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Expanding Health Coverage in California: County Jails as Enrollment Sites

By Shannon McConville, Mia Bird

In 2014, the first year of Affordable Care Act (ACA) implementation, the number of Californians with health insurance increased substantially. However, millions of state residents continue to lack comprehensive health coverage, and those who remain uninsured are likely more difficult to enroll through traditional strategies.

In this report, we find that uninsured rates are highest for young men and for those with low levels of education, income, and employment. The prevalence of these same characteristics among correctional populations suggests that the justice system—and, in particular, county jails—may offer points of contact for many uninsured individuals who would otherwise be hard to reach.

Outreach and enrollment efforts aimed at local jail populations are set within the policy context of California’s 2011 Public Safety Realignment, which created incentives and resources for local corrections agencies to improve reentry outcomes. With expansions in access to health insurance coverage under the ACA, nearly all counties are establishing programs to provide enrollment assistance to jail inmates as part of a more comprehensive reentry strategy. But resources and capacity are limited, so it is important to identify effective models to maximize the potential of county correctional systems as sites of insurance enrollment.

Report

Impact of Realignment on County Jail Populations

By Steven Raphael, Magnus Lofstrom

Has California’s historic public safety realignment shifted the problem of overcrowding from state prisons to county jails? This report finds that the shift of most lower-level offenders to the counties has increased the statewide county jail population but decreased the overall incarceration rate. The authors also examine county-level factors outside the direct impact of realignment that help explain variations in jail population growth.

This research was supported with funding from the Smith Richardson Foundation.

Report

Pretrial Detention and Jail Capacity in California

By Sonya Tafoya

California’s persistently overcrowded jails are facing additional challenges now that public safety realignment has shifted many lower-level offenders from state prisons to county supervision. Jail capacity challenges are prompting a reconsideration of California’s heavy reliance on holding unsentenced defendants in jail pending trial—known as pretrial detention. The legal rationale for pretrial detention is to ensure court appearances and preserve public safety. But California’s high rates of pretrial detention have not been associated with lower rates of failure to appear or lower levels of felony rearrests. This report concludes that pretrial services programs—if properly implemented and embraced by the courts, probation, and the jails—could address jail overcrowding and improve the efficiency, equitability, and transparency of pretrial release decision making.

Report

Capacity Challenges in California’s Jails

By Magnus Lofstrom, Katherine Kramer

In an effort widely known as "realignment,” California has given its counties enormous new responsibilities for corrections—including authority over many new types of felony offenders and parolees. Rather than go to state prison, these offenders now go to county jail or receive an alternative sanction. In the first few months of realignment, California’s jail population increased noticeably—but many jails were already facing capacity concerns. We find that some offenders who would have been incarcerated prior to realignment are now either not locked up or are not spending as much time in jail. Going forward, counties will need to consider a wide variety of approaches for handling their capacity concerns and their expanded offender populations.

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Expanding Health Insurance Coverage in California: County Jails as Enrollment Sites

About the Program
Health coverage rates in California have increased significantly under the Affordable Care Act. But millions remain uninsured, and traditional enrollment strategies might not reach these residents. Given the characteristics—and size—of California's jail population, along with recent policy changes, county jails could be promising sites for enrollment. PPIC researcher Shannon McConville will outline a new report on expanding health coverage through the jail system.

This research was supported with funding from The California Wellness Foundation.

Report

Key Factors in California’s Jail Construction Needs

By Magnus Lofstrom, Brandon Martin

Now that California has shifted responsibility for many criminal offenders to the counties, county jail systems face greater capacity challenges. This report highlights two important factors in addressing jail capacity constraints: aging jail facilities and long-term needs. We show that a number of facilities are old and likely in need of costly updates or replacement and that growth in the state’s population is likely to exert significant pressure on the county jail system. Our analysis suggests that a thoughtful combination of further jail construction and decreased reliance on incarceration is needed, given the magnitude of the current and future jail needs.

blog post

California’s Jail Construction Needs

By Brandon Martin

The governor’s proposal to spend $500 million for local jail construction raised many questions at a hearing Thursday of the Senate Budget Subcommittee on public safety.

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