The study [PDF], "Understanding the Public Health Implications of Prisoner Reentry in California," released last week, said the plan to shift low-level offenders to county custody could strain local health care and social services programs that already have been ravaged by budget cuts.
California began sending low-level felony offenders and parole violators to county jails on Oct. 1.
"There's no turning back," Brown said at a Sept. 29 press conference. "The only way is forward in a collaborative way."
But releasing low-risk prisoners could put additional strain on local services because inmates often return to communities with high poverty and low levels of education, the study says. The report found that newly released prisoners have a high level of health care needs, especially for mental health care and alcohol and drug treatment.
State budget cuts, though, have devastated many of the essential programs upon which former prisoners depend. The state reduced funding by 40 percent for in-prison rehabilitative programs, meaning prisoners who are released might have more needs that weren't addressed earlier, the report said.
It could leave community health care providers in a situation in which they must treat a population with no health insurance, limited funds to pay for care and no medical records for caregivers to make more informed recommendations.
The study looked at Alameda, Los Angeles, San Diego and Kern counties, which have significant populations of parolees. The study involved focus groups with former prisoners and their families and interviews with health service providers and community groups.
So far, there are some indications that counties are responding inconsistently to the realignment plan. Counties have varying occupancy levels in their jail systems, with some like Los Angeles County already among the most crowded. The Los Angeles Times reported that the county could, as a last resort, move inmates to other counties if it does not have room for them.
Counties also have different ideas about how to use their resources to check on parolees within their borders. Kern County plans to use an automated phone system to monitor parolees.
The governor argued his plan was necessary in the wake of a Supreme Court decision requiring the state to reduce the population of its overcrowded prisons. Brown said realignment was the best way to lower the prison population while still keeping the public safe.
But the RAND report argues that the law needs to be implemented in a way that tracks its effects on health services.
The study also recommends that the state allocate funds to evaluate the impacts of the move in order to determine if changes need to be made. If the state and counties work together in a comprehensive way to gather information about the effects of the program, it would be easier to gauge whether it is working, the authors said.
"Counties across California face a significant challenge responding to this seismic shift in corrections policy," Lois Davis, the study's lead author and senior policy researcher for RAND, said in a statement.
The federal health care reform bill might provide an opportunity to alleviate some of the cuts to these services, the authors said. Because the new law would increase eligibility for Medi-Cal, it could help more parolees become eligible for coverage and make it easier for them to receive medical care.
"Investing in treatment for this population may help offset criminal justice costs later," Davis said.
Read more California investigative reports at CaliforniaWatch.com.