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White House Announces Data-Driven Initiative to Reduce Overreliance on ER Care and Disrupt Cycle of Incarceration

July 7, 2016
by Heather Landi
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The Obama Administration announced this week the Data-Driven Justice Initiative with the aim of bringing together data from the criminal justice and health systems to reduce overreliance on emergency healthcare and encounters with the criminal justice system.

According to an announcement from the White House, every year, more than 11 million people move through America’s 3,100 local jails, many on low-level, non-violent misdemeanors, costing local governments approximately $22 billion a year. In local jails, 64 percent of people suffer from mental illness, 68 percent have a substance abuse disorder, and 44 percent suffer from chronic health problems.

“Communities across the country have recognized that a relatively small number of these highly-vulnerable people cycle repeatedly not just through local jails, but also hospital emergency rooms, shelters, and other public systems, receiving fragmented and uncoordinated care at great cost to American taxpayers, with poor outcomes,” the White House officials stated in the announcement.

The Data-Driven Justice Initiative (DDJ) is designed as a bipartisan coalition of 67 city, county, and state governments who have committed to using data-driven strategies to divert low-level offenders with mental illness out of the criminal justice system and change approaches to pre-trial incarceration, so that low-risk offenders no longer stay in jail simply because they cannot afford a bond.

The states involved in the initiative include Connecticut, Illinois, Maryland, Oregon, Pennsylvania, Rhode Island and Utah along with 60 cities and counties.

As part of the initiative, DDJ communities will bring together data from across criminal justice and health systems to identify the individuals with the highest number of contacts with police, ambulance, emergency departments, and other services, and link them to health, behavioral health, and social services in the community, with a goal of reducing overreliance on emergency healthcare and encounters with the criminal justice system.      

The initiative includes a number of Obama Administration commitments, such as the Department of Housing and Urban Development (HUD) and the Department of Justice (DOJ) recently awarded $8.7 million to seven organizations, including three who will work with DDJ communities, to address the needs of individuals cycling between the criminal justice system and homeless services. The grants will fund Permanent Supportive Housing (PSH), an evidence-based intervention that aims to reduce homelessness, arrests, hospitalization, and emergency room visits.

As part of the initiative, a number of organizations are supporting efforts to link data across the criminal justice and health systems and to enable the use of data to reduce incarcerations and improve outcomes.

A Managed Care Organization under Washington AppleHealth Medicaid and the Jail Health Services division of Public Health Seattle & King County are developing a demonstration project to allow managed-care community health workers and care coordinators to enter the King County jails to conduct release planning and transitional-care services. “Building from existing work centered on creating a system of integrated care for populations with complex health needs, this pilot will test innovative ways to share data for clients who receive treatment by both providers, while protecting privacy and seeking to ensure continuity of care and appropriate support for shared clients when they are leaving jail,” the White House announcement stated.

Triggr Health, a mobile app developer focused on addiction recovery, will work with multiple DDJ communities to prevent re-incarceration for people with substance-use disorders. By using real-time phone data, Triggr Health aims to reach people at times of highest need and increase the odds of individuals reaching long-term substance-use recovery.

Appriss, a data analytics vendor, also is involved in the initiative. The company conducted an analysis of data from over 3,000 local, criminal justice agencies to help DDJ communities identify indicators in jail data that appear to be most predictive of individuals at high risk of re-arrest, overdose, and housing instability or homelessness. According to the White House press release, DDJ jurisdictions can use these data fields to develop reports from their jail management systems to help identify individuals with frequent bookings for low-level offenses. Appriss is also releasing their national-level analysis of more than 9.8 million bookings from 2015 to identify arrest patterns and repeated bookings, finding more than 276,000 individuals across the country who had four or more bookings in 1 year. Using this analysis, Appriss is developing a data-driven product that will systematically identify individuals who meet data-validated criteria as high utilizers of multiple criminal justice and healthcare systems.

In the White House announcement about the initiative, it provided Miami-Dade, Florida as an example. Miami-Dade officials found that 97 people with serious mental illness accounted for $13.7 million in services over four years, spending more than 39,000 days in either jail, emergency rooms, state hospitals, or psychiatric facilities in their county. In response, the county provided key mental health de-escalation training to their police officers and 911 dispatchers. Over the past five years, Miami-Dade police have responded to nearly 50,000 calls for service for people in mental-health crises, but have made only 109 arrests, diverting more than 10,000 people to services or safely stabilizing situations without arrest. The jail population fell from over 7,000 to just over 4,700, and the county was able to close an entire jail facility, saving nearly $12 million a year, according to the press release.





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