By Klaudia Dukala/For CU-CitizenAccess.org -- When consultant Alan Kalmanoff was conducting his assessment on the Champaign County jails, he noticed inmates with mental health problems were "decomposing" because of the lack of medications available to them.
Now, Kalmanoff, executive director of the Institute for Law & Policy Planning, based in Berkeley, Calif., said first steps have been taken to combat the problem.
Kalmanoff, a consultant hired by Champaign County to assess the county’s criminal justice system, presented a 272-page report to County Board members in September 2013.
In his report, Kalmanoff criticized the county for its treatment of mental health inmates at both the downtown jail, at 204 E. Main St., and the satellite jail, at 502 S. Lierman Ave., in Urbana.
The report stated the jails didn’t have the proper "… resources to house, and sometimes segregate, [the mental health] population as necessary to provide for their care."
He also cited the system for insufficient communication between the jails’ mental health care contractor and the jails’ community service providers, which are "vital to continuity of care" once inmates are released.
But Kalmanoff said he believes there have been improvements in the medical and in the mental health treatment of inmates since the release of his assessment.
"Linkages have been created, and programs have been created," he said, praising the county jails’ staff members for keeping their information on mental health inmates organized, making it easier for people to stay on their medications while incarcerated and when released.
But there have not been improvements in preventing recidivism by previous offenders with mental health problems and in the continuous incarceration of people who need mental health treatment, Kalmanoff said.
According to his report, those problems are fairly common in U.S. jails, but, to Champaign County, they are expensive ones.
"Champaign must rapidly improve their response to this major issue to proactively manage costs and problems that arise from the mental health subpopulation," the report stated. "They represent many chronic offenders, who cycle in and out of the jail at great cost to the County."
Kalmanoff said if officials actively worked to prevent recidivism, there would be no need to spend money on reconstructing the satellite jail, which has been an ongoing debate in the county for more than 10 years.
Peter Tracy, executive director of the Champaign County Mental Health Board, said the board has been trying to address those issues by working on restructuring the jails’ contract with their mental health service provider.
He said the board has also been encouraging better communication between the jails’ mental health provider and the community providers to "assure coordination of care."
"The biggest issue for us is to design a system which appropriately deflects people with behavioral health issues from incarceration," he said. "This means there must be a rapid response and intervention by the mental health provider."
But Kalmanoff said the jails need to work with their mental health provider to implement a "risk assessment instrument" and a pre-trial release program to effectively combat their issues with recidivism.
If structured correctly, the risk assessment will be able to determine whether inmates can be released from jail before their trial date, saving Champaign County money, time and space for people who truly need to be incarcerated, Kalmanoff said.
The current medical and mental health provider for the Champaign County jails is Correctional Healthcare Companies Inc., a company based in Greenwood Village, Colo. According to their website, the company provides correctional healthcare nationally and aims to "improve public safety, manage risk, reduce recidivism and extend budgetary resources in the facilities and communities in which we work."
According to their contract with Champaign County, CHC is responsible for the following services at the county jails:
- A total of 40 hours per week of visitations from a healthcare unit administrator (registered nurse).
- A total of 80 hours per week of visitations from a licensed practical nurse.
- Up to four hours per week of services provided by a physician.
- Up to two hours per week of services provided by a psychiatrist.
- A physician and/or nurse available on call 24 hours per day and seven days a week.
- And a psychiatrist and/or mental health professional supervisor available on call 24 hours per day and seven days a week.
More hours may be requested, however, if both the company and Champaign County believe additional services are needed at the jails.
Nancy Griffin, Champaign County jail program coordinator, said, by law, the providers are required to see all of the inmates at the jail within 14 days of their incarceration.
"This assessment is important so people are adequately diagnosed and treated for medical or mental health needs," she said. "The 14 day physical is the bench mark set by statutes – people are often assessed before the 14 day period … people with immediate medical and mental health needs are assessed immediately and treated accordingly."
But, according to Kalmanoff’s report, "… the contractor’s staff does not have a substantial amount of experience working in jails and suffers from turnover without being able to recruit new people."
The report also said, "The mental health staff seems only able to provide basic services and struggles with inmates who present dual diagnosis drug problems associated with mental stability." And inmates with mental health issues cannot be managed with the resources currently available at the jails.
In 2013, the company provided care to more than 5,700 inmates at the Champaign County jails, Griffin said in a letter in response to a records request. That number has increased 54 percent since 2010.
According to Kalmanoff’s report, the number of inmates with mental health issues has increased because many of them are recurring offenders.
"Individuals with mental health issues make up a disproportionate number of jail and justice system caseload, and contribute to the system’s ‘revolving door’ problem," the report stated.
Kalmanoff said in a recent interview that if an effective risk assessment instrument and a pre-trial release program are not created soon, Champaign County will have to reconstruct the satellite jail to continue housing the returning inmates. The program, which would help lower the inmate population, would make the expansion of the satellite jail unnecessary, Kalmanoff said.
"There is going to have to be construction," he said, if a program is not created. "Construction will take money away from everything else that’s really needed and put it into something that is totally not needed."
A majority of County Board members approved the pre-trial release program and included the costs of implementing it in the 2014 budget, County Board member Christopher Alix said.
But after the presiding judge, courts administrator, public defender and state’s attorney completed a five-week pilot testing the program’s effectiveness, plans halted and the program was dropped from consideration.
"They concluded that the program wouldn't be effective and suggested that the County Board reallocate the funding," he said. "The County Board didn't, so the funding is still in the budget, but the Court has not implemented it. So to a large extent it's out of our hands."
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