The increased health care costs the Counties will have to absorb from the transfer is an overlooked aspect of the debate, which is examined in this article from RAND.
“The reality that tens of thousands of California state prisoners may soon be sent to local lockups is beginning to hit home. Los Angeles County Supervisor Michael D. Antonovich likens the impending prisoner influx to a "bar scene — a violent bar scene that you saw in 'Star Wars.'"
“That may be overstating the case. But the fact is that the U.S. Supreme Court decision ordering California to reduce its prison population by 30,000 — to be achieved in part by having more low-level offenders serve their time in county jails — is going to have serious repercussions.
“The most obvious may be, as Antonovich alluded to, public safety. Jails, many of which are already overcrowded, are likely to become more crowded, and they often lack the capacity to provide the rehabilitative services needed by this population. Local criminal justice systems are also likely to come under additional strain.
“And there's another consequence that hasn't been talked about as much: The strain on local budgets of trying to meet the healthcare needs of this population. The chief reason the court ordered a reduction in the prison population was the failure of the state to meet the basic medical needs of prisoners. Can strapped local governments really do any better?
“Many of those incarcerated, whether in state prisons or county jails, have significant medical, mental health and drug treatment needs that counties are ill-equipped to handle. Many also have chronic conditions or infectious diseases that need to be treated and managed. And of course these prisoners ultimately return to our communities, bringing their medical needs to places where the healthcare safety net is fraying at best.
“The problems the prisoners contend with are serious. It is well known that California prisoners tend to be disproportionately sicker on average than the California population. The Rand Corp.'s ongoing study on the public health implications of prisoner reentry has found that 18% of California inmates report having been diagnosed with hypertension, 8% with cardiac problems and 5% with diabetes — all chronic conditions that require medical management.
“Moreover, 13% reported having been diagnosed with tuberculosis, 13% with hepatitis and 9% with sexually transmitted diseases. If left untreated, such infectious diseases have implications for the public health of the communities to which ex-offenders will return.”