California has agreed to improve health care for newly released prison inmates who are disabled, including through a series of measures that advocates say will help almost everyone trying to make the transition from incarceration.

Attorneys representing inmates say proper care during the transition from prison has long been lacking and can lead to homelessness. A recent study found that 1 in 5 Californians experiencing homelessness came from an institution such as prison or jail.

The state agreed in June to release inmates with a 60-day supply of their prescription medications, up from the previous 30-day requirement, and promised to replace medical equipment lost within the first month of an inmate’s being released from prison. Officials will also submit applications for Medi-Cal, California’s version of Medicaid, on their behalf at least 90 days before they’re discharged.

The agreement will benefit at least 11,000 parolees who have physical, developmental, or mental health disabilities, or nearly a third of the state’s 36,000 parolees, inmates’ attorneys estimated. But many of the provisions will aid most inmates being released, even those without a qualifying disability.

The improvements “should help shut the revolving door between homelessness and incarceration that prevents far too many people with disabilities from succeeding on parole and reintegrating into the community,” said attorney Ben Bien-Kahn, one of the lead negotiators on behalf of inmates.

California corrections officials declined comment.

The June agreement is the latest to come from a nearly 30-year-old class-action lawsuit brought on behalf of inmates and parolees who have trouble seeing or hearing or have mobility, learning, mental, or kidney disabilities. A federal judge found in 1996 that the state violated the Americans with Disabilities Act in its treatment of inmates and parolees.

Seven years ago, attorneys pushed the state to do a better job planning for the release of inmates with disabilities. They sent a demand letter to state officials two years ago that ultimately led to the agreement to change the state’s parole process for the disabled.

By moving to providing a 60-day supply of prescriptions, the state is promising to double the amount of medication it previously provided inmates upon their release, which should be enough to cover parolees until their health coverage kicks in. A federal receiver who controls the state prison medical system had made that change in February 2022, after earlier negotiations with inmates’ attorneys, and it’s now written into the parole policy.

The state agreed to release inmates with appropriate medical equipment, such as canes, wheelchairs, and walkers, and promised to replace lost or damaged equipment in the first month without charge.

And the state will generally require that applications be filed for inmates’ Medi-Cal, Social Security, and veterans’ benefits at least 90 days before their release, making delays less likely.

“Most people on parole and who they are releasing to parole are going to end up benefiting from this,” Bien-Kahn said.

About 95% of parolees are eligible for Medi-Cal. According to a recent state report, about 17% of Medi-Cal applications and 70% of Social Security applications were still pending when inmates were released, leaving them at least temporarily without health insurance or income.

“The transition from prison to parole is fraught with danger for all parolees, but especially those with disabilities,” the attorneys’ letter said in arguing for better care.

Among examples, it said a former inmate was released without his wheelchair, walker, and cane, and with no help applying for his Social Security benefits or Medi-Cal. He was left “at extreme risk of being homeless” after he had to wait several months after his release for coverage to begin to receive inpatient care for a neurological condition.

And Bien-Kahn said in an email that attorneys learned this June of a paraplegic with disability-related incontinence who became homeless after he was released without any planning, following more than four decades in prison.

Attorneys said both men were told there was no appropriate transitional housing available for them, another area addressed in the agreement. The demand letter cited a study that found “being released homeless or marginally housed puts ex-offenders in almost immediate risk of failure.”

To help fix that, officials agreed to assess the disability, medical, and mental health needs of every parolee, information that will be used to place them in transitional housing and provide services in the community. And state-funded transitional housing programs will be barred from rejecting parolees because of a disability.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

By Don Thompson
Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.