Caring for California's aging prisoners

In response to the dangerous gap in health services that incarcerated people face upon release, California and 26 other states have implemented Medicaid waivers allowing coverage to begin up to 90 days before release and continue for up to a year afterward. The program connects inmates with case managers, medications, housing assistance, and mental health care before they walk out the door. California's program has already enrolled more than 50,000 incarcerated people in prerelease services since January 2023.

The U.S. prison population is aging, which is costly because older inmates need more care. Some states have responded by creating special wards, having the young inmates care for the old, or building nursing homes.

A Rotary club in Topeka, Kansas, has transformed reentry support for incarcerated women at the Shawnee County Jail through Intersection to Care, a program that pairs immediate-release support with mentorship, skills classes, and subsidized housing. The program, led by women with lived experience of incarceration, meets women at the jail exit to prevent trafficking, connects them to recovery housing through Oxford House of Kansas, and offers technology, health, art, and movement classes inside the facility. Since launching in 2022, the initiative has assisted more than 1,000 women.

Via legislative efforts, six U.S. prison systems and dozens of jails have made phone calls free for incarcerated people (with governments paying providers instead of families). This has resulted in 600 million additional calls, 6.4 billion more call minutes, over $620 million in savings for families, and improved mental health, family connections, and prison environments.

Illinois has implemented mental health courts across 31 counties as an alternative to incarceration for people with mental illness. These specialized courts divert defendants into community-based treatment programs lasting 1-2 years, featuring regular court appearances, counseling and drug testing. Since 2017, approximately 50% of participants have successfully graduated from mental health court programs statewide, with 11,000+ diverted from prison through the broader Adult Redeploy Illinois initiative.

For the People identifies eligible cases for California’s resentencing law, conducts outreach to incarcerated women, reviews applications, and makes referrals to prosecutor resentencing units in participating counties in an effort to address the gender gap in resentencing cases. The program has helped resentence about 1,000 people, including three women, and is being implemented in five other states.

After Colorado passed a state law requiring all jails to create in-person polling places for incarcerated voters, the number of ballots cast from county jails rose from 231 in 2022 to more than 2,300 in 2024.

Project Rebound at the Pelican Bay State Prison is a partnership with California State Polytechnic University, Humboldt that provides associate and bachelor’s degree education to incarcerated individuals. Research shows access to higher education in prison lowers recidivism rates and increases the likelihood the person will find a job post-incarceration. Currently, about 14,000 incarcerated individuals in the state are taking classes toward a college degree, or about 15% of the prison population.

California's incarcerated firefighter programs offer meaningful benefits to some inmates, such as the ability to leave the traditional prison environment, get meaningful training, and have sentences shortened in exchange for service. However, low wages and stigmas leave many appealing for program improvement.

To improve voter access for people in jail, the Davidson County Sheriff’s Office hired an election worker to comb through county records and identify incarcerated people who are registered to vote. The staffer then went from pod to pod in the jail to deliver absentee ballot request forms and give others an opportunity to register. In all, 70 people were able to request their absentee ballots.