Jails Play Key Role in Advancing County Health and Safety Goals

A prison guard at Dade County Correctional Facility in South Florida.

A prison guard at Dade County Correctional Facility in South Florida. Shutterstock

 

Connecting state and local government leaders

But with short stays and high turnover, continuity of care after release is crucial.

This article was originally published by The Pew Charitable Trusts' States' Fiscal Health initiative and was written by Maria Schiff and Frances McGaffey.

Every year, millions of people are booked into U.S. jails. The jurisdiction holding them—usually a county—has a constitutional mandate to provide necessary health care while individuals are incarcerated. Yet to date, little has been known about how jails arrange this care.

According to new research from The Pew Charitable Trusts, jails fulfill this challenging obligation in a multitude of ways that reflect the diversity of counties in terms of size, resources, needs, and aims. They vary in the types of care offered, how it is paid for, and when it is routinely available, among other aspects. Understanding the range of practices and options available to jails as they design health care programs can help counties determine whether their programs can better meet their public health and safety needs.

According to Jonathan Thompson, the executive director of the National Sheriffs’ Association, treatment for mental illness is the most pressing issue facing sheriffs across the country. In fact, people in jail are more likely than the general population to have chronic and infectious diseases, mental illnesses, and substance use disorders. Short lengths of stay, ranging from a few hours to an average of 23 days, along with unpredictable releases and bookings, discourage development of care strategies for many people in jail or even the comprehensive screening such as might be required for accurately diagnosing a specific mental illness.

Connecting people leaving jails to available health or social services could improve health outcomes, decrease mortality rates, and save money. For example, recently released individuals with HIV who stay connected to primary care go to emergency departments less frequently than those without such a connection. They also exhibit a longer timespan between release from jail and their first emergency room visit. For individuals with behavioral health disorders, such connections could play a role in reducing recidivism rates and the overrepresentation of these individuals in correctional institutions. One financing vehicle for such services is Medicaid coverage, but another valuable resource is the Veterans Administration health system for those who qualify. As the country’s largest health care system it provides care to individuals in all 50 states and the District of Columbia, but can be especially useful for those not eligible for their state’s Medicaid program.

Jail health care is not just a criminal justice issue. Counties that invest effectively in jail health care can improve outcomes for their whole communities. After the San Francisco County jail introduced screening and treatment for chlamydia and gonorrhea, a nearby neighborhood clinic reported seeing fewer cases of these diseases among young women.

Despite the potential for care continuity services to further a broad range of county goals, from public health to public safety, it can be difficult for jails to offer them. Beyond the short stays, jails often lack the capacity to provide substantive programming. And even if they do offer such services, they need the cooperation and participation of health and social service organizations to which people leaving jails are likely to be referred.

Over the past few years, a range of initiatives have emerged as counties consider innovative approaches to running their jails, including diverting ill individuals from jail in favor of more appropriate treatment. The Stepping Up Initiative provides a forum for sharing best practices for reducing the number of people with mental illness in jails, while the MacArthur Foundation Safety and Justice Challenge provides funding to counties to help them develop and implement solutions to safely reduce their overall jail populations. The Data-Driven Justice Initiative brings communities together to identify the processes and policy frameworks needed to reduce the cycle of incarceration among individuals with complex health needs who repeatedly enter jails, emergency rooms, shelters, and other public systems.

Yet, when considering participation in any of these initiatives—or even concurrent with participating—policymakers can benefit from a better understanding of how specific jail health care and release programs are furthering public health and safety goals. And because jurisdictions are so varied, additional research is needed to understand which counties are achieving the greatest success at meeting these universal goals and how best to adapt their programs to meet localities’ needs and resources.

Maria Schiff is a senior officer and Frances McGaffey is a senior associate in The Pew Charitable Trusts’ project on states’ fiscal health.

FEATURED CASE STUDIES
Powered By The Atlas
Forecasting Ambulance Needs for the City of San Diego
San Diego, CA, USA
A large urban park creates a "connected" visitor experience with SMART.NODEs™
Sydney NSW, Australia
Community feedback increases 13x in Lancaster, PA with both offline and online engagement methods
Lancaster, PA, USA

NEXT STORY: There Are Hundreds of New State Gun Laws And Most Expand Access

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.