Transcript Health Impact Assessment Training

Treatment Alternatives to Prison
A Health Impact Assessment
HIA Research Scope
February 2012
Health Impact Assessment – a structured yet flexible
research and engagement tool used to elevate the
consideration of health outcomes in decision-making.
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General
Incarceration
∆ recovery
∆ substance
addiction
∆ injuries
ALTERNATIVES
Drug / alcohol
courts
∆ crime and violence
Mental health
courts
∆ ability to
manage mental
health
mortality
∆ chronic
disease
Bail diversion /
Day report
programs
∆ family life
Job placement
programs
∆ quality of life in
communities
∆ unemployment
∆ infectious
disease (HIV,
Hep C, STI)
∆ homelessness
Community
based SATS
Community
based MH
services
∆ premature
∆ economic impact
∆ stress
∆ mental
health
Overarching Questions
How would Treatment Instead of Prison (TIP) impact:
1 Number of slots for each intervention
2 Proportion of the general population incarcerated vs. in
each alternative intervention
3 Number of people employed after each intervention
4 Number of people able to find housing after each
intervention
5 Educational attainment for those in each intervention
6 Racial distribution of population in each intervention
7 Rates of infectious disease (STIs, hepatitis), chronic
disease (hypertension, heart disease, respiratory
disease), mental health issues (stress, depression,
anxiety) among the targeted population and among the
general population
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Recovery
Incarceration
ALTERNATIVES
Δ recovery from
substance
addiction
∆ access to
drugs and drug
tx services
∆ neurological
damage
∆ heart disease
Drug / alcohol
courts
∆ ability to
manage mental
health
∆ case
management
Mental health
courts
Bail diversion /
Day report
programs
Job placement
programs
∆ risk of
infectious
disease (HIV,
Hep C, STI)
∆ access to
prescription tx &
MH services
∆
homelessness
∆ access to a
living situation
∆ physical
health
conditions
Community
based SATS
Community
based MH
services
∆ respiratory
harm
∆ access to
medical ins/ tx
for co-occurring
issues
∆ mental
health
∆ stress
Recovery: Primary Question
Primary question:
How would TIP impact substance abuse recovery
and mental health management?
Questions address each intervention, with statewide
and per county counts
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Recovery: Research Questions
How would Treatment Instead of Prison impact:
1. Rates of substance abuse recovery and ability to manage
mental health issues
2. Access to: substance abuse and mental health treatment
services; affordable medical insurance; prescriptions; and
active case management
3. Number of people who are homeless or otherwise do not
have access to affordable housing
4. Number of people who overdose and/or commit suicide
5. Number of neurological disorders, STIs, and infectious
disease in the targeted population
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Crime and Safety
Incarceration
∆ property/violent
crime (for those in
drug courts or job
training programs)
∆ injury
∆ levels of
crime in the
community
ALTERNATIVES
Drug / alcohol
courts
Mental health
courts
Δ solitary
confinement/
punitive tx
∆ recidivism
Δ access to case
management and
rehab programming
Bail diversion /
Day report
programs
Δ access to
prescription tx &
drug/MH tx services
Job placement
programs
Δ access to SATS
∆ parole services
∆ legal income
∆ chronic
disease
∆ stress
∆ mental
health
∆ access to a living
situation
Community
based SATS
Community
based MH
services
∆ death
∆ access to jobs
Δ prison reentry
∆ educational
opportunities
Crime and Safety: Primary Question
Primary question:
How would TIP impact crime and safety levels?
Questions address each intervention, with statewide
and per county counts
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Crime and Safety: Research Questions
How would Treatment Instead of Prison impact:
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2
3
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Number of violent and property crimes committed? Injury
and fatality from these crimes
Recidivism
Number of people receiving parole, per intervention, and the
rate of recidivism in these population groups
Average time out of circulation to commit crimes in public,
per type of crime
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Family
Incarceration
ALTERNATIVES
∆ individual
living with
family
∆ child injuries
∆ exposure to
crime & violence
∆ child mental
health
∆ dependent
abuse/ neglect
Drug / alcohol
courts
∆ parent mental
health
∆ bonding w/
parent
Mental health
courts
Bail diversion /
Day report
programs
∆ immune function
∆ single parent
families
∆ children to
foster care
∆ Behavioral issues
for children
∆ peer bonding
Job placement
programs
Community
based SATS
Community
based MH
services
∆ extended
family to care
for dependents
∆ ability for
custodial caregiver
to hold job
∆ financial effects
of caring for
others’
dependents
∆ educational
outcomes for
children
∆ youth
involvement in
justice system
∆ ability to afford
food, medicine,
clothes
Family: Primary Question
Primary question:
How would TIP impact children/dependents of
individuals involved in these programs?
Questions address each intervention, with statewide
and per county counts.
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Family: Research Questions (High Priority)
How would Treatment Instead of Prison impact:
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2
3
4
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Number of children in foster care or living with a nonparent family member
Exposure to violence for children/dependents of
individuals in each intervention
Educational attainment of children in these families
Abuse/neglect of children/dependents for parents in each
intervention
Number of single parent families
Cost of caring for child/dependent for alternate caretaker
and unemployment for alternate caretakers
Children/youth in these families involved in youth justice
system
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Community
Incarceration
∆ injury
∆ violent and
property crime
ALTERNATIVES
Drug / alcohol
courts
∆ persons who
commit crimes
residing in
community
∆ wealth
∆ rates of
unemployment
Mental health
courts
∆ income levels
∆ community-wide
poverty
Bail diversion /
Day report
programs
Job placement
programs
∆ premature
Mortality
∆ exposure to
weather
∆ parolees
living in
community
∆ chronic disease
(obesity, nutrition,
cardiovascular,
asthma, other)
∆ infectious
disease
∆ homelessness
Community
based SATS
Community
based MH
services
∆ social cohesion
& support
∆ mental health
Community: Primary Question
Primary question:
How would TIP impact the quality of life in
communities where many are involved in the
criminal justice system?
Questions address each intervention, with statewide
and per county counts.
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Community: Research Questions (High Priority)
How would Treatment Instead of Prison impact:
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2
3
4
5
Community-level poverty, average household income,
unemployment, and homelessness?
The number of those under supervision?
Community-level crime, fear of crime, and participation in the
underground economy?
Levels of social cohesion and/or social support in each of these
communities?
Level of substance abuse in each of these communities?
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Economic
∆ cost of
interventions
Incarceration
∆ Government
spending
ALTERNATIVES
∆ parole costs
∆ homeless costs
Drug & alcohol
courts
Mental health
courts
∆ cost benefits
∆ Medical costs
∆ MH costs
∆ Health Care
costs
∆ case mgmt
∆ ED use
Bail diversion
Day Report
programs
∆ Employment
Job Placement
Programs
Community
Based SATS
Community
Based MH
Services
∆ Stress & Mental
Health
∆ Poverty
∆ Personal
income
∆Criminal Justice
system
employment
∆ Premature
mortality
∆ HH income
∆ income tax
revenue
∆ Chronic disease
∆ use of education
system
∆ Occupational
Injuries
Economy: Primary Question
Primary question:
What is the economic impact of TIP?
Research questions address each intervention, with
statewide and per county counts
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Economy: Research Questions
How would Treatment Instead of Prison change:
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2
3
4
5
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Annual costs of incarceration and alternate treatments
Amount funded publicly and funded from other means for each
intervention
Health care costs for prison health care, health care provided
to target population outside of prison, substance abuse
treatment services and mental health services costs for each
intervention
Median household income and employment prospects for
those participating in these intervention; Stress levels, mental
health outcomes, and chronic disease associated with
employment and low-income
Number of people employed in each intervention, their average
salary and benefits
Income tax revenue from employees in each intervention
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Economy: Research Questions (Medium Priority)
How would Treatment Instead of Prison impact:
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Case management and supervision costs of each
intervention
8 Annual costs of construction vs. start-up for alternate
treatments); Cost of operations/maintenance
9 Emergency room use and costs for people in each
intervention
10 Costs of post-incarceration homelessness
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