Better-staffed mental health units, mini clinics and telehealth services are among several features that will soon be put in place to improve health care at Rikers Island, Island, Mayor Bill de Blasio's administration announced Tuesday.
These reforms, backed by funding in de Blasio's executive budget, represent the first investments in the health care provided at city jails since the public hospital system took over care at Rikers and other jails in January.
City officials said the money would be used to address two of the biggest challenges facing jail administrators: The large number of mentally ill Rikers inmates, and the rampant violence at the jail complex.
The biggest investment will go toward improving mental health care at Rikers. The city plans to triple the number of units under the Program to Accelerate Clinical Effectiveness. These PACE units have proven to be both safer and more clinically effective for people with serious mental-health needs than other types of mental-health programs. Building eight new units and hiring 163 new health workers to staff them will cost the city $8.7 million in the coming fiscal year, with funding increasing to $24.2 million in fiscal 2020.
PACE-unit patients are more likely to adhere to their medicine and there's a much lower use of force, according to Dr. Homer Venters, chief medical officer and assistant vice president of the Division of Correctional Health Services for NYC Health + Hospitals. Their success is largely attributed to more consistent and higher levels of staffing, he said.
"For patients in the jail system with serious mental illnesses, they fare much better when they're in a setting where the health staff and security staff train as a team and work as a team and work on the units everyday together," said Venters.
Each PACE unit serves 20 to 25 patients, so they will still be reserved primarily for people who are at risk of being hospitalized or have just returned from the hospital, said Venters.
It's a step in the right direction, said Jennifer Parish, director of criminal justice advocacy at the Urban Justice Center.
"Where they've been able to create PACE units, they've seen much better outcomes," said Parish. "Ultimately, it would be good if all the mental observation units had the staffing they need to provide adequate services. Hopefully they're moving in that direction and trying to figure out how to get the financial support to do it."
The city is also pledging $2.7 million annually to expand pre-arraignment health screenings. It's unclear whether the move is intended to help divert some people from the criminal justice system to settings that could be more appropriate, or to simply better address their health needs while they are incarcerated.
The city's budget also sets aside $2.5 million to expand Hepatitis-C treatment in jails, which will increase to $5 million in the following year. In fiscal 2017, another $700,000 will go toward telehealth services and $1.2 million will go toward building 12 mini clinics for the general jail population.
In a recent presentation, correction department officials cited mini clinics as a way to complete more scheduled health care appointments at Rikers. However, they also said there was a need to address the factors that contribute to appointments being skipped, including frequent lockdowns, under staffing and poor coordination among staff.
"City to invest in mental health to reduce violence at Rikers Island jail" originally appeared in Crain's New York Business.