Courts Push Back on California Prisons

By Bernice Yeung | Crowdfund this with Spot.Us
Part of the Prisons & Public Health news blog

How will California resolve its chronic prison overcrowding problems? With court-imposed deadlines ahead, the answer is as murky as ever.

Sept. 18 Deadline Looms

In August, following class-action litigation filed by California inmates, a federal court found that the state’s prisoners were receiving Constitutionally sub-par health and mental health care because of overcrowding, and issued an order requiring the inmate population to be lowered by more than 40,000 over the next two years.

Gov. Arnold Schwarzenegger filed a motion to delay the order, which the district court denied; a further appeal filed with the U.S. Supreme Court was also turned down last week.

California is now out of appeals, and has no choice but to come up with a plan for reducing the prison population by Friday, September 18.

Budget Battles

Simultaneously, there’s been a lot of back-and-forth on efforts to trim the prison budget by $1.2 billion.

The state senate bill, which Mr. Schwarzenegger supported, would have cut the prison population by 27,000 inmates, by re-categorizing some nonviolent felonies as misdemeanors, and releasing elderly and sick inmates early, among other strategies.

Last week, citing concerns about public safety, the state assembly passed a modified version of the bill that did away with its most controversial portions, including early release (although some nonviolent inmates will still be eligible for early release if they complete rehabilitation programs).

The assembly bill would reduce the prison population by 17,000 and tighten the prison budget by less than $1 billion.

Though last-minute negotiations threatened to derail the bill, California lawmakers agreed to adopt the assembly’s prison bill on Friday, the last day of this year’s legislative session.

The prison bill falls short of the 40,000-inmate reduction required of the state, and how the state plans to meet the federal court order remains to be seen.

California Counties Brace for Parolee ‘Tsunami’

By Bernice Yeung | Crowdfund this with Spot.Us
Part of the Prisons & Public Health news blog

As the state of California grapples with overcrowded prisons, its counties struggle with the flip side of the problem — a lack of support for the increasing number of people returning from prison who need reentry services.

For example, a recent survey by prisoner advocates found that most shelters and services for women parolees in San Francisco and Alameda counties have long waiting lists, and many are unreachable by the phone numbers in official resource guides published by the state.

Budget Cuts Deepening

“There are not nearly enough services and what services do exist are not coordinate optimally,” says Darryl Stewart, a constituent liaison and organizer for Alameda County Supervisor Nate Miley, and a member of the Alameda County Reentry Network.

State budget cuts have drastically affected “any program that deals with the safety net for low-income individuals,” he said, “Cuts to social services, food stamps, general assistance and health care — this is the safety net that people are talking about, and that safety net has been shredded.”

Factor in the pending release of state prisoners, he says, and the result is “a tsunami coming at us, not just with the potential of early release, but because about 7,000 people are paroled to Alameda County each year.”

In Hayward, Calif., the 14-year-old Women on the Way Recovery Center provides addiction treatment services primarily to formerly incarcerated women.

Currently, the organization has 36 women on the waiting list for its 10-bed residential treatment program, while an additional 56 women are waiting for space at the center’s eight-bed transitional housing.

Once they become clients of the program, these women face additional challenges to accessing services, said Barbara Quintero, the center’s director of operations.

“The barriers to reentry are medical, dental, mental health and housing,” Quintero said. “There are barriers to these women getting health care consistently. There is a system, but it takes weeks to get in. So it’s not that we don’t have a system, it’s just that the system is broken down, especially with the budget cuts.”

Women’s Services Struggle

When the nearby Central Health Clinic in Fairmont Hospital closed due to budget cuts several years ago, Women on the Way clients were lucky to receive most of their health care, dental work and mental-health prescriptions through an Alameda County program called Health Care for the Homeless.

Quintero, whose clients include women with stomach cancer and diabetes, said that without Health Care for the Homeless’s last-minute suport, “these women would get no care.”

Not all returning prisoners have such a fallback, however.

This August, All of Us or None, a national advocacy organization of ex-prisoners, teamed with the California Coalition for Women Prisoners to survey the East Bay and San Francisco housing programs for women listed in the parolee resource guide given to inmates upon release.

They found that of the 17 East Bay housing options listed in the resource guide, 10 weren’t reachable by phone; in San Francisco, four of the 11 housing options were unreachable.

Of the housing services that All of Us or None was able to contact, most of them had waiting lists; there were no beds available in the East Bay and only five beds in San Francisco (two beds required a one- to two-week process to become eligible, two beds were for single women without children only, and one bed required a referral from a social service agency).

The results were announced at the Alameda County Reentry Network’s meeting last month, said Linda Evans, an organizer with All of Us or None, and “what became really clear from this presentation is that this is an ongoing crisis.”

In other words, the early release of inmates from California state prisons is only going to make an existing problem worse.

“[W]hat came out from the research and the discussion afterward is that the services that people need aren’t there now for the people who are normally coming home,” Evans said. “And that is a crisis in and of itself.”

The sparse reentry services for women will be re-visited at the next Coordinating Council meeting, which is coming up on September 17.

By Bernice Yeung | Crowdfund this with Spot.Us
Part of the Prisons & Public Health news blog

With 40,000 inmates slated for release in the next two years due a federal court order targeting overcrowding in California prisons, what to do with all those convicts re-entering society is at the top of peoples’ minds.

(In fact, the state has to come up with a plan of action by mid-September, although it will likely appeal the order.)

This is on top of the nearly 140,000 inmates released annually to California communities. Gov. Arnold Schwarzenegger has also indicated that he’d consider the early release of even more inmates to help cut $1.2 billion from the state budget.

For years, the state’s more savvy cities and counties have convened reentry task forces to improve public safety by helping parolees transition more smoothly.

One of the most proactive efforts comes out of Alameda County — which receives about 7,000 parolees a year — and which has paid particular attention to the health and mental health needs of the formerly incarcerated.

In 2007, the county’s then-director of the Department of Public Health, Arnold Perkins, helped create the Alameda County Reentry Network, which includes elected officials and representatives from a variety of local social-service and law-enforcement agencies.

At their meeting in July, the group discussed a plan to direct health and social-service funding toward inmates who are supposedly scheduled for early release, creating a better system for parolees to access their medical records, and handle the many health issues that women and the elderly face when they are released from prison.

The Reentry Network’s coordinating council takes up the issue once again in Oakland on Thursday, August 20, from 1:00 p.m. to 3:00 pm, at the California Endowment Oakland Conference Center at 1111 Broadway, 7th Floor, Oakland.

Stay tuned for an update on their next move …

By Bernice Yeung | Crowdfund this with Spot.Us – if you appreciate this reporting, help support it!
Part of the Prisons & Public Health news blog at NewsDesk.org

Fresh from lockup and battling a host of health problems — including chronic illness, addiction and mental illness — a majority of California parolees wind up in a handful of cities like Los Angeles, Oakland and San Diego.

But here’s the rub: Parolees often can’t get the services they need because they’re going back to low-income communities where health services are “severely strained,” according to a recent RAND Corporation study.

The study also says that access to care for minority parolees also tends to be uneven. For example, African Americans living in Los Angeles and Alameda counties had less access to hospitals than Latino or white parolees, while in Kern and San Diego counties, Latino parolees had the least access.

I spoke with Lois Davis, the lead researcher on the RAND study, which mapped where parolees go after they’re released, and analyzed — for the first time — California’s safety net of medical, mental health and addiction services available to parolees in their communities.

Bernice Yeung: Why should we care about the health of parolees?

Lois Davis: A lot of people ask that question–why does this matter?–and they are usually fairly unsympathetic. But California is in the top five states in terms of the sheer number of prisoners and the truth is, they all return to communities.

[T]hey should care because [parolees] become a part of a larger set of public health and social problems that California will have to deal with. They become part of the medically indigent population, those suffering from mental illness, homelessness and those having drug problems.

It has affects on our public safety, since those conditions can be associated with property crimes. This population also brings with them infectious diseases, which can have an impact on the communities that they’re returning to. So policy makers need to make sure that they are getting the service and the medications that they need.

How would you summarize the major findings of this study?

Certain California counties and communities are disproportionately impacted by reentry. They are often returning to disadvantaged communities where the medical and health safety nets are already restrained and where they have limited resources to help those individuals returning from prison. So some communities are disproportionately impacted.

Also, these individual tend to be in poorer health. They have higher rates of chronic health conditions such as asthma and hypertension, higher rates of infectious diseases and conditions that require rigorous use of health care to keep them in check. Two-thirds of California inmates report having drug-abuse or -dependency problems, and one-third report having mental health problems. So they are disproportionately sicker than the average citizen in California.

The key message is that certain counties and communities are disproportionately affected by reentry and if we want to think about how to target resources, we should take that into account.

How is this study unique?

The innovation of this study is not in mapping where parolees return to and the location of healthcare facilities; it’s in trying to define, for the first time, the safety net for these individuals and figuring out what the capacity of that system is in terms of being able to meet the needs of these individuals.

We are beginning to recognize that access to services varies from community to community and it varies in terms of types of service. And this impacts parolees by race and ethnicity–it’s important for people to understand that mental health services for African Americans and Latinos in Los Angeles or Alameda County, for example, reside in areas with lower access to these services …

What was surprising to me was that in the mental health area, there is a patchwork of two small networks for parolees. But in truth, they need to rely on country resources [Something we'll explore in future posts--Ed.]. It’s often hard for parolees and their advocates to navigate this patchwork.

We need, fundamentally, for policy makers to ask themselves about what reentry looks like in their community. What capacity do they have to meet the health care needs of people returning from prison? As reentry plans are getting more attention, how do we design strategies to target the resources to these individuals?

What policy recommendations would you make based on your research?

My specific recommendations are that policymakers have to realize that nonprofit community organizations–in Los Angles they’re called public-private partnership clinics–fill an important role in the medical safety net. So if a county is thinking about how to target their resources, they should think about the possibility of funding more of these clinics in places where there are gaps in services for this population.

They also need to look at the patchwork of mental health and drug treatment for parolees because this is an area where parolees have the greatest need, and it will have an impact on whether they reoffend or violate their parole, whether they can find housing or a job. There is a real need to look at how we can better rationalize these services so that people have better access to the resources that they need.

Is California somehow different in terms of reentry and health care?

We have to recognize that we are one of the states with a large number of people coming out of prison, so this is not an issue that we can ignore. The sheer size of the prison population is not trivial in terms of the public health and public safety impacts.

And as the state is trying to find reductions in health care and corrections costs, they are considering cutting out rehabilitative services in prisons. For example, they are thinking of cutting substance-abuse counseling unless it is court ordered, or they are thinking of releasing individuals without parole. So we could have more people coming back out but at the same time, rehabilitative services are potentially being cut while they are incarcerated. And the state is also trying to trim funding to the medical and mental health safety net when they come out. What does this mean for the medically indigent? This population will essentially push the costs to a local level. So there are impacts of reentry on public health.

Why is health not often been discussed in terms of reentry?

We know that this population is sicker on average, but when people think of people that are coming out of prison, they think about how they need housing and a job. And they do. But what some people do not appreciate is the impact that health has on the ability of people to do these things.

This population has a higher burden of disease, whether you’re talking about mental health, drug abuse or chronic illness. And the public-health community has not traditionally seen prisoners, or those returning from prison, as important when they’re dealing with things like infectious diseases. But [it] does have a role to play in meeting these individuals needs; these individuals are part of the population that they need to worry about …

We need to understand this population as part of the homeless and medically indigent population, which often needs alcohol and drug treatment.

As Jeremy Travis, the former director of the National Institute of Justice, said, “They all come back,” and that’s true. This is not an issue that we can ignore. And this impacts certain communities in a profound way. This goes back to the question of why we should care.