Jail and prison inmates are much more likely than the general population to have a mental illness or chronic disease like diabetes. But nine in 10 didn't have health insurance when they were booked, according to the American Journal of Public Health.
That's changing in San Diego County under the Affordable Care Act.
Medi-Cal Outreach, Enrollment In County's Criminal Justice System
Medi-Cal Applications Submitted: 996
Applications Approved: 281
Applications Denied: 25
Applications Pending: 691
Note: Figures are from July to October 2014
The law extended Medi-Cal to low-income, childless adults and county corrections officials are spreading the word. Programs in jails and probation offices have helped nearly 1,000 soon-to-be-released and recently released inmates sign up for the health coverage.
Elizabeth Siggins with the criminal justice reform group Californians for Safety and Justice said access to health care could go a long way in keeping individuals out of jail for good.
"So much of the criminal behavior is actually driven by drug addiction problems and mental health problems that have gone untreated," Siggins said. "So if we can actually get someone into treatment, the research shows that we then see a reduction in their offending behavior."
More than 16 percent of people in jail have a serious mental illness, according to the National Institute of Mental Health. Nearly 65 percent have a substance abuse disorder.
Siggins commended San Diego County for proactively working to sign up individuals re-entering the community. The county was at the forefront of setting up enrollment programs. Before the Medi-Cal expansion went into effect, local detention centers were already helping inmates sign up for a pilot program meant as a feeder program to Medi-Cal.
Probation Chief Mack Jenkins said he has "application assisters" stationed at all of the county probation offices. They ask former inmates if they have insurance and offer to help them apply for Medi-Cal if they don't. Jenkins said more than half of those who are offered help return to fill out Medi-Cal forms.
"We think that's very significant," Jenkins said. He added that the coverage is a huge help for probation departments across the state, which have struggled to pay for mental health services.
A quarter of California counties have not yet begun Medi-Cal enrollment programs in their jails.
The stream of people leaving jail and prison is swelling in California. The first wave began under the state's 2011 public safety realignment law, which was designed to ease state prison overcrowding. More will be released under Proposition 47, which voters approved in November. It reduces a number of non-violent felony crimes to misdemeanors and allows prisoners serving time for those felonies to request a resentencing.
As of November, the county had 2,367 former inmates out in the community as a result of the public safety realignment law. Most had been locked up for drug and property crimes.
