This week in Realignment: July 19, 2013

150 150 Christopher Nelson

In journalism, you are told that a meeting is never the actual story. There is always subtext, a larger problem that is being addressed in the meeting with opposing viewpoints verbally clashing over the solution.

In the case of public safety realignment, however, the meeting truly is the story. The Partnership for Community Excellence is holding a series of regional convenings across the state of California to discuss the benefits of the Affordable Care Act (ACA) to counties. Ultimately, these meetings are still a means to an end (which we will describe below) that will come about entirely from the efforts of those involved, but they represent an important first step nevertheless.

Whereas something like split sentencing will spawn different (and sometimes opposing) viewpoints from each area of criminal justice, the ACA stands to relieve the burden of health care costs placed on county jails and probation departments to provide services to offenders with mental illness and/or substance use disorders.

Counties will need a plan with clear outcomes, strategies, and measures along with good collaboration and coordination among the key stakeholders, including county health care systems along with the usual suspects from community corrections. If all work together well,  this will be a win for everyone involved and here’s why.

Collaboration between county criminal justice and health care systems can increase the number of those receiving services, especially those with substance use disorders and/or mental illness, providing targeted treatment shown to work and stopping the revolving door of recidivism for these offenders.

In turn, this collaboration will not only help to identify specific strategies that are tailored to the unique needs of individual counties, but it will help to identify the steps needed to move from a pie-in-the-sky idea to action and eventually results.

A large chunk of those who constantly cycle in and out of county jails do not have health insurance yet suffer from a myriad of health problems. The longer these go undiagnosed and untreated, the more they contribute to the perpetual cycle of re-offense, burdening jails with housing costs and reducing safety within communities.

A number thrown around a lot is $55,000. That’s how much it costs, on average, to house one inmate per year in a county jail. To simply lock someone up with a drug problem or mental illness for a year and then release them back into the same set of problems and challenges their illness presents means a high likelihood that they will wind up right back on the taxpayer’s tab in no time.

Thankfully, President Obama’s National Drug Policy Strategy represents a major generational shift in how we see drug treatment through the lens of criminal justice. By instituting reforms such as drug courts, smart probation programs and community-based policing programs, the new policy aims to break the cycle of drug use, crime and incarceration while focusing limited enforcement resources on more serious offenses.

It represents a serious, and very welcome, shift in attitude that can only benefit California. The generous Medicaid reimbursement of 100 percent of costs for three years starting next year and then 90 percent of costs after that can create a paradigm shift that when paired with a savings boon creates an enormous opportunity for counties to make wholesale changes for the better.

Widespread health plan enrollment of people in jails and on probation along with the federal reimbursements will reduce jail operating costs, populations and health care spending. County general fund spending on health care and criminal justice should also see some relief.

Bearing all of this in mind, partnerships between those enforcing the law and those administering health care in counties is paramount to taking full advantage of this opportunity. The convenings sponsored by the Partnership for Community Excellence, along with Community Oriented Correctional Healthcare Services and Californians for Safety and Justice, will help foster this collaboration. And beyond the doors of these meetings, the Partnership for Community Excellence and its partners will assist counties in implementing the Affordable Care Act in conjunction with Realignment. 

Funding is consistently the roadblock so when the chance comes along to relieve that ever-present pressure valve, we must grab the bull by the horns and ensure the opportunity is not squandered.


Christopher Nelson

All stories by: Christopher Nelson