Decarcerating Correctional Facilities during COVID-19 Advancing Health, Equity, and Safety (2020) / Chapter Skim
Currently Skimming:
5 Guidance for Depopulating Correctional Facilities
5 Guidance for Depopulating Correctional Facilities
Pages 79-108
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 79... ...
Incarcerated people once infected are three times more likely to die from COVID-19 than the general population (Saloner et al., 2020)
|
From page 80... ...
summarizing scholarship on COVID-19 and correctional facilities and assembling and analyzing data on COVID-19 infection in incarcerated people and staff and decarceration trends; and (3) describing prior scholarship on recidivism and evidence-based reentry supports, detailing the challenges and opportunities for responding effectively to the pandemic in the current context.
|
From page 81... ...
Attention to COVID-19 Prevention and Control among Incarcerated Individuals Following CDC and other official guidance and through informal sharing of lessons between correctional leaders, facilities have adopted a range of approaches to prevent and mitigate SARS-CoV-2 transmission. These include population management (quarantines, medical isolation, cohorting, and single celling)
|
From page 82... ...
March 29, 2020 • First incarcerated person with a positive test for COVID-19 • Implemented a statewide quarantine of incarcerated people • Incarcerated individuals ate in their cells but were allowed out-of-cell time for video visits, phone calls, and access to the law library, as well as provided with in-cell programming a facility. Quarantines involve separating individuals who are exposed to or expected to have an infectious disease from others in the facility until their disease status is known.
|
From page 83... ...
confinement are used for quarantines or medical isolation, individuals may mask or disguise coronavirus symptoms for fear of being sent to solitary confinement, which could lead to more extensive outbreaks (Cloud et al., 2020; Williams, 2020)
|
From page 84... ...
Furthermore, correctional staff can be assigned to a single cohort, reducing the mixing of correctional staff with many different incarcerated people. In some state prison systems, disused facilities or housing units were reopened in order to quarantine and/or medically isolate incarcerated people.
|
From page 85... ...
Communication with Incarcerated Individuals and Their Families Correctional leaders in some systems have used frequent communication with incarcerated individuals and correctional staff to encourage compliance with COVID-19 protective measures. The Correctional Leaders Association recommends "overcommunication" between corrections leaders and incarcerated individuals, with regular explanations of operational changes as they happen (CLA, 2020)
|
From page 86... ...
Attention to Prevention among Correctional Facilities Staff The most recent CDC guidance details protections for correctional staff (CDC, 2020) , and public health experts emphasize the central importance of the occupational health of correctional staff to mitigating COVID-19 in correctional facilities (Sears et al., 2020)
|
From page 87... ...
• Equal regard and fairness with view to mitigation of health and ra cial inequities -- The principle of equal regard recognizes the equal worth and value of all people, protecting them from discrimina tion, when determining fair approaches to limiting the use of custody and releasing individuals from correctional facilities. This principle requires that decarceration strategies be implemented in ways that do not raise risks to the health and well-being of already vulnerable individuals, families, and communities, and it also acknowledges how institutions and structures continue to increase the risk of incarcerated people for poor health outcomes, especially for Black and low-income people.
|
From page 88... ...
Decarceration is a process, not a one-time action, and will vary by state and jurisdiction, adjusting as needed for the state of viral transmission within a correctional facility and the surrounding community and the complement of housing, health care, and income supports necessary and available at the time. Safe and equitable decarceration will require a mix of policy and practice decisions among federal, state, and local officials and will require actions to reduce the number of people detained and to release incarcerated individuals from correctional facilities.
|
From page 89... ...
During public health crises, there are few compelling public safety reasons to hold many people in custody. While there may often be risks of criminal behavior in the future, for many individuals, especially those held in pretrial detention, evidence suggests these risks are relatively low (see Chapter 3)
|
From page 90... ...
However, consideration of health equity prompts a deeper look at incarcerated individuals, especially those in prisons, who tend to be at greater risk for COVID-19 due to their age, the presence of chronic health conditions, and the length of potential exposure given their typically longer sentences. While the total prison population across the country has declined by roughly 5 percent since the onset of the pandemic (Franco-Paredes et al., 2020; see also Chapter 3)
|
From page 91... ...
Compassionate release -- intended to reduce sentences and release incarcerated people for compelling reasons, usually related to medical and family circumstances -- would in theory be appropriate during the pandemic. However, the committee's review of state policies revealed substantial barriers to using compassionate release policies to shorten sentences when incarcerated people are facing significant risks to health, including death, hampering the ability of jurisdictions to undertake large-scale releases.
|
From page 92... ...
Recommendation 4: Given the extreme medical vulnerability of some incarcerated people to COVID-19, federal and state policy makers should revise compassionate release policies to account for petition ers' medical condition, age, functional or cognitive impairment, or family circumstances. Because of the severity of the health risks, such applications should be reviewable by the courts or some other decision maker external to the standard parole process and should allow scope for representation by counsel in the process on behalf of petitioners.
|
From page 93... ...
. Incarcerated people being released need to therefore be given phones, preferably with video capacity, through a prepaid cell phone service or expedited referral to the Federal Communications Commission's lifeline service.
|
From page 94... ...
94 DECARCERATING CORRECTIONAL FACILITIES DURING COVID-19 TABLE 5-1 Strategies for Ensuring the Availability of a Bundle of Supports and Services for Reentry Domain General Postdischarge Concerns COVID-19–Specific Concerns Housing • Limited access to housing; high risk for • Shortage of reliable and safe homelessness noncongregate housing • Families live in housing and neighborhoods at high risk if infected Food • Limited access to public assistance and • Interruption of normal Security SNAP benefits food supply chains; difficulty obtaining government IDs Income • Extreme poverty • Economic recession, high • Income instability unemployment • Difficulty enrolling in SSI • Limited eligibility for social insurance programs like unemployment insurance, SSDI Health • Gaps in primary care and substance • Limited outpatient Care use and mental health treatment, and inpatient capacity; Access high utilization of emergency care, transition to telemedicine discrimination; many have never used services; limitations on or the community health system cessation of new patient visits Health • Underinsurance or lack of insurance • Difficulty obtaining Insurance common among release individuals government IDs • Medicaid/Medicare coverage is terminated instead of suspended NOTES: DEA, Drug Enforcement Agency; SAMHSA, Substance Abuse and Mental Health Services Administration; SNAP, Supplemental Nutrition Assistance Program; SSDI, Supplemental Security Disability Insurance; SSI, Supplemental Security Income. SOURCE: Adapted from Howell et al.
|
From page 95... ...
GUIDANCE FOR DEPOPULATING CORRECTIONAL FACILITIES 95 Strategies • Perform COVID-19 tests on individuals prior to release • Expand access to noncongregate transitional housing, rapid rehousing, and permanent supportive housing programs • Eliminate bans on housing assistance and tenancy in public housing based on criminal record • Facilitate SNAP enrollment prerelease • Eliminate work requirements and bans on public assistance based on criminal record • Provide financial support at the time of release to the individual/family • Program enrollment prior to release as part of discharge planning • Obtain ID to assist in enrollment in income support programs and benefit receipt • Ensure all people have access to a phone appropriate for telemedicine • Provide timely primary care • Arrange for coordination between correctional and community health • Arrange for effective transfer of health records • Provide a 90-day supply of medication • Expand funding and capacity to enhance primary care based transitional services, including peer/community health workers • Maintain SAMHSA and DEA measures to increase access to buprenorphine and methadone and further deregulation • Facilitate expedited Medicaid/Medicare enrollment • Facilitate use of Medicaid waivers 1115 and 1135 • Allow Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period prior to the individual's release • Eliminate termination of Medicaid upon incarceration
|
From page 96... ...
The economic downturn brought on by the COVID-19 pandemic poses particular challenges for individuals who may be decarcerated during this period and require special considerations for social support systems related to employment, income support, and food security. Income support typically relies on the major federal antipoverty and social insurance programs, such as SNAP, Supplemental Security Income, and Social Security Disability Insurance, as well as unemployment insurance.
|
From page 97... ...
(b) State and local officials should identify barriers to access pub lic benefits for individuals returning from incarceration; work to maintain continuity of benefits; and support enrollment in benefits for income and basic needs, including access to the Supplemental Nutrition Assistance Program, Medicaid, Medi care, and Supplemental Security Income.
|
From page 98... ...
Many of the families and communities associated with incarcerated individuals are vulnerable to health risks, food and housing insecurities, and other forms of socioeconomic disadvantage because of the many existing institutional and structural barriers. Those challenges and needs have been exacerbated in the wake of COVID-19.
|
From page 99... ...
. Recommendation 6: Correctional officials in coordination with local public health authorities should implement measures to avoid creating additional COVID-19–related health risks for families and commu nities.
|
From page 100... ...
Improving Access to Health Insurance upon Release Access to health insurance or assistance with navigating health care benefits is important for successful reentry during COVID-19. As discussed in Chapter 4, there are many barriers to Medicaid eligibility for incarcerated and formerly incarcerated individuals.
|
From page 101... ...
There is evidence that tailoring health care practices to this population's needs by hiring peers or community health workers with past histories of incarceration can improve patient engagement in health care (Cunningham et al., 2018; Wang et al., 2008; ) and reduce preventable hospitalization, also reducing future contact with the criminal justice system (Wang et al., 2019)
|
From page 102... ...
As prison conditions and populations and the laws governing them are likely to change, existing state and federal public health agencies could provide an ongoing review of incarceration and release policies from a public health perspective and help ensure that the criminal justice system is prepared to respond appropriately to public health crises. These efforts could include the establishment of a planning and review group comprising public health experts, health care providers, and community representatives, including formerly incarcerated individuals, in collaboration with correctional officials and lawmakers, to review release policies from a public health perspective that weighs medical criteria and public health considerations with criminal justice system considerations.
|
From page 103... ...
In the context of an emergency, a group convened by federal, state, or local government could also be empowered to implement decarceration strategies in accordance with public health preparedness plans. In their deliberations, the group would need to consider both the needs of incarcerated people and those of staff, who also face elevated risks of harm during a pandemic.
|
From page 104... ...
Immigration and Customs Enforcement, and juvenile facilities) should report daily standardized, aggregated data on COVID-19 incidence, testing rates, hospitalizations, mortality, and all-cause-mortality among incarcerated people and staff by age, gender, and race/ethnicity to public health officials as directed and via a public-facing website or dashboard.
|
From page 105... ...
GUIDANCE FOR DEPOPULATING CORRECTIONAL FACILITIES 105 BOX 5-3 Data That Should Be Reported by Correctional Facilities COVID-19 Data: All data would include age, race, gender, and sex of individuals in each of these categoriesa • COVID-19 Risk: Prevalence of COVID-19 risk factors • COVID-19 Testing: Information relevant to the type of test used, number of people tested and retested, and number of tests administeredb • COVID-19 Cases: Information on the number of new, active, and cumula tive positive cases identified among incarcerated people and staff • COVID-19 Recovery: Information on the number of recovered cases among incarcerated people and staff • COVID-19 Hospitalization: Information on the number of incarcerated people and staff who have been and are currently hospitalized • COVID-19 Deaths: Information on deaths from COVID-19 among incar cerated people and staff • All-Cause Deaths: Information on deaths from other causes among in carcerated people and staff • Medical Isolation and Quarantine: Information on the number of incarcer ated people and staff in quarantine and medical isolation (including staff on sick leave) Demographic Data of Incarcerated Population: All data would include aggregate data on age, race, gender, and sex of individuals in each of these categories • Daily Population: Daily population of both incarcerated people and staffc • Jail Status Counts: Counts of jail population that distinguish between sentenced and unsentenced populations Decarceration Data: All data would include age, race, gender, and sex of individuals in each of these categories • Releases: Information on the number of people who have been released to mitigate COVID-19 risk by type of released (e.g., releases by facility, ordered by court or governor)
|
From page 106... ...
Furthermore, research should aim to examine the mutual influence of community and correctional facility on the transmission of disease, including the influence of community health conditions on the prevalence of infection and virus transmission inside correctional facilities and the influence of correctional facilities on surrounding communities. CONCLUSION In the perspective of this report, public safety encompasses good public health.
|
From page 107... ...
The actions the nation takes now to prevent and mitigate COVID-19 will need to be measured and evaluated, as they represent an opportunity for learning to guide improvements to correctional health (and, by extension, to public health in vulnerable communities) and to the equitable and just use of incarceration.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.