Prepared by Jeffrey Coots, JD, MPH

John Jay College of Criminal Justice

Special thanks to Peter Kiers, Jonathan Heller,
Charlene Leistman, Sue Mowrey, Craig McNair
& David Lowry

P2PH is funded in part by NYC Dept of Health &

Mental Hygiene, the Van Ameringen
Foundation and the Langeloth Foundation,
along with several research projects funded by
NYC Mayor’s Office of Criminal Justice and
National Institute of Justice
Overview of Public Health Best Practices Opportunities
P2PH Perspective in Community for Innovation
Initiative on Reentry Supervision in Pre-Trial
P2PH is a consortium of academic, research,
policy and direct service agencies focused on
accelerating reforms at the intersections of public
health and public safety.

P2PH members recognize the endemic social and

structural problems that lead to incarceration.
We strive to position public health interventions
to be successful and held accountable to better
health, safety and social outcomes and to reduce
the risks of criminal and anti-social behaviors.
 Stimulate collaborative
dialogues across disciplines

Accelerate innovation & the

adoption of proven strategies

Build systemic capacity of

community-based providers
 Pre-Arrest Diversion
in NYC Subways

Court-Based Health
Engagement

Annual
Interdisciplinary
Conference
 NYC • Knowledge sharing
Health & Justice • Data integration
Working Group • Policy advocacy

Pre-Arrest
•Upstream at arrest / booking
Diversion for
•220.03, petit larceny,
Drug-related
trespassing
charges
 Blended
Homeless
CJ/Health
“HotSpots”
profiles

Supervised
Release
Harm Prison
PH & gun
Reduction reentry SMI
violence
EBPs homeless
Overview of
Public Health Best Practices Opportunities
P2PH Perspective on in Community for Innovation
Initiative Supervision in Pre-Trial
Jail / Reentry
Courtesy of NYC DOHMH
 Jail

Trauma Opioids
From John Jay’s
Misdemeanor
Justice Project;
Preeti Chauhan;
DCJS Data

Other Urban:
Albany, Buffalo,
Rochester,
Syracuse and
Yonkers
Source: Vera Institute’s Incarceration Trends webtool
at http://trends.vera.org/incarceration-rates
via Green & Schiraldi
Greene, J.A. & Schiraldi, V. Better by Half: The New York City Story
of Winning Large Scale Decarceration while Increasing Public Safety.
Federal Sentencing Reporter, Vol. 29, No. 1 October 2016
 Jail

Trauma
Opioids
Source: CDC
A Research Brief on Child
Well-Being

Commissioned by the NY
Council on Children &
Families

Published in 2010
ACEs in ATI Clients

Reavis, James A et al. “Adverse Childhood Experiences and Adult

Criminality: How Long Must We Live before We Possess Our Own Lives?”
The Permanente Journal 17.2 (2013): 44–48. PMC. Web. 27 Oct. 2017.
 Jail

Trauma Opioids
 https://nyti.ms/2yPfXQI
Opioid epidemic major contributor to rural jail
overcrowding, by Brian Molongoski

Watertown Daily Times, June 18, 2017

Inboarding vs. Outboarding and revenues

http://www.watertowndailytimes.com/ogd/opioid-epidemic-major-
contributor-to-rural-jail-overcrowding-20170618
 Higher rates of cardiovascular disease, diabetes,
respiratory disease, and infectious disease
(including HIV)
 Elevated risk factors due to high rates of
smoking, substance misuse, obesity, and unsafe
sexual practices
 Increased vulnerability due to poverty, social
isolation, trauma and violence, and incarceration
 Lack of coordination between mental and primary
healthcare providers
 Prejudice and discrimination
 Side effects from psychotropic medications
 Overall lack of access to health care, particularly
preventive care
Source: SAMHSA
 Webb v US (1919)

 MAT Options
◦ Methadone
◦ Buprenorphrine
 Suboxone
◦ Naltrexone (Vivitrol)

 Harm Reduction Approaches

◦ Naloxone (Narcan)
◦ Stages of Change
◦ Motivational Interviewing
Brief Trauma Questionnaire (10 questions)

PTSD Checklist (17 questions)

Tx providers with expertise in COD

TIC is an approach / competency, not a service

 Best Practices
Public Health Opportunities
in Community
Overview of
Perspective on for Innovation
P2PH Initiative
Reentry in Pre-Trial
Supervision
Risk – Needs – Responsivity
 Screens for SMI: schizophrenia, bipolar, major
depression

 Six questions re: symptoms

 Prior psych hospitalization(s)
 Current use of psychotropic meds

 Validated in a study that included 10,330 detainees

from New York and Maryland;

 Takes 2.5- 3 minutes to administer.

 17-item instrument with which utilizes closed ended check
off questions;

 Takes 8-10 minutes to administer

 TCUDS provides a self-report measure of substance use

problems within the past 12 months.

 The TCUDS-V is an updated version of TCUDS-II and is based

on the most recent Diagnostic and Statistical Manual of
Mental Disorders (DSM-5);
What should Team Collaboration look like?
 Consistent Communication between
treatment providers and community
supervision officers
 Client Advocacy,
 Reports,(i.e. email, progress reports,
telephone communication) and
 Interagency Dialogue (i.e. Case conferences,
meetings )
Dr. Larry Thornton, LCSW,
NYC DOP Behavioral Health Unit
 Level of Service Inventory – Revised (LSIR)

 Assertive Outpatient Treatment (AOT)

 SSI/SSDI Outreach, Access, and Recovery

(SOAR)

 Harm reduction approaches

 Public Health Department
 Hospital System
 In-patient and out-patient tx providers
 Supportive Housing Providers
 Managed Care Organizations
 Health Homes
 Workforce Development / Higher Education
 Religious Institutions
Overview of
Public Best Opportunities
Health Practices in
P2PH
Perspective Community
for Innovation
Initiative
on Reentry Supervision in Pre-Trial
 NY Bail Reform Advocacy
◦ November 6th at 6pm – Community Conversation
about Bail Reform in NY, Capital South Campus
Center, 20 Warren Street

 LEAD Albany Partners

 Harm reduction framework for CJ

practitioners
 Naloxone training & equipment (all)

 Crisis Intervention Team (CIT) Training

◦ 6,000 NYPD trained to date, pace of 90/week

 Law Enforcement Assisted Diversion (LEAD)

 Heroin Overdose Prevention & Education (HOPE)

 Co-Response Teams – Psychologist + PD

 Pre-Arraignment Screening Unit (PASU)
◦ 50,000 clients seen by LCSW since May 2015
◦ Electronic Screening (5 min)
◦ Rikers EHR (31%) & PSYCKES
◦ 25% referred to NP for enhanced screening
◦ Clinical summary provided to Def. Attorney
◦ > 1% sent to ER (est. 2000 trips avoided)
Arraignment Courts – NYC SRP
Supervised Release Raw Points Risk Points NOTES
16 to 19: 6 0
20 to 29: 1 0
Age From CJA Interview Report
30 to 39: -3 0
40 & up: -4 0
No: -1 0
Open Cases From CJA Interview Report
Yes: 1 0
No: 3 0
First Arrest From CJA Interview Report
Yes: -3 0
No: 2 0
Fulltime Activity From CJA Interview Report
Yes: -2 0
Warrant in last 4 years No: -1 0
From Full RAP History
Yes: 1 0
Misd. Conv. in last 1 year No: -2 0
From Full RAP History
Yes: 2 0
Fel. Conv. in last 9 years No: -1 0
From Full RAP History
Yes: 1 0
Drug conv. in last 9 years No: -2 0
From Full RAP History
Yes: 2 0

Low Minus 10 or lower

Medium-Low Minus 9 to Minus 5
Medium Minus 4 to Zero
Medium High 1 to 4
High 5 or higher
10,000
2016 2017
8,907 8,931 8,796
9,000 8,567 8,550
8,381 8,332 8,314
8,208

8,000
7,173

7,000 6,642
6,359
5,952 6,041 6,006
5,782 5,802 5,717
6,000

5,000 16.3% decrease over first six months

 Project Reset

 HOPE/LEAD

 Blanket Non-pros Orders

 In-house ATI departments

 Failure to
Appear

Unnecessary
Detention
 Questions?

Jeffrey Coots
John Jay College of Criminal Justice
jcoots@jjay.cuny.edu
212-484-1157