusing on safely reducing jail populations through the John D. and Catherine T. MacArthur Foundation’s Safety and Justice Challenge (SJC).


1Statistical tables retrieved from the Bureau of Justice Statistics Jail Inmates in 2023. [Retrieved Here]

The Call Takers and Dispatchers: Unseen Gatekeepers of Public Safety and Justice

By: Joseph Schafer, Beth Huebner, Lee Ann Slocum

Collaboration Communications Data Analysis November 6, 2025

When communities discuss reform of the criminal justice system, attention usually focuses on the actions of patrol officers. Yet, our research for the Safety and Justice Challenge’s Research Consortium highlights that the public safety communications personnel — the dedicated call takers and dispatchers who answer emergency and non-emergency lines — are critical, often-overlooked, initial gatekeepers of justice. Their instantaneous, high-stakes decisions can affect outcomes, including law enforcement response, diversion options, and even the jail population.

What Happens When Someone Calls the Emergency Line?

The process begins when a call enters a Public Safety Answering Point. The call taker, operating with limited and sometimes inaccurate audio information, must make fast, interpretive judgments and decisions, including:

  1. Information Gathering and Classification: The call taker must quickly ascertain the location, ask detailed questions, and classify the incident, often translating the caller’s narrative into fixed-choice fields within the computer dispatching system. This classification immediately assigns a priority level and dictates which initial resources are mobilized, such as police, fire, and emergency medical services).
  2. Dynamic Resource Adjustment: The situation is fluid; if a simple disturbance call escalates to a serious event, the call taker must reclassify the call, which increases the priority and prompts the dispatcher to mobilize additional resources. The interpretive judgments made by the call taker—classifying the call, prioritizing the response, and deciding what narrative details to include—are acts of professional discretion. This process, known as “dispatch priming,” is crucial because it shapes the mindset, assumptions, and tactics of the responding officer before they arrive on scene, which can critically affect how event play out.
  3. Resolution or Referral: Communications personnel ultimately decide if a response is necessary or if the call can be addressed over the phone. Our data showed that in East Baton Rouge Parish, a significant portion of calls (23 percent) were resolved directly by the call taker. However, many administrative or informational calls that do not result in officer deployment are omitted entirely from the dispatching systems, limiting the visibility of their true workload.

Strengths and Pitfalls of Diversion at the Communications Office

As alternatives to incarceration gain traction, the communications office is recognized as a vital point for diversion.

The Strength: Specialized Care and Staff Relief. Call takers frequently acknowledged they would prefer more training so they can better assist callers experiencing mental health crises. Both communications staff and patrol officers widely support integrating specialized behavioral health professionals into these operations. They see this as a way to ensure callers receive better, tailored care, and this collaboration allows police and dispatchers to focus on higher-priority emergencies.

One participant explained the advantage of having specialized staff: “It’s nice that we . . . can redirect to a resource that’s better fitted and well-trained to handle those types of calls… it takes a big burden off of our shoulders where we don’t have the training to do things like that.”

The Challenge: Sustainability. Integration of mental health services into the call taking and dispatch model varies widely even within communities that have experimented with doing so. Having an embedded clinician in the call and dispatch center is also challenging. Such programs are expensive, require that clinicians be trained on call center operations, and necessitate establishing workable protocols detailing the roles and responsibilities of behavioral specialists, communications personnel, and patrol officers. These models also create their own set of staffing pressures. One study site paused its program due to staffing difficulties.

The Unrecognized Front Line: Personnel Experiences

Communications personnel operate in environments characterized by unpredictability and exposure to trauma. They routinely navigate chaotic events, quickly transitioning from slow periods to intense times. The communications personnel might not have any incoming calls and, only moments later, find themselves flooded with dozens of calls describing one or more critical events.

The complexity of their workload goes far beyond serious crime; a substantial portion of calls involve non-criminal issues like traffic incidents, medical emergencies, 911 hang-ups, and general requests for assistance. To manage this environment, call takers require strong “multi-listening” skills, attending simultaneously to distressed callers, nearby colleagues, and radio traffic, all while quickly securing accurate information. They must also maintain composure, as callers often exhibit evidence of anger, frustration (observed in 13 to 16 percent of calls), or panic.

The personnel often feel unseen and excluded from formal recognition as first responders. One participant said they don’t feel that there is always enough acknowledgement of “the things that we hear, the things we have to talk about, the things we put onto the radio.” They handle scenarios few others experience: “Not very many people have been on the phone with someone who’s just been shot or someone who’s wanting to kill themselves or someone who’s just found a loved one dead.”

Yet, despite the emotional toll, many find deep fulfillment in their role, stating: “No matter how hard this job sounds, it’s so rewarding. You feel like a better person because you helped somebody who needed help.”

What Decision-Makers Must Keep in Mind

To leverage public safety communications personnel as effective partners in justice reform, decision-makers must recognize their critical function and provide appropriate support.

They can do this by:

  • Formally recognizing communications personnel as first responders.
  • Making investments in career-long training, including mandatory training to handle mental health calls effectively.
  • Addressing data gaps, including the administrative and informational calls often omitted from computer systems, to truly understand workloads and community service demands.

By supporting these professionals, we don’t just improve efficiency; we ensure better outcomes for everyone who reaches out in crisis.