Post on 09-May-2018
Prepared by Jeffrey Coots, JD, MPHJohn Jay College of Criminal Justice
Special thanks to Peter Kiers, Jonathan Heller, Charlene Leistman, Sue Mowrey, Craig McNair & David Lowry
P2PH is funded in part by NYC Dept of Health & Mental Hygiene, the Van AmeringenFoundation and the Langeloth Foundation, along with several research projects funded by NYC Mayor’s Office of Criminal Justice and National Institute of Justice
Overview of
P2PH
Initiative
Public Health
Perspective
on Reentry
Best Practices
in Community
Supervision
Opportunities
for Innovation
in Pre-Trial
P2PH is a consortium of academic, research, policy and direct service agencies focused on accelerating reforms at the intersections of public health and public safety.
P2PH members recognize the endemic social and structural problems that lead to incarceration. We strive to position public health interventions to be successful and held accountable to better health, safety and social outcomes and to reduce the risks of criminal and anti-social behaviors.
Stimulate collaborative
dialogues across disciplines
Accelerate innovation & the
adoption of proven strategies
Build systemic capacity of
community-based providers
Pre-Arrest Diversion
in NYC Subways
Court-Based Health
Engagement
Annual
Interdisciplinary
Conference
•Knowledge sharing
•Data integration
•Policy advocacy
NYC
Health & Justice
Working Group
•Upstream at arrest / booking
•220.03, petit larceny,
trespassing
Pre-Arrest
Diversion for
Drug-related
charges
Harm
Reduction
EBPs
Supervised
Release
Prison
reentry SMI
homeless
Blended
CJ/Health
profiles
PH & gun
violence
Homeless
“HotSpots”
Overview of
P2PH
Initiative
Public Health
Perspective on
Jail / Reentry
Best Practices
in Community
Supervision
Opportunities
for Innovation
in Pre-Trial
Courtesy of NYC DOHMH
Jail
OpioidsTrauma
From John Jay’s Misdemeanor Justice Project; Preeti Chauhan; DCJS Data
Other Urban: Albany, Buffalo, Rochester, Syracuse and Yonkers
Source: Vera Institute’s Incarceration Trends webtoolat http://trends.vera.org/incarceration-rates
via Green & Schiraldi
Greene, J.A. & Schiraldi, V. Better by Half: The New York City Story of Winning Large Scale Decarceration while Increasing Public Safety. Federal Sentencing Reporter, Vol. 29, No. 1 October 2016
Jail
OpioidsTrauma
Source: CDC
A Research Brief on Child Well-Being
Commissioned by the NY Council on Children & Families
Published in 2010
Reavis, James A et al. “Adverse Childhood Experiences and Adult Criminality: How Long Must We Live before We Possess Our Own Lives?” The Permanente Journal 17.2 (2013): 44–48. PMC. Web. 27 Oct. 2017.
ACEs in ATI Clients
Jail
OpioidsTrauma
Opioid epidemic major contributor to rural jail overcrowding, by Brian Molongoski
Watertown Daily Times, June 18, 2017
Inboarding vs. Outboarding and revenues
http://www.watertowndailytimes.com/ogd/opioid-epidemic-major-contributor-to-rural-jail-overcrowding-20170618
Higher rates of cardiovascular disease, diabetes, respiratory disease, and infectious disease (including HIV)
Elevated risk factors due to high rates of smoking, substance misuse, obesity, and unsafe sexual practices
Increased vulnerability due to poverty, social isolation, trauma and violence, and incarceration
Lack of coordination between mental and primary healthcare providers
Prejudice and discrimination Side effects from psychotropic medications Overall lack of access to health care, particularly
preventive care
Source: SAMHSA
Webb v US (1919)
MAT Options◦ Methadone◦ Buprenorphrine
Suboxone
◦ Naltrexone (Vivitrol)
Harm Reduction Approaches◦ Naloxone (Narcan)◦ Stages of Change◦ Motivational Interviewing
Brief Trauma Questionnaire (10 questions)
PTSD Checklist (17 questions)
Tx providers with expertise in COD
TIC is an approach / competency, not a service
Overview of
P2PH Initiative
Public Health
Perspective on
Reentry
Best Practices
in Community
Supervision
Opportunities
for Innovation
in Pre-Trial
Risk – Needs – Responsivity
Screens for SMI: schizophrenia, bipolar, major depression
Six questions re: symptoms
Prior psych hospitalization(s)
Current use of psychotropic meds
Validated in a study that included 10,330 detainees from New York and Maryland;
Takes 2.5- 3 minutes to administer.
17-item instrument with which utilizes closed ended check off questions;
Takes 8-10 minutes to administer
TCUDS provides a self-report measure of substance use problems within the past 12 months.
The TCUDS-V is an updated version of TCUDS-II and is based on the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5);
What should Team Collaboration look like?
Consistent Communication between treatment providers and community supervision officers
Client Advocacy,
Reports,(i.e. email, progress reports, telephone communication) and
Interagency Dialogue (i.e. Case conferences, meetings )
Dr. Larry Thornton, LCSW, NYC DOP Behavioral Health Unit
Level of Service Inventory – Revised (LSIR)
Assertive Outpatient Treatment (AOT)
SSI/SSDI Outreach, Access, and Recovery (SOAR)
Harm reduction approaches
Public Health Department
Hospital System
In-patient and out-patient tx providers
Supportive Housing Providers
Managed Care Organizations
Health Homes
Workforce Development / Higher Education
Religious Institutions
Overview of
P2PH
Initiative
Public
Health
Perspective
on Reentry
Best
Practices in
Community
Supervision
Opportunities
for Innovation
in Pre-Trial
NY Bail Reform Advocacy◦ November 6th at 6pm – Community Conversation
about Bail Reform in NY, Capital South Campus Center, 20 Warren Street
LEAD Albany Partners
Harm reduction framework for CJ practitioners
Naloxone training & equipment (all)
Crisis Intervention Team (CIT) Training◦ 6,000 NYPD trained to date, pace of 90/week
Law Enforcement Assisted Diversion (LEAD)
Heroin Overdose Prevention & Education (HOPE)
Co-Response Teams – Psychologist + PD
Pre-Arraignment Screening Unit (PASU)
◦ 50,000 clients seen by LCSW since May 2015
◦ Electronic Screening (5 min)
◦ Rikers EHR (31%) & PSYCKES
◦ 25% referred to NP for enhanced screening
◦ Clinical summary provided to Def. Attorney
◦ > 1% sent to ER (est. 2000 trips avoided)
Raw Points Risk Points NOTES
16 to 19: 6 0
20 to 29: 1 0
30 to 39: -3 0
40 & up: -4 0
No: -1 0
Yes: 1 0
No: 3 0
Yes: -3 0
No: 2 0
Yes: -2 0
No: -1 0
Yes: 1 0
No: -2 0
Yes: 2 0
No: -1 0
Yes: 1 0
No: -2 0
Yes: 2 0
Fulltime Activity
Warrant in last 4 years
Misd. Conv. in last 1 year
Fel. Conv. in last 9 years
From Full RAP History
Age
Open Cases
First Arrest
Drug conv. in last 9 years
From CJA Interview Report
From CJA Interview Report
From CJA Interview Report
From CJA Interview Report
From Full RAP History
From Full RAP History
From Full RAP History
Low Minus 10 or lowerMedium-Low Minus 9 to Minus 5Medium Minus 4 to ZeroMedium High 1 to 4High 5 or higher
Arraignment Courts – NYC SRP
Supervised Release
8,907 8,931 8,796 8,567
8,3818,550
8,332 8,208 8,314
7,173
6,642 6,359
5,9525,782 5,802 5,717
6,041 6,006
5,000
6,000
7,000
8,000
9,000
10,000 2016 2017
16.3% decrease over first six months
Project Reset
HOPE/LEAD
Blanket Non-pros Orders
In-house ATI departments
Failure to
Appear
Unnecessary
Detention
Questions?
Jeffrey CootsJohn Jay College of Criminal Justicejcoots@jjay.cuny.edu212-484-1157