This week in Realignment: May 31, 2013

150 150 Christopher Nelson

The tide is turning. It has been for a while now on public safety realignment.

First, the media narrative started to shift. Then Able Maldonado tried to turn realignment into a wedge issue in his bid to unseat Gov. Brown and was met with widespread criticism.

And now the press is in full-blown reversal mode. Take this piece by the Sacramento Bee editorial staff, published on May 28, that delves into the CDCR recidivism report released last week:

“The takeaway from the CDCR report should be that the public and leaders at all levels of government should get past doomsday rhetoric about realignment and work with counties to attack the link between drugs and crime. Simply jailing these folks, over and over and over again, will not solve the problem.”

The CDCR’s report is based on 6 months of data, which we have previously said is too short a window to draw any substantive conclusions about realignment’s success or failure. However, the Bee’s top-level conclusion couldn’t be more accurate. 

At the very least, the report says that “California is not undergoing some new massive crime wave because of the change in who supervises offenders finishing their prison terms.” 

But as we have said many times over, the real boon from realignment will come in the long term. 

Our own Sharon Aungst, Director of the Partnership for Community Excellence, presented to the Senate Select Committee on Mental Health today discussing prisons, parole, probation and how to leverage the Affordable Care Act (ACA) to save money and reduce recidivism..

She pointed out that the state currently pays 100 percent of the cost for most parolees’ mental health and substance use disorder treatment services. The LAO released a report suggesting that CDCR’s division that deals with parole (DAPO) receive reimbursement for Med-Cal services provided.  We propose that parolees receive services through county mental health systems, which provide more comprehensive services and have extensive experience in billing Medi-Cal.  This will allow these offenders to find a mental health “home” immediately upon release.  

Transitioning offenders from prison providers to parole providers and then to the community mental health system is fraught with problems. Offenders with mental illness have a difficult time with too much change and also often fall through the cracks.  Continuity of care is a chief concern for these offenders.

The ACA will be a boon to all areas here. The generous Medicaid reimbursement rate of 100 percent from 2014 to 2016, then decreasing to 90 percent by 2020, and the plan subsidies provided for those who are not Medicaid eligible, provides enormous opportunities for local criminal justice systems. Widespread health plan enrollment of people in jails and on probation coupled with both currently under-utilized and new health care resources, wholly or partially funded by federal dollars, will result in reduced:

  • Jail operating costs; 
  • Jail population pressures; 
  • Health care expenditures by probation; and/or, 
  • County general fund expenditures for health care and criminal justice. 

Counties should focus on enrolling all eligible offenders incarcerated or under supervision. The State should also change the rules to allow for suspension versus termination of Medi-Cal while detainees and offenders are incarcerated. 

Under ACA the mental health benefit will likely stay the same. It is important to remember that many of the services and supports needed by people with serious mental illness are not reimbursable under Medicaid (and by extension Medi-Cal) and will remain so under ACA. 

There are some successful treatment options not included in the Drug Medi-Cal benefit. Counties will have an option to expand the benefit if they pay for it. It’s a tough decision. No one wants to pay more if they don’t have to, but without the expanded treatment options, many offenders will offend again and wind up back in jail.

If we can shift our philosophy and prepare ourselves for the opportunities that ACA presents, we will be attacking the revolving door of recidivism from many different angles with a high potential for permanent, long-lasting results.  


Christopher Nelson

All stories by: Christopher Nelson