Projects: Improving the Health of Arrestees: The Pre-Arraignment Screening Initiative
For people with complex health conditions in need of timely access to medical services, the time between arrest, arraignment, and admission to jail is particularly dangerous and represents a missed opportunity to connect this population with much needed services and support. The Vera Institute of Justice is working with the New York City Department of Health and Mental Hygiene (DOHMH) to ensure that people who are arrested in the city have timely access to the health care that they need.
In 1994, New York City established Pre-Arraignment Screening Units (PASUs) meant to identify medical needs at the point of booking and direct those who require emergency care to city hospitals to receive treatment. However, the current paper-based medical screening process is outdated and does not provide an effective measure of emergency health conditions that require immediate attention. Vera and DOHMH will pilot and evaluate the effectiveness of an enhanced PASU and devise recommendations for capitalizing on the opportunity to link people with the treatment they need. Enhanced PASUs address several inter-connected problems resulting from the lack of communication including avoidable morbidity and mortality, unnecessary transfers to hospitals, and missed opportunities for public health interventions.
With funding from the Langeloth Foundation, this project will:
- Provide staff at existing PASUs in Manhattan courts with access to the jail electronic health records (EHRs) to improve clinical decision making;
- Develop a shared strategy among city agencies for sustaining the use of data stored in the EHR in a clinically effective manner; and
- Explore opportunities to use information gathered through PASU to improve decision making about individuals who are eligible for alternatives to incarceration.
Why This Work Matters
Compared to the rest of the population, people in jail have higher rates of mental illness, as well as infectious and other chronic diseases. Pretrial diversion programs and other alternatives to incarceration that link people with underlying health needs to treatment are not only more humane, but can also lead to cost savings by improving public health and reducing recidivism. Developing and implementing an enhanced PASU screening process will directly benefit a significant proportion of the nearly 320,000 people who pass through the city’s central booking units every year. This project may have longer-term benefits by creating the infrastructure needed to link the PASU to community health information resources, setting the stage for new public health-led interventions and diversion opportunities.