JSP Staff

Providing 30 days of medications at release is a core requirement of California’s CalAIM Justice-Involved Initiative—and one of its most operationally challenging components. While the policy goal is straightforward, implementation in jail settings requires counties to navigate unpredictable release dates, pharmacy operations, medication-specific clinical considerations, and coordination across multiple partners.

Drawing on interviews with leaders from 11 California counties, focus groups with community-based organizations and people with lived experience, and a statewide county survey, this report captures the early lessons emerging from implementation across California. It highlights practical strategies counties are using to address planned and unplanned releases, strengthen pharmacy workflows, improve cross-system coordination, and support continuity of care after release.

Rather than prescribing a single model, the report shares real-world experiences from counties that are testing, adapting, and refining their approaches—offering practical ideas for jurisdictions preparing to launch or strengthen their own medications-in-hand programs.