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UMass Chan Medical School and UMass Amherst addiction researchers are leading a pilot study to examine the effectiveness of a federal waiver in Massachusetts sheriff’s offices to improve transitional treatment for incarcerated individuals receiving medication to treat opioid use disorder (MOUD).
Ekaterina Pivovarova, PhD, associate professor of family medicine & community health and emergency medicine; and Elizabeth Evans, PhD, professor of community health education and associate chair of the Department of Health Promotion and Policy at UMass Amherst, are principal investigators on a five-year, $7.6 million award from the National Institute on Drug Abuse, which will study the impact and determine best practices of the federal Medicaid Inmate Exclusion Policy Section 1115 waiver in pilot correctional facilities. UMass Chan has partnered with sheriff leadership in Franklin, Hampden, Middlesex, and Suffolk counties on this initiative.
The waiver restarts MassHealth coverage 90 days before incarcerated people are released to the community.
The Medicaid Inmate Exclusion Policy previously removed Medicaid eligibility in Massachusetts for individuals during incarceration, which earlier studies found to be a barrier to receiving transitional treatment during reentry into the community. The commonwealth received federal permission for the exclusion policy waiver in 2025, and the state is currently in the planning stages to implement the waiver in jails. Massachusetts is one of 20 states to date that have been approved for the waiver for justice-involved individuals.
“We’re trying to help give information back to policymakers and the public on what’s an effective and worthwhile investment of our common resources. I think this new study will put us in a position to make those types of recommendations.”
— Elizabeth Evans, PhD
“We hope to provide a roadmap for other states on how to use waivers to support individuals with substance use disorder, increase the use of medications for opioid use disorder after release, reduce the number of people who disengage from care, and create a an intervention that connects community agencies with jails to deliver services they otherwise couldn’t provide,” said Dr. Pivovarova.
Pivovarova will be overseeing a clinical trial of the implementation of “Reach-In CBT,” an evidence-based manualized cognitive behavioral therapy intervention, which will be delivered by community providers via telehealth to roughly 450 incarcerated people over a one-year period.
“This intervention would start while individuals are still incarcerated and receiving medications for opioid use disorder and would then help to bridge them to counseling services and medications in the community,” Pivovarova said.
The project, Justice Community Opioid Innovation Network Phase II Clinical Research Hub, builds off earlier research from the Phase 1 hub, which evaluated 2019 pilot programs providing FDA-approved opioid use disorder medications in seven Massachusetts county jails. That research, led by Dr. Evans and Peter Friedmann, MD, MPH, professor of population & quantitative health sciences and former associate dean for research at the UMass Chan-Bay State regional campus, showed that only 50 percent of individuals who received MOUD in jail continued in the community after release.
“The first phase of the research showed that the link to care is critical. This next phase of the research will take a further look at the impact and future implications of engaging community providers in transitional care,” Dr. Friedmann said. “We’re looking at an innovative policy change through these waivers that has a chance to revolutionize how we treat people in transition from carceral settings into the community.”
Evans said a focus of the new study is to determine how the waiver will affect access to health care and future outcomes, as well as how it might impact public policy.
“Massachusetts has shown that if jails do provide evidence-based treatment, they can help reduce overdose deaths and recidivism,” Evans said. “This research has implications for public health and public safety at the same time. That’s the role researchers can play. We’re trying to help give information back to policymakers and the public on what’s an effective and worthwhile investment of our common resources. I think this new study will put us in a position to make those types of recommendations.”
