Report

Human Toll of Jail Mental Health Reentry October 3, 2024

Implementing the Medicaid Reentry Waiver in California

Lore Joplin, Justice System Partners, Maureen McDonnell, TASC’s Center for Health & Justice, Kimberly Richards, Justice System Partners, Miriam Popper, Justice System Partners, Vikki Wachino, Health and Reentry Project, Margot Cronin-Furman, Health and Reentry Project, John Sawyer, Waxman Strategies, Silicia Lomax, Waxman Strategies, David Ryan, Health and Reentry Project

In January 2023, California became the first state in the nation to receive approval from the federal Centers for Medicare and Medicaid Services (CMS) for a Medicaid Section 1115 demonstration request to amend Medicaid’s inmate exclusion. People detained in jails and prisons have high rates of chronic and acute health needs, including physical, mental health, and substance disorders and reentry is a high-risk time. A key to addressing these reentry risks is addressing people’s health needs while they are incarcerated and building continuity of care from jail to community when they are released.

California’s waiver, called California’s Advancing and Innovating Medi-Cal (CalAIM), and the specific component focused on individuals who are transitioning out of the criminal justice system, the Justice Involved (JI) initiative, will for the first time provide a targeted set of Medicaid-covered services right before someone is released from prison or jail. These services aim to smooth reentry transitions from jail and prison to the community, establish better connections to community-based providers at release, and enhance access to necessary care and support. California’s approach is designed to reduce the high risk of post- release mortality, morbidity, and other adverse outcomes, including repeat contact with the criminal justice system, by bringing Medicaid financing and coverage standards to bear.

The work to implement California’s waiver and make these changes a reality is demanding, involving multiple partners at the state, county, and local level who have not previously worked together at this level of vital cross-system collaboration. Implementation of these changes is well underway, and county-level changes will roll out over the next two years, starting in October 2024. This paper highlights California’s implementation approach, focusing on the county-level impacts on jails, health care providers, and reentry processes. It also explores several implementation challenges and the steps the state and the counties have taken thus far to implement this change.

The John D. and Catherine T. MacArthur Foundation’s Safety and Justice Challenge Initiative provides funding for this project, including technical assistance conducted by Justice System Partners (JSP) and the Health and Reentry Project (HARP). As part of the project, JSP and HARP conducted interviews and group discussions with representatives from 11 California counties and the California Department of Health Care Services (DHCS) who offered insights into implementation challenges and promising approaches to maximize the benefits of these important changes.

Companion Paper: Using a Learning Collaborative to Facilitate Broad Systems Transformation

In this paper, we explore the process and impact of convening a cross-sector peer learning network to foster coordination and collaboration between criminal justice, health care, behavioral health and community parters in support of this new Medicaid and criminal justice initiative.

Read more on our blog.

Report

Incarceration Trends Presumption of Innocence Pretrial and Bail Pretrial and Jails Pretrial Justice Pretrial Services October 12, 2022

Cages Without Bars

Patrice James, Illinois Black Advocacy Initiative
James Kilgore, MediaJustice
Gabriela Kirk, Center for Policy Research at Syracuse University
Grace Mueller, Chicago Appleseed Center for Fair Courts
Sarah Staudt, Chicago Appleseed Center for Fair Courts
Emmett Sanders, Challenging E-Carceration
LaTanya R. Jackson Wilson, Shriver Center on Poverty Law

Pretrial Electronic Monitoring Across the United States


Across the United States each year, hundreds of thousands of people accused but not yet convicted of crimes are required by the courts to participate in electronic monitoring programs. These people are fitted with a locked, tightened ankle shackle, which often tracks every move they make.


Pretrial electronic monitoring programs represent a fast-growing type of incarceration that imposes significant harm and burdens on people who are subject to it. We interviewed people subject to monitoring, program administrators, judges, prosecutors, and defense attorneys across select jurisdictions to better understand how pretrial electronic monitoring is used.

Report

Courts Data Analysis Frequent Jail Users Incarceration Trends Probation Sanctions May 5, 2022

Trends in Jail Incarceration for Probation Violations

Rochisha Shukla, Ammar Khalid, Arielle Jackson

Urban Institute report on Trends in Jail Incarceration for Probation Violations

In partnership with the Adult Probation Department in Pima County, Arizona, and as part of broader research funded by the Safety and Justice Challenge to examine the impact on jail use of providing housing supports for people on probation in Pima County, the Urban Institute analyzed trends in jail incarceration for people with probation violations using datasets for overall jail bookings in the county from 2015 to 2020 and petitions-to-revoke for people on probation from 2016 to 2020. This case study summarizes our findings on patterns in overall jail bookings and petitions-to-revoke and, for the probation population in jail, analyzes average lengths of stay and patterns by race and ethnicity and sex.

Report

Data Analysis Human Toll of Jail Pretrial and Bail September 9, 2020

In the Shadows: A Review of the Research on Plea Bargaining

Ram Subramanian, Leon Digard, Melvin Washington II, and Stephanie Sorage (The Vera Institute of Justice)

There are concerns about plea bargaining’s coercive nature, its role in encouraging the forfeiture of procedural protections, and its role in fueling mass incarceration. In order to provide an accessible summary of existing research, the Vera Institute of Justice, with support from the Safety and Justice Challenge, examined the small but growing body of empirical studies that has developed around plea bargaining. The result is a mix of complicated, nuanced, and sometimes contradictory research findings.

Power of “The People”: Rethinking Prosecution Towards Greater Community Safety

By: Chidinma Ume, Chloe Aquart

Community Engagement Pretrial Services Prosecutors May 12, 2020

The mass uprisings spurred by the killing of George Floyd, Breonna Taylor, and other Black Americans, have led many people to ask what role police should play in keeping communities safe. Despite this focus on policing, an observer of the criminal legal system might tell you that how police enforce laws is often influenced by how prosecutors handle criminal cases. We, as former prosecutors working to assist jurisdictions across the country with justice reform, believe the strategies outlined below are starting points for prosecutors to help promote a new vision of justice.

As cities explore ways to safely reduce the footprint of law enforcement, is there a reckoning that needs to happen for prosecutors? How might prosecutors better reflect communities’ values for public safety and provide community-driven solutions to crime? Given that prosecutors wield substantial influence over how laws may be enforced, we will benefit from prosecutorial approaches that improve people’s ability to sustain their own safety and the wellness of their communities.

As our colleagues at the Center for Court Innovation have set forth in Shrinking the Footprint of Police: Six Ideas for Enhancing Safety, there are proven ways for localities to invest in solutions that increase safety, limit the use of police, and remain rooted in anti-racist, community centered practices.

Prosecutors, too, have the ability—and indeed, an opportunity—to take these efforts even further.

This moment can inspire prosecutors, who see their role as representing the interests of the “the People” (their constituents), to forge new practices, partnerships, and programs that complement community-led safety efforts.

New Practices

First, prosecutors can develop practices that prioritize the well-being of survivors and accused people. Enter, again, the outside observer of the criminal legal system. This person sees prosecutors mostly urging swift legal action against people arrested for crimes. And the consequences are primarily retributive in nature: file charges, seek a conviction, and pursue an accompanying sentence. Prosecutors are trained to review an accused person’s criminal history and the alleged offense to recommend how the justice system should respond to the accused. These factors are indeed relevant to how cases might best be resolved, but how might early decision-making improve with more information? Perhaps the accused has a long trauma history, has unmet mental health needs, or is battling a substance use disorder without resources to address it. What if one or many of these factors contributed to the alleged offense? Prosecutors would do well to embrace a more holistic view of who accused people are early and often.

Prosecutors, who often advocate for sentencing outcomes, can also push for options other than jail to promote a person’s healing and community restoration. This concept is not new to prosecutors. They often obtain similar information, about how harm has affected someone, to better understand survivors and witnesses on their cases. Given that accused people are also part of communities that we want to keep safe, it is important to extend this practice to them.

New Partnerships

Along with developing the internal practices needed to ensure consistency between the office’s mission and its culture, prosecutor’s offices must embrace existing community solutions early and often. Community-based organizations (CBOs) provide tailored and targeted services that are needed in community as supplements to the social services provided by city and state government. Prosecutors can use these services as early on in cases as possible. In certain instances, they can also hold off on prosecuting people while they participate in these programs, to reduce further exposure to the court system. As an office beholden to its constituents and charged with protecting community safety, prosecutors must be familiar with and use community-based organizations and the services they provide as a bridge between the criminal justice system and communities affected by crime. Research supports this approach.

New & Expanded Programs

Once formal pathways to community-based services are in place, prosecutors may begin to identify gaps in the landscape to safely meet people’s needs outside of the court system. Maybe there’s a need for more programs that can reflect the cultural and ethnic needs of constituents. Perhaps services need to be available beyond business hours to serve people at the most critical times. There may also be a demand for more holistic programming that can offer housing and employment support—for accused people and their families—to help address the root causes of contact with the court system.

Whatever the needs may be, localities must be in a position to meet them if they intend to provide the supports that can preemptively address community needs. This kind of response takes investment, and prosecutors are in a unique position to offer a much-needed assist. Prosecutor’s offices often have access to civil asset forfeiture funds, which allow police and prosecutors to seize property with a suspected connection to criminal activity. These resources are often funneled back into the budgets of these same entities to spend in ways that promote public safety. To this end, prosecutors could invest asset forfeiture funds in local organizations that provide services to court-involved people.

Safe communities require investment—in networks and resources that can respond more nimbly, and often more affordably, than government might sometimes be able to do. At this moment of reckoning, prosecutors, too, can examine ways to heed communities’ renewed concerns about the criminal legal system.

Prosecutors can harness their power as representing “the People” to heed their call to broaden our view of how to keep them safe. This cannot happen unless we promote a culture that prioritizes healing and well-being over convictions. Indeed, prosecutors, who see their role as seeking justice can lead the charge to promote more human-centered approaches, for people accused of crime and survivors.