Sicker, Older Inmates May Wind up on California Hospitals' Doorsteps

Hospital officials throughout the state say that they have six major concerns about the impact of early release of older, sicker inmates:

1. Delays in getting inmates qualified for Medi-Cal or Medicare may take as long as 18 months. "And to the extent that it takes a year or 18 months, that's debt on your books, " says Kelly Brooks, of the State Association of Counties.
2. Medi-Cal and Medicare reimburse hospitals for far less than their costs, which translates into another unfunded mandate.
3. Many inmates will not qualify for either program, resulting in a demand for uncompensated care from local healthcare networks.
4. Many inmates are likely to continue to have behavioral, drug or alcohol treatment needs after their release.
5. Hospital officials worry quietly that when these inmates are released, they will be in need of much deferred care that wasn't or couldn't be provided during incarceration. Medical problems that might have been more cheaply and more easily managed may have been allowed to get out of control.
6. California is one of only two states in the country where all inmates are released on condition of parole, and that release is to the area where they committed the crime, unless that region lacks the ability to provide a certain type of care the patient needs. In that case, they would be paroled near that health service they need.

Hospitals in counties with numerous prisons, including Kern, Kings, and Imperial, worry that they may receive more former inmate patients as a result.

"There's no one who wants to step up and pay for this population," says Brooks of the County Supervisors Association. "That's what it comes down to."

Hospital officials are also irritated because of a bill attached to the current budget that capped reimbursement to hospitals for treating prison inmates during their incarceration, a cap that shortchanges hospitals and doctors relative to the cost of providing that care. Not only are health providers not being reimbursed fairly for taking care of inmates while they are incarcerated, but providers will have to absorb the unfair burden after they are released, they say.

For David Green of El Centro Regional, it isn't just Centinela State Prison, population 4,556, that he's worried about. Imperial County also is home to Calipatria State Prison, which incarcerates 4,268 felons.

“Maybe this is hearsay, but I heard at a recent supervisors' meeting they would be paroling 2,500 into Imperial County, and many of them will be paroled right here."