This project is a partnership between NASHP and The Health and Reentry Project (HARP).
Community supervision partners, such as parole and probation agencies, are uniquely positioned to assist with promoting individual health and success and enhancing public safety when a person returns to the community from incarceration.
The goal of community supervision programs is to support successful reintegration and promote behavioral change by addressing the needs of individuals returning to the community on supervision, while improving access to services that target behaviors linked to criminal conduct, ultimately reducing recidivism and enhancing public safety.
Proactively aligning community supervision with health and human services systems and providers develops a pathway for states adopting programs supporting health care continuity to address those behaviors and enhance outcomes during reentry and through the term of post-release supervision.
What are probation and parole? While all states define these terms slightly differently, they can generally be thought of as:
Probation is when a court sentences an individual to supervision in the community through a probation agency. Individuals may be sentenced to probation instead of incarceration, though a sentence can also include incarceration followed by probation.
Parole is community supervision after a prison sentence.
For more information, see Reentry Key Terms and Acronyms.
The evolution of the criminal justice system, driven by decades of research on justice-involved populations and effective interventions, reveals that a significant percentage of the population has behavioral health issues, including substance use disorder, mental health challenges and social service needs (see Risk Needs Responsivity Model). The research shows that as these issues are addressed, outcomes are improved, meaning more individuals desist from criminal conduct and achieve recovery.
Some jurisdictions have created opportunities for community supervision to more closely interact with efforts to expand access to health care, including mental health and substance use care and social services. We will highlight examples from Arizona, North Carolina, and North Dakota, with successful collaborations among probation, parole, and key health partners. Common features of these partnerships include a focus on multidisciplinary training, information sharing, and facilitating and coordinating hand-offs and referrals to services.
North Carolina
Since 2013, North Carolina has been implementing an innovative approach to supervision through its Specialty Mental Health Supervision (SMHS) program, which aims to prevent recidivism and support healthier individuals and communities. The model responds to the perennial challenge of people with serious mental illness (SMI) cycling through acute care and institutional systems and their chronic overrepresentation in the probation and parole populations. The model grew out of collaboration among the North Carolina Department of Adult Correction, Division of Community Supervision (NCDAC DCS) and researchers at the University of North Carolina (UNC)-Chapel Hill School of Social Work to design and pilot a model that grounds its approach in evidence-informed supervision practices and mental health expertise.
SMHS assigns smaller caseloads to participating probation and parole officers (PPOs) dedicated to individuals with SMI and co-occurring mental health and substance use disorders, limiting each officer’s caseload to around 40 individuals to allow for deeper engagement and time to link individuals to treatment, housing, and recovery supports. PPOs and their chiefs (CPPOs) receive intensive and ongoing training on recognizing and managing symptoms of mental illness, motivational interviewing, engagement strategies, crisis de-escalation, and collaborative case planning to actively engage and assist in coordination of care to medical and social needs, monitoring, and increased time interactions to mitigate recidivism and interruption of services.
Additional support includes monthly clinical consultations by NCDAC DCS for licensed mental health professionals. This monthly consultation helps strengthen PPOs’ case management skills and serves as a bridge for community engagement with local management entities and managed care organizations — leveraging clinical expertise and fostering stronger provider-officer partnerships to ensure individuals receive coordinated community-based care.
SMHS also integrates a tool called the Functioning Abilities Rating System (FARS), developed in collaboration with UNC, to assess participants’ needs across 10 domains (e.g., basic self-care, housing stability risk, substance use, social support) to help tailor how frequently officers meet with people and what issues to prioritize. In practice, SMHP officers coordinate Medicaid benefits and treatment access, including medication adherence, transportation, and housing, often alongside community providers.
As of 2026, NCDAC DCS reports that more than 250 PPOs and CPPOs now hold these specialty caseloads across 100 counties. The approach has reshaped how supervision is delivered to people with behavioral health needs, as officers act as both accountability agents and care coordinators — working directly with treatment teams and local providers to prevent probation violations rooted in untreated illness. The SMHS program now serves as a model for other states seeking to blend behavioral health and community supervision through evidence-informed design and practical training investments.
North Dakota
North Dakota’s Free Through Recovery (FTR) program, launched statewide in 2018, grew out of a justice reinvestment effort to confront rising incarceration populations and costs driven by untreated behavioral health conditions. North Dakota created a framework that resulted in the state legislature appropriating $7 million under SB 2015 to build a community-based behavioral health infrastructure for justice-involved people, along with an additional $500,000 to expand the treatment provider network.
Administered jointly by North Dakota’s Department of Corrections and Rehabilitation (DOCR) and Department of Health and Human Services (HHS), FTR weaves together care coordination, peer support, and access to treatment to help individuals achieve long-term recovery and stability. Each participant has a multidisciplinary care team that includes a probation or parole officer, a care coordinator, and a peer support specialist, creating a single plan that aligns supervision requirements with behavioral health goals. The program includes a cross-sector network of community-based providers, including faith-based organizations, peer-run organizations, culturally specific providers, brain injury specialists, young adult specialists, and other community partners, reflecting the needs of North Dakota communities and the program’s philosophy of “local solutions for local problems.” Staff are trained in Effective Practices in Community Supervision (EPICS) and motivational interviewing, ensuring evidence-based engagement.
The program now operates through more than 40 nonprofit providers serving thousands of participants across the state, including rural and Tribal communities. To evaluate progress, the state tracks monthly outcome measures in housing, employment, recovery progress, and criminal justice involvement, using data to identify areas for improvement and expand provider cross-sector partnerships within community services.
As of June 18, 2025, FTR is serving 1,528 active participants through 42 provider agencies statewide, with more than 7,800 individuals having participated since the program’s inception. Supported by one full-time employee at DOCR and five full-time employees at HHS, the program continues to strengthen collaboration between criminal justice and behavioral health systems. According to program leads, early findings show a 10 percent reduction in recidivism among participants in the high-risk of reoffending group compared to non-participants, with ongoing efforts to refine engagement strategies for lower-risk groups.
Arizona
Arizona has leveraged a statewide Medicaid provider incentive program to encourage stronger coordination between health providers, community supervision and justice partners. Since 2016, Arizona’s Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS), has administered the Targeted Investments (TI) program to reduce fragmentation across behavioral health, primary care, and health-related social needs services.
Justice-involvement is a key area of focus for the TI program, which incentivizes participating providers to develop robust care coordination strategies for individuals involved in or transitioning from the criminal justice system. These strategies include enhanced care coordination with probation and parole, partners’ increased access to medication-assisted treatment, screening for behavioral health conditions and social risk factors, and strengthened connections between managed care organizations, justice agencies, and community-based providers.
During the first iteration of TI, AHCCCS required co-location of clinicians and justice partners such as integrated clinics, safety net providers, and community health centers to adopt a “one-stop shop” model during COVID-19 to complement virtual and hybrid community supervision efforts. Under the current TI 2.0 iteration (October 2022–September 2027), AHCCS implemented a competitive application process for the justice-focused component, prioritizing provider proposals that demonstrated strong cross‑sector partnerships and clear plans to address the primary care, behavioral health, and health-related social needs of justice-involved individuals.
One example of this collaborative approach can be seen in Yuma County, where AHCCCS selected a TI 2.0 project focused on reducing recidivism among individuals involved with the Yuma County Adult Probation Department, State Parole Department, and Federal Probation Department. Through partnership with Community Health Associates, HOPE Inc., and Living Center Recovery, the project supports an integrated outpatient setting that facilitates access to primary care, behavioral health services, and supportive services while maintaining close coordination with community supervision partners. This localized model illustrates how state Medicaid programs can use incentives to promote alignment between health care delivery and community supervision without supplanting corrections authority.
Conclusion
Community supervision, including probation and parole, provides states with a strategic opportunity for collaboration across systems, including corrections health, to align community supports at a critical point in reentry and through the term of supervision. Through this cross-sector effort, states are able to establish a coordinated approach to reducing system fragmentation to drive better reentry, effective supervision, and public safety outcomes.
As part of our work, NASHP, in partnership with The Health and Reentry Project (HARP), has led the State Reentry Learning and Action Network, a network of state officials across health and human services, behavioral health, corrections, and public safety to engage in peer learning to advance reentry policies and programs. Please join us for our final meeting in June 2026, and learn more about NASHP’s reentry policy work and related resources on NASHP’s website. In addition, the HARP’s website offers extensive resources for state health and corrections officials that are working to improve access to health care as people return to communities.
