10/28/2015. Medical Alternatives to Incarceration: Health Liaison to the Court Advocates for Community Health and Health in All Policies
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1 Medical Alternatives to Incarceration: Health Liaison to the Court Advocates for Community Health and Health in All Policies Alison O. Jordan Jacqueline Cruzado-Quinones Randi Sinnreich, Lea Hane, Ross MacDonald, Zachary Rosner, Quintin Maidment, Homer D. Venters NYC HHC Correctional Health Services American Public Health Association Annual Meeting November 3, 2015 Background / History 1989: First Drug Court established Miami, Florida 2004: NYC CHS creates medical discharge planning program 2005: NYC CHS creates HIV Continuum of Care Model (HCCM) 2007: HRSA SPNS Jail Linkages funds NYC HCCM using 2008: NYC CHS & Drug Court representatives establish collaborative 2012: 2,734 Drug Courts operating in every U.S. state and territory 2015: HRSA SPNS seeks to replicate the HCCM using NYC Diversion Courts Treatment courts for those with first time non-violent felon charges; monitored by substance use treatment programs Detox Treatment Alternatives to Prison (D-TAP) for those facing felony charges; run by DA offices Alternatives To Incarceration court-mandated SATP placements monitored by justices Judicial diversion programs at the judge s discretion (Article 216) TASC (Treatment Accountability for Safer Communities) facilitates Court mandated treatment for all populations; not available in Manhattan 1
2 to the Court Facilitates : Community alternatives to incarceration (ATI) Medical informed placements in lieu of continued incarceration: o Program placement (substance use treatment) o Compassionate release (skilled nursing / hospice care) Service plans address: Individual health and social support needs Public safety Health information: Medical summary, labs, TB screening and psycho-social history Patient Review Instrument (PRI) for nursing home placement Patient care management needs (letter from MD) Care Coordination: Defense attorney, prosecutor, justices and jail health staff Community and jail providers Process Flow A. Court Affiliate/ Legal Aid PRU requests Assistance B. CHS contacts Court Affiliate for medical placement (nursing home or hospice) with client consent identifies jail-based Patient Care Coordinator (PCC) requests PRI from CHS Nursing requests MD letter (as needed) PCC obtains client consent & sends health information to Court Affiliate and Medical team confer with defense / district attorneys or justices toward compassionate release or medical placement in lieu of incarceration Court affiliate identifies community resource and updates PCC and Health Liaison identifies community resource and updates Court Affiliate Placement Verification is documented in CHS health record Referral Source 16% 19% 65% Court Affiliate Initiated Legal Aid Society Parole Revocation Unit CHS Initiated 2
3 Outcome Summary Clients Oct Sept Clients Released Verified Linkages to Care 91% Verified Linkages to Care After Release Parole Revocation Cases % Restored Total Parole Cases Revoked & Restored to Parole CHS Initiated 120 Nursing Home (86% Placement Rate) Non Traditional Medical Alternatives (44% Placement Rate) Applications Placements Compassionate Release (90% Placement Rate) 3
4 Presenting Issues Substance Use (Non-HIV) HIV Other Medical Conditions 16% 8% Medical Letters 21 letters 10 compassionate release HIV, cancer, Liver/renal disease, TBI/seizure, cardio-vascular, diabetes, hypertension, retinopathy, polysubstance use, mental illness. 76% Outcomes From to , 793 individuals received services Released & Linked N=545 Other N= 248 Court mandated ATI Parole R&R Non-traditional medical ATI 1% 15% 21% 63% Incarcerated Ineligible for program Unknown Declined program option Case dismissed 4% 3% 1% 4% 12% 76% Compassionate release Died Court Affiliates & Collaborators Legal Aid Society and Legal Aid Society Parole Treatment Court Treatment Accountably for Safer Communities (TASC) The Bronx Defenders Brooklyn Defender Services Neighborhood Defender Services of Harlem NY County Defender Services Midtown Community Court Drug Treatment Court (DTAP) 18b Attorneys Private Attorneys 4
5 Contact us Alison O. Jordan, Senior Director Jacqueline Cruzado-Quinones, Program Manager Randi Sinnreich, Director, Transitional Service Projects /
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