Calif. Counties Spending More on Inmate Care Amid Realignment

Health care costs at California county jails have increased significantly since the state implemented a prison realignment plan that spurred an influx of county-level inmates, according to an analysis of county-level data by the Sacramento Bee (Branan, Sacramento Bee, 9/8).

Background on Realignment

In 2006, U.S. District Judge Thelton Henderson ruled that federal oversight of the state's prison health care system was needed after determining that an average of one inmate per week died as a result of medical malpractice or neglect.

To help curb prison overcrowding, the state implemented a plan by Gov. Jerry Brown (D) to send inmates convicted of lower-level crimes to county jails (California Healthline, 12/16/13).

Since California began sending such inmates to county jails in 2011, the populations of such facilities have been rising, resulting in inflated health care costs, according to the Bee.

Details of County Health Spending on Inmates

In fiscal year 2013, California's 10 largest counties spent a total of $560 million for inmates' medical and psychological care -- a 16% increase from FY 2011, according to the Bee.

Meanwhile, state data during approximately the same time period show that counties saw:

• A 21% increase in spending on inmates' medical care; and
• A 32% increase in out-of-jail medical visits.

County officials say the increased spending largely was caused by the influx of inmates related to the state's prison realignment plan. However, other contributing factors could include inmates:

• Being in worse physical condition; and
• Receiving longer sentences, which could result in the county paying for treatments for chronic health conditions.

Help Covering Costs

According to the Bee, the state has tried to offset counties' higher costs by:

• Allowing counties to purchase medicine at a lower bulk rate; and
• Developing a plan to enroll inmates in health coverage through the Affordable Care Act.

In addition, California last year provided counties with $1 billion for jail-related expenses.

However, the counties said the funding was not enough to cover health care in addition to incarceration and rehabilitation costs. For example, the Sacramento County Sheriff's Department received $3.9 million to pay for jail inmates' medical, dental and mental health care, but the county ended up spending $7.9 million on such care (Sacramento Bee, 9/8).