With numerous incarcerated individuals in Arizona prisons and jails living with a chronic or serious health condition, the state is assisting their transitions out of the carceral setting by connecting them with health and social services.
David Crutchfield, MD, medical director of Maricopa County Correctional Health Services, spoke at the 2023 Arizona State of Reform Health Policy Conference about efforts in the state to provide this kind of support to incarcerated individuals.
“We’re caring for roughly 30 pregnant inmates at any time. We do substance use and withdrawal care. We do over 500 withdrawal checks daily. We receive 4,000 requests for healthcare monthly. This is one area where females have not caught up to males yet, thankfully. We don’t have as many, but I think that’s changing—I think we’re getting closer to a 50:50 ratio.”
— Crutchfield
Crutchfield said that over eight percent of incarcerated individuals in Maricopa County have a serious mental illness, with about 16 percent having more than one serious mental illness. He explained how once an individual is booked, they undergo a “receiving screening,” which identifies health needs, including physical and mental. An average of 4,500 to 5,500 screenings take place each month.
“The receiving screening takes place—it’s supposed to be as soon as possible. Our goal is to get it done within an hour and a half,” Crutchfield said, adding that EMTs, nurses, and medical providers are available at the intake facility 24/7.
Following the receiving screening, every individual in jail is required to undergo an initial health assessment within 14 days.
“Anybody with an urgent need that we’ve identified, and that turns out to be 65 to 70 percent of our intakes, will get what’s called a priority health assessment, which means [being] face-to-face with a nurse or a provider within 24 hours. That’s our goal.”
— Crutchfield
Captain Brandon Smith, division commander for inmate medical services at Maricopa County Sheriff’s Office, said the health screenings have been going well, and they can catch medical issues early on.
“What we’re finding is a lot of the population isn’t showing any signs or major symptoms until 24 to 96 hours in, and that’s when they’re starting to have medical complications. We’ve been experiencing high ER runs—emergency runs,” Smith said.
From Jan. 1st to Oct. 17th of 2022, about 230 incarcerated individuals were rushed to the ER every month. Smith said for this year, the average is 250 incarcerated individuals per month. Last year, all detention staff members got trained on how to use Narcan after experiencing many overdoses in the carceral setting.
“This year so far, a total of 513 doses of Narcan has been used,” Smith said. “Some of those inmates received multiple ones, but last year there was only 172, so that’s a lot more coming in.”
Shelley Curran, director of crisis, cultural, prevention, and court services at MercyCare, explained how Maricopa County jails have a jail data link agreement in place between the sheriff’s office, correctional health services, and MercyCare.
“Every 15 minutes, every person that’s booked into jail, their information comes over to Mercy Care. We match that up against our enrollment files, and then I have a jail diversion team that’s co-located there at the intake, transfer, and release center,” Curran said.
MercyCare has a total of three staff members co-located at the facility each day of the week. Curran said when a MercyCare member is booked into jail, MercyCare jail workers will know within an hour. She explained how jail diversion staff receive notifications about members being incarcerated, and the first thing they do is reach out to the clinical team to ensure medication is available, and any health conditions or concerns are transferred to correctional staff.
“It’s not completely automated, but it is a good way to make sure that correctional health services knows as soon as we do, what that person is going to need to continue their care while they’re in custody,” Curran said.