An Act to Reduce Recidivism by Improving Access to Benefits for Individuals
with Psychiatric Disabilities upon Release from Incarceration
Commentary on Article X
The proposals in this model law are designed to be cost-effective for
states in the long run. Tax dollars are wasted when individuals with
psychiatric disabilities leave correctional settings without access to
health care and income supports. Lacking access to mental health services,
housing and other needed supports, they often experience crises, deteriorate
and end up in emergency rooms, psychiatric hospitals, jails or all three.
It is extraordinarily inefficient and expensive to provide care
in this way. In King County, Washington, officials identified 20 individuals
with mental illnesses who had been repeatedly jailed, hospitalized or
admitted to detoxification centers. In the course of one year alone,
providing emergency services to these 20 individuals cost the county
about $1.1 million.1
Better care can be provided less expensively, as
experience demonstrates.
For example, a study of Chicago’s Thresholds program, a community-based
jail diversion program, documented substantial cost savings from public
investment in community mental health care and housing for released inmates.
During a year in the Thresholds program, the 30 program participants
studied spent approximately 2,200 days less in jail than in the year
preceding their participation, for savings of $70 per day plus the expense
of arrest and booking. They also spent about 1,800 fewer days in public
psychiatric hospitals, for savings of $500 per day. Thresholds costs
around $26 per day.2
The model law recognizes that states will incur some expense to implement
it. For example, by accelerating the receipt of federal benefits, states
will also accelerate their costs in these programs (i.e., state Medicaid
shares and state SSI supplements). In addition, training state workers
and taking other steps required to ensure inmates access to benefits
immediately upon release is not without cost.
The fiscal analysis of Colorado’s 2002 benefit-reinstatement law
provides some guidance on calculating implementation costs. In Colorado,
participating state agencies estimated that staff training and benefit-application
assistance could be provided by existing personnel at no additional cost.
Additional Medicaid expenditures were anticipated. Colorado calculated
these expenditures as follows: considering historical data, including
typical delays in receiving benefits, analysts estimated the numbers
of eligible inmates who, upon release, would more speedily receive benefits,
the number of total additional months for which benefits would be received,
and the resulting state cost. Figuring that federal financial participation
would cover half the cost, the required general fund appropriation for
FY 2002-2003 was determined to be $122,564.3
Notes
1. Council of State Governments (June 2002), Innovative Programs’ Impact
on Costs and Public Safety, Criminal Justice/Mental Health Consensus
Project, at p.13 (citing unpublished data provided by Patrick Vanzo,
Section Chief, Crisis and Engagement Services, Mental Health, Chemical
Abuse and Dependency Services Division, King County Dept..of Community
and Human Services). New York: Council of State Governments. The report
may be found at www.consensusproject.org.
2. Information available at www.thresholds.org. The
Council of State Governments Consensus Project report and website contain information
about other exemplary programs and their cost-effectuveness.
3. Colorado Legislative Council staff, State Fiscal Impact of HB02-1295
(2/16/02).
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