Directory Issue 2022 by Criminal Justice Media Inc.

DIRECTORY 2022 VOL. 31 NO 2

THEN, NOW & INTO THE FUTURE

OVERCROWDING

REFORM & REENTRY EFFORTS

MEDICAL TREATMENT & EDUCATION

BA TH A RO G T E NI AINTLE C S IL T LN ES S

3-STRIKES LAWS & MANDATORY SENTENCING

ORIGINS OF CONTEMPORARY INCARCERATION

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DIRECTORY 2022

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Jennifer A. Kapinos

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Associate Publisher Peggy Virgadamo (718) 456-7329 pegpaulv@aol.com • Northeast

Contemporary Incarceration Then, Now & Into the Future To Protect and To Serve PPE for COs 10 Questions To Ask When Evaluating X-ray Body Scanners

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BY DONNA ROGERS, EDITOR-IN-CHIEF

In commemoration of the founding of this magazine in 1992 we look at how crime policy over the past three decades has impacted incarceration rates—as well as taking note of many reforms taking place today.

r a e Y 30 ective p s o r d t n Re rime a C n o i n t o a r e c r a c In In the ’90s law-and-order rhetoric, the War on Drugs, and the Omnibus Crime law led to increased arrests and longer sentences, culminating in a peak in incarceration rates in 2009.

Over the past 30 years the number of those incarcerated in the U.S. has soared. At yearend 1992 the total number of prisoners was about 1.328 million, according to the Bureau of Justice Statistics, including about 884,000 in state and federal custody and roughly 445,000 in jail. At the end of 2019 (prior to the Covid-19 outbreak), just under 2.1 million people were behind bars in the 4 CORRECTIONS FORUM • DIRECTORY 2022

U.S., including 1.43 million under the jurisdiction of federal and state prisons and roughly 735,000 in the custody of locally run jails. Even accounting for growth in the general population, the number of those who are justice involved has swelled to numbers that are untenable. What factors and policies charted the course over the past 30 years to ensnare people in the widening net of incarceration? How did public perception and trends get us where we are today?

Finally, how are we undoing some of the damage? For this magazine’s 30th anniversary, we decided to look back three decades beginning with 1992, focusing on how crime legislation formed the way our nation dealt with offenders. How did tough-on-crime policies such as “Three Strikes” laws, mandatory sentencing, the War on Drugs, the Crime Bill of 1994, supermax construction and the explosive growth of prison construction, law-and-order rhetoric

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and other issues shape the resulting mass incarceration we are seeing today? We speak to a criminal justice ethicist, criminologist/ sociologist and an architect for their perspectives on the causes and effects. We also pivot to focus on newer reforms in the pipeline today that support successful treatment, reentry and integration.

Getting Tough on Crime In the early 1990s fear of crime was the public mood, fueled by high murder rates, and capped (in California) by a former prisoner’s murder of 12-year-old Polly Klaas. The crack-cocaine epidemic in the mid-1980s had already added fuel to the fire, and handgun-related homicides in the U.S. had more than doubled from 1985 to 1990. That year, murders peaked in New York City. Politicians reacted, says Matt Ford in The Atlantic, by embracing tough-on-crime platforms and enacting harshly punitive policies. During the 1992 presidential campaign, Bill Clinton sought to reposition the Democratic Party, which had previously been attacked as "soft on crime," as an advocate for "gettough" policing strategies (as well as investing in community policing). At the same time, California passed the Three Strikes and You’re Out sentencing law. The essence of the three-strikes laws was to require a defendant convicted of any new felony, having suffered one prior conviction of a serious felony to be sentenced to state prison for twice the term otherwise provided for the crime. If the defendant was convicted of any felony with two or more prior strikes, the law mandated a state prison term of at least 25 years to life. According to official ballot materials promoting the original California Three Strikes law, the 6 CORRECTIONS FORUM • DIRECTORY 2022

sentencing scheme was intended to “keep murderers, rapists, and child molesters behind bars, where they belong.” Indeed, it became a trend with more than 20 states joining California in adopting some form of a threestrikes law. More tough on crime legislation followed. During the early 1990s, Congress initiated various omnibus crime bills, culminating with the Violent Crime Control and Safe Streets Act of 1994, which was called “the granddaddy of them all,” by Nkechi Taifa, founder and principal of The Taifa Group LLC, a Washington, D.C., justice advocacy group. “This bill featured the largest expansion of the federal death penalty in modern times, the gutting of habeas corpus, the evisceration of the exclusionary rule, the trying of 13-year-olds as adults, and 100,000 new cops on the streets, which led to an explosion in racial profiling. It also included the elimination of Pell educational grants for

prisoners, the implementation of the federal three-strikes law, and monetary incentives to states to enact ‘truth-in-sentencing’ laws, which subsidized an astronomical rise in prison construction across the country, and lengthened the amount of time to be served….” By this time, the “War on Drugs” had already been well under way with the passage of 1986 Anti-Drug Abuse Act which had established mandatory minimum sentencing schemes, including the infamous 100-to-1 ratio between crack and powder cocaine sentences. According to Taifa, “Its expansion in 1988 added an overly broad definition of conspiracy to the mix. These laws flooded the federal system with people convicted of low-level and nonviolent drug offenses.” Statistics bear this out. Analysis by Urban Institute researcher Jeffrey Roth published in the Federal Sentencing Reporter, July/August 1994, “makes clear that drug traffickers sentenced to prison serve longer expected prison terms—between 300% and

Dear Readers: Back in 1992 when CF was founded, the criminal justice system was taking a sharp turn toward being tough on crime, meting out longer and harsher sentences, and eliminating programs that could be seen as “soft.” Prison populations grew, leading to overcrowding and an explosion of prison construction and even more overcrowding. About 20 years later, criminal justice leaders acknowledged that imprisoning low-level offenders, a disproportionate number of Black and brown populations and the mentally ill was not working. We now know we need to take a look at these disparities, some overly-harsh punishments and address treatment programs, alternatives to incarceration, better medical care, education and reentry. That is what CF has tracked so far and intends to cover going forward. Hope you hop on for the ride! —Tom Kapinos, publisher VISIT US AT WWW.CORRECTIONSFORUM.NET

Mandatory minimum sentencing laws set the infamous 100-to-1 ratio between crack and powder cocaine sentences. These laws flooded the federal system with people convicted of low-level and nonviolent drug offenses and led to overcrowding.

1,100% longer, depending on the Criminal History Category–under the new law rather than the old law.” The analysis also compared sentences for low-level drug violators in 1992 with those imposed in 1985. It found that “sentences have increased 150% since guidelines and mandatory penalties became effective.” “In short,” the article continues, “penalties for low-level drug traffickers have more than doubled and by some calculations more than tripled since 1985.”

Incarceration Rate on a Downward Trajectory Prison rates continued their precipitous climb until peaking in 2009, when a variety of factors began to bring down numbers. Justice advocacy groups demanded fairer treatment, especially for minorities who were imprisoned at higher rates than their white counterparts. Outcries from civic rights groups recommended that California abandon or significantly modify its three-strikes policy due to budget concerns and their claims of a lack of positive outcomes. 8 CORRECTIONS FORUM • DIRECTORY 2022

According to legal advocates with the Three Strikes Project at Stanford Law School at that time, “We find the people serving the longest and most unjust sentences and represent them in state and federal courts across the country. Almost all of our clients are serving life sentences [under] Three Strikes law for crimes as minor as shoplifting a pair of socks, attempting to steal a car radio, and simple drug possession. Their mission, they stated, “is to repeal and amend the harshest and least effective criminal laws across the country. Our initiatives have reduced sentences for nonviolent crimes, led to early release of over 2,200 prisoners serving life sentences for petty offenses, improved public safety, and saved hundreds of millions of taxpayer dollars.” Facing opposition from civil rights advocates, prison overcrowding and an estimated $19 billion in cost to the state, nearly two decades after its original passage, California voters overwhelmingly enacted the Three Strikes Reform Act (Proposition 36) in 2012 to address the harshest, and unintended, consequences of the sentencing law.

Prop. 36 eliminated life sentences for non-serious, non-violent crimes and established a procedure for inmates sentenced to life in prison for minor third-strike crimes to petition in court for a reduced sentence. Prop. 36 was the first voter initiative since the Civil War to reduce the sentences of inmates currently behind bars. In the first eight months of its enactment, over 1,000 prisoners were released from custody. Incarceration rates have been trending on a downward trajectory ever since. Overcrowding had become an issue, most notably in California where the prison population peaked at more than 165,000 in 2006—in a system designed to house just 85,000. In 2011, the U.S. Supreme Court ruled that California must release more than 30,000 prisoners, or whatever number it would take to get the population down to a reasonable and Constitutional level, deemed to be 137.5% of capacity or 110,000 inmates, in a process termed “realignment.” Changes in criminal laws, as well as prosecution and judicial sentencing patterns, also likely play a role in the declining incarceration rate and number of people behind

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An education program at the Rose M. Singer Center at Rikers and other NYC DOC jails run by Manhattan College’s Professor Andrew Skotnicki partners college students and incarcerated individuals for accredited courses.

bars. In late 2018, for example, then-President Donald Trump signed a law aimed at reducing the federal prison population. In its first year, the law led to shorter sentences for thousands of federal offenders and earlier release dates for many others, according to a 2020 report from the U.S. Sentencing Commission. In fact, the U.S. incarceration rate fell in 2019 to its lowest level since 1995—and that is not even considering the drastic reductions of 15% declines in 2020 in state

and federal prisons caused by Covid-19, according to the BJS. Yet despite this decline, the reality is that United States has the largest share of its population behind bars of any country in the world that keeps records. And while the BJS reported a 25% reduction in jail populations to midyear of 2020, the Prison Policy Initiative has found the number in jails through 2020 to be creeping back up to near pre-pandemic levels (based on data of 400 jails, the average population change since March 2020 among those jails had by October 2021 only experienced a 7% decrease).

Available Free Education Things were very different in the 1970s, according to one criminal justice sociologist. Back then, the New York City university system (CUNY) had open admissions and free tuition for anyone as long as they had graduated from high school, notes Andrew Karmen, Ph.D., professor

The Pell grant program was recently expanded so that in the 2022-23 school year incarcerated individuals in 42 states and D.C. can get federal grants for education.

of sociology at John Jay College of Criminal Justice in New York City, who has taught for nearly five decades. In the ’90s, things began to change, Dr. Karmen points out. Under the administration of N.Y. Gov. George Pataki, “the partly distorted image that prisons were too comfortable—that the incarcerated were enjoying basketball,

Emphasis in the soon-to-be completed Franklin County Correction Facility building design is to provide mental health care, medical care, and programming intended to reduce reoffending by inmates. Principles of trauma-informed design used throughout the building include abundant natural light, soothing colors, good acoustics and biophilic design elements. 10 CORRECTIONS FORUM • DIRECTORY 2022

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Part of the Illinois Department of Corrections In-Patient Treatment Center (IPTC) on the Joliet Treatment Campus, this rendering shows the family gathering area. The in-patient treatment facility establishes a new standard nationwide for the delivery of health services in a secure environment. Individual treatment units have been designed to accommodate multiple classifications and patient acuity levels in settings that utilize abundant daylight, natural materials, and therapeutic colors. HDR delivered the project based on criteria documents developed by a team led by HOK.

cable TV and college courses” became a prevalent notion. The backlash led to the concept of “no frills prisons, which were supposed to be austere and part of the punishment. The result was that any funding for college courses behind bars was cut.” Studies show, however, Dr.

Karmen says, that those who are incarcerated do better on release if they have some education. Another New York educator strongly believes that message. For the past 10 years Andrew Skotnicki, Ph.D., professor, religious studies, Manhattan College, Bronx, N.Y., has run a program

that brings Manhattan College students to Rikers Island, Westchester County and Bronx correctional centers to take an accredited course called Criminal Justice Ethics in conjunction with a group of incarcerated individuals. The program grants anyone incarcerated within the correctional facility who passes the course a full ride to the college once they’re released. To date over 70 of the confined students who have completed the course have received tuition-free classes at Manhattan College. The crime bill of 1994 had cut some 300 active education programs in New York state, Dr. Skotnicki points out. “Only recently have they been rebounding.” He furthers that former Gov. Andrew Cuomo was instrumental in reestablishing college funding for prisons, with TAP grants again being able to be used to educate those that are confined. Presently the tuition assistance has enabled “close to a dozen active prison programs in New York state.” Additionally, the Obama-Biden Administration launched the Second Chance Pell experiment in 2015, providing Pell grants to incarcerated students in up to 67 programs through postsecondary education programs in state and Continues on page 26

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BY DONNA ROGERS, EDITOR-IN-CHIEF

To Protect And To Serve Protection should be provided not only to the public, but to oneself. These tools can save COs from injury, communicable disease or even from death.

orrections Officers are outnumbered. They need all the assistance they can get in doing their jobs. Slash- and biteresistant gloves and clothing, masks and gloves to protect against disease, and crowd control suits for protection in a riot are some of those protective items available. Corrections Forum queried vendors with such gear and will present the latest tools and apparel they reported that can help keep COs safe and secure. Homemade weapons abound inside walls. Every day officers are accosted with shivs, shanks, and picks fashioned from toothbrushes, razors, even meat bones left over from meals. Officers are also subject to spit and other bodily

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fluids tossed at them. Pathogens in blood through a needle stick can also infect them with disease such as hepatitis C. And today tiny droplets in the air can infect them not only with conventional diseases such as TB, influenza, and staph infections, but most recently the BA.2 variant of Covid-19. One of the biggest barriers to keeping safe is actually wearing the apparel and devices meant to protect. The gear that officers use to keep themselves safe needs to be accessible, easy to use, effective and offer protection from being used against the officers as a weapon, points out Erin Howell, product group manager, Bob Barker Company. “If the equipment is too difficult to use or access, it’s possible that officers might accept the risk of not

carrying the equipment with them. The gear should be made specifically for corrections or detention officers to address their unique needs.” “Officer assaults are up,” says Jeff Niklaus, founder, Compliant Technologies, a veteran-owned company that produces a line of nonlethal, non-injurious low voltage products. “At times officers can be ambushed by one or more inmates,” he says. The company’s flagship product is a glove that serves as a humane de-escalation tool that allows for seamless weapons transition, excellent weapons retention, and eliminates weapons confusion, while at the same time freeing up both hands. He says it aids in effective nonlethal de-escalation. “We’ve noticed workplace

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injuries and inmate attacks to be the highest threat to COs,” says Chris Sfedu, ExecDefense, Inc. Even though facilities do their best to eliminate contraband and in-prison weapons, the reality is that these items will always be present in modern day correctional and detention centers. “While many facilities have updated their personnel's equipment, there are still hundreds, if not thousands, of correctional officers around the United States that are still using old and outdated protective gear—or some no gear at all. It’s important that administrators budget new protective equipment for their staff and plan ahead.”

Personal Protective Equipment Gear Bob Barker Company Bob Barker Company has an in-house Product Development Team that “creates products that

Bob Barker Company offers a spit and bite shield called the InnoShield 8K that they say is one of the easiest and safest bite shields to deploy.

add to the safety and security of their customers’ facilities,” explains Howell. “They work with a Customer Panel that vets the new ideas to ensure that the products are convenient and provide value in an institutional setting.” Products they offer are a spit and bite shield and a riot control suit. They also carry various types of disposable masks, as well as a choice of disposable gloves, and

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they outline the levels of protection in which they are available. First, the InnoShield 8K® is an innovative spit and bite shield with a patent-pending design that makes it one of the easiest and safest bite shields to deploy, says Howell. It comes pre-rolled for a quick application method that keeps officers’ fingers safe, and there are no straps or plastic pieces that can be turned into weapons. The shield is breathable and has over 100% better air permeability compared to a leading respirator mask. Another tactical tool from Bob Barker is the Sirchie® TacCommander Riot Control Suit, an adjustable crowd control suit that fits most sizes with a convenient, comfortable fit. With it, you can stock fewer sizes to save money and inventory space while still offering a high degree of maneuverability and protection. In addition, says Howell, Bob Barker Company offers level 1, 2

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and 3 surgical grade disposable masks, and the N95 Particulate Respirator, which is a high-grade mask that’s effective in areas with high Covid-19 infection rates. The mask has a filtration efficiency of greater than 97%, exceeds the Particulate Filtration Efficiency (PFE) per ASTM F2999 Standard, exceeds the Breathability per Test MIL-M-36954 C: LP Standard, and is NIOSH certified (TC-84A-9272). “Wearing high-grade, effective masks is a proven method of mitigating an individual’s risk of catching or spreading viruses such as Covid-19,” she says. “Due to Covid-19’s high transmissibility rate, officers should not let their guard down when around others, especially in a contained environment like a jail or prison where the virus can spread rapidly.” The company carries vinyl, latex and nitrile gloves, and you can find out more about the differences of each glove by reviewing the comparison chart on page 20. The pandemic greatly affected the availability and the price of gloves, but maintaining an abundant supply is a top priority for Bob Barker Company, says Howell. Generally, nitrile gloves provide the most protection. Their elasticity and puncture resistance are both higher than most vinyl or latex gloves. Latex gloves offer medium-level protection, but they do carry the risk of latex allergies. Both wearers and patients should be aware if latex gloves are being used. Vinyl gloves offer the least amount of protection and are usually the least expensive gloves. They’re great to wear during cleaning or food handling.

Compliant Technologies The G.L.O.V.E., which stands for Generated Low Output Voltage Emitter, is a very low optic, non-threatening, humane de-escalation tool. It is nonlethal, non-injurious and it does no soft tissue damage. The voltage output is a low current, and is 16 CORRECTIONS FORUM • DIRECTORY 2022

The G.L.O.V.E. delivers a humane, low-optics de-escalation tool.

at the user’s disposal throughout the Force Continuum. “Our G.L.O.V.E. can come to the aid of the officer being attacked or for an unarmed officer who is breaking up fights between inmates or rescuing an inmate from assault,” says Niklaus. “The officer is still able to use other tools, talk on the radio, etc. while holding others off. They will never confuse it with any other weapon. Finally, as the gloves are worn on the hands of the user, they would be very difficult to take off of an officer as long as he's conscious and alert and able to fight back.” Compliant Technologies also carries a tool that is worn by an offender and utilizes the same technology as that of the G.L.O.V.E. The E-Band Restrictor and E-Vest technology are nonlethal devices that emit a low voltage, providing a humane de-escalation tool for officers to use for inmate/subject transport, courtrooms, medical visits or hospital stays. Both are magnetically operated and remotely controlled CEWs (Conducted Electrical Weapons.) The E-Band comes in two models—for use on arm or leg.

ExecDefense Inc. (EDI-USA) ExecDefense works closely

with correctional facilities on all different levels, says Sfedu. From providing demonstration samples for officers to try and test in realtime, to working closely with the facility’s administrators to plan their next fiscal year’s budget, “we make sure a realistic action and budget plan is drafted to correspond with the specific needs that the officers face on a daily basis. For example—the needs of an officer in a large high-security state prison will differ greatly from the needs of an officer in a small low-risk municipal prison.” He acknowledges, “It’s important to understand the risks to which each user is exposed in order to accurately propose, deliver, and implement into action effective equipment for correctional officers.” Below are two highlighted items that he notes have shown to be most beneficial. “Riot suits have been around for many years, and are infamous for being heavy, hot, complicated, and impede the user’s mobility. This all changed in 2018 when ExecDefense (EDI-USA) released its new TURBO-X Riot Suit for law enforcement and corrections,” says Sfedu. Manufactured with durable polymer fibers, this full body suit protects the officer’s shoulders, chest & back, torso, groin, thighs, legs (including shins, calves, and

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TERMINATOR-X Riot Helmet is a heavy-duty helmet designed for some of the toughest riot threats on the streets, as well as in prisons. The helmet shell is tested to NIJ anti-impact standards to resist small common prison items typically thrown at COs.

feet), and even includes a pair of half gloves with hardened knuckle for free, along with a durable transport carry bag. The TURBOX Riot Suit is extremely lightweight, mobile and can be worn for hours without overheating or

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exhausting the user, he adds. Correctional officers particularly like this suit because it features several adjustable bands and fasteners so that it molds well to the user’s body for ultimate mobility and flexibility during use. It’s tested to NIJ 0115 level 1 stabresistant (ambient) on the front chest plate and back chest plate. Manufactured by ExecDefense, the TERMINATOR-X Riot Helmet is a heavy-duty helmet is designed for some of the toughest riot threats on the streets, as well as in prisons. The helmet shell is extremely strong, tested to NIJ 0104.02 anti-impact standards to resist small common prison items that may be thrown at the user. In addition, the helmet includes a thick visor (0.16” thickness) with has a rubber gasket seal attached to the top to prevent liquids that are thrown at officers from entering into the helmet or officer’s face. What makes correctional offi-

cers feel extra safe using the TERMINATOR-X Riot Helmet is the helmet’s integrated steel "face cage," says Sfedu. This face cage features horizontal and vertical steel bars that are permanently attached to the outside of the helmet’s visor. The steel face cage helps resist larger impact projectiles, which may otherwise crack or break the visor. This helmet is one-size-fits-all, with a sizeadjustable interior headband—no need for officers having to waste time sorting through sizes when they need to deploy fast during emergencies.

TurtleSkin, distribution by Warwick Mills “Corrections Officers are put in hostile situations between inmates when creative and dangerous home-made weapons can be pulled out as an attack. The TurtleSkin LimberSlash is a breathable layer of clothing that can be worn under a uniform and

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Turtleskin Alpha Plus and Bravo LE gloves provide comfort and dexterity and offer protection against both cut and puncture injuries.

provide protection for most demanding and high-risk work environments,” says Juliana Wilson, TurtleSkin Product Specialist with Warwick Mills. She also notes: “The TurtleSkin LE Glove lines offer an assortment of styles to protect all correction officers from the threat of needles and other sharps during patdowns and inmate control situations. The TurtleSkin Alpha Plus glove is used by the Federal Bureau of Prisons officers.” These are the products from Warwick Mills. The LE Gloves—Alpha Plus and Bravo provide comfort and dexterity with excellent levels of protection against both cut and puncture injuries. The BladeTect—Offered in both long sleeve and sleeveless, cut protection is offered in a breathable shirt. Limber Slash—Anti-slash short sleeve T-shirt or polo is lightweight and comfortable soft armor. It provides 60-80N of slash protection. While this was not an exhaustive list, these offer head to toe protection, and even protection in the air officers breathe. Perhaps 20 CORRECTIONS FORUM • DIRECTORY 2022

it’s time to get onboard? % For further information: Bob Barker Company, Greta Modlin, branding & communications director, 919.346.2174, gretamodlin@bobbarker.com, www.bobbarker.com Compliant Technologies, Jeff Niklaus, founder, 859.447.0576, info@complianttechnologies.net www.complianttechnologies.net ExecDefense Inc. (EDI-USA), Chris Sfedu, 215.235.4300, Chris@ExecDefense.com, www.ExecDefense.com Warwick Mills, Juliana Wilson, Turtleskin product specialist, 603.291.1000, customerservice@warwickmills.com, www.turtleskin.com

Generally, nitrile gloves provide the most protection; latex gloves offer medium protection, while vinyl are best for cleaning or food handling. VISIT US AT WWW.CORRECTIONSFORUM.NET

BY STEVEN W. SMITH, PH.D.

Contraband Detection:

10 Questions to Ask When Evaluating X-Ray Body Scanners

The latest generation scanners look through the body horizontally, the shortest path, a tissue thickness of about 11 inches. Older technologies mount the x-ray generator on the floor, which creates distortion and reduces image resolution.

ontraband has reached epidemic proportions in U.S. correctional facilities, posing a significant threat to the safety of those confined or working inside jails and prisons. Drug and alcohol deaths increased by more than 600% in U.S. state prisons over the past two decades, according to the Department of Justice, Bureau of Justice Statistics, April 2021. Obviously drugs are getting in. Prison searches routinely

uncover huge amounts of contraband. For example, a 2021 topdown sweep of the Elayn Hunt Correctional Center in Louisiana recovered more than 34 ounces of organic and synthetic marijuana, crystal meth, ecstasy, and suboxone, as well as 100 cell phones, sim cards and 60 homemade weapons, according to December 2021 article in The Advocate. The growing problem of contraband has prompted corrections to beef up detection measures, including pat-down searches, surveillance cameras, drone detec-

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tion, perimeter patrols and K9 sweeps. In fact, one of the fastest growing solutions is high-tech xray body scanning that can detect threats hidden under clothing and within body cavities. Body scanners are becoming an industry standard and best practices for jails and prisons. This technology, first commercialized in the early 2010s, has become increasingly deployed and effective. Last year the U.K. Ministry of Justice reported in a press release dated October 14, 2021 that x-ray body scanners stopped 10,000 attempts to smuggle contraband into their CORRECTIONS FORUM • DIRECTORY 2022 21

prisons in just over one year. Newly available federal funding has further fueled the U.S. demand for body scanners. Local, state and federal institutions are routinely purchasing these products using grants under the American Rescue Plan Act of 2021.

An actual scan showing contraband concealment. The image uses an inverted grayscale that makes lower density areas, such as the air trapped inside the balloon containing drugs, appear darker.

10 Questions to Ask X-ray body scanning is a proven technology; however, not all systems are created equal. System designs vary, which can affect image quality, installation considerations, data management features, training and operation. Correctional facility managers should consider the following questions when evaluating these high-tech systems. 1) IS X-RAY BODY SCANNING SAFE? Yes. All persons receive about 1,000 microsieverts (uSv) each year from naturally occurring radiation. Persons living at higher elevations, such as Denver, receive about twice this level. Body scanners operate with a user selectable dose between 0.25 and 2.0 uSv per scan. The American National Standards Institute (ANSI), in conjunction with the Food and Drug Administration (FDA), established the internationally recognized standard for body scanner radiation safety (ANSI N43-17). This permits individuals to be screened up to 1,000 times per year by a body scanner operating at 0.25 uSv per scan, or 125 screenings per year at 2.0 uSv per scan. 2) WHAT IS THE QUALITY OF THE SCANNED IMAGES? Image quality depends primarily on the amount of radiation used. Routine screening for internal concealment is generally conducted at 2.0 uSv or below. Lower doses may be insufficient to detect objects concealed in body cavities, especially in larger subjects. On the other hand, 0.25 uSv is generally sufficient for external screening, allows more frequent scanning, and is exempt 22 CORRECTIONS FORUM • DIRECTORY 2022

from recordkeeping. All x-ray images degrade as they pass through body tissue. The thicker the subject, the lower the quality of the resulting image. The latest generation (most) scanners look through the body horizontally, the shortest path, a tissue thickness of about 11 inches. This is accomplished by mounting the x-ray source at waist height or moving the source vertically from below the feet to above the head. Older technologies mount the x-ray generator on the floor, which creates some major disadvantages. The 45-degree upward angle of the x-ray beam must pass through about 16 inches of body tissue, greatly reducing the quality of the scanned image. Angled scanning also results in significant image distortion. A subject’s navel, for example, may appear 8-10 inches away from its actual location, making analysis and contraband detection more difficult. Be wary of misleading claims. Promises of “medical quality” images are dishonest. Medical images are 100 to 1,000 times higher quality than for body scanners, simply because the dose is that much higher. Be skeptical of software purported to automatically detect concealed objects. In everyday use, this only detects the most obvious of threats that any reasonable operator would immediately spot without assistance. Fortunately, there is a simple answer for new buyers. Just as ANSI N43-17 was enacted for radiation safety, a companion standard, ANSI N42-47, was created for image quality verification.

Ask each vendor for documentation that its product meets the N42-47 minimum requirements. Many products on the market do not. 3) WHAT IS THE FOOTPRINT OF THE SYSTEM? The body scanner footprint has decreased over the past few years. Older designs are as large as 6 x 10 foot while the newest products are as small as 3 x 6 foot. Obviously, smaller units fit better in the tight confines of most jails and prisons. A related parameter is the Inspection Zone, the location around the scanner where operators and staff are prohibited during scanning for radiation safety. In the best case this may be as small as the actual footprint of the apparatus or, in the worst case, up to 10 feet away. 4) HOW EASY IS THE SYSTEM TO USE? The ability to complete a scan quickly and easily is essential. Does the subject remain motionless during scanning or are they moved on a platform? The latter may be challenging if the subject is uncooperative or impaired. What is the total scan time? Four to 14 seconds is a significant difference in many everyday situations. Also, look for “smart” systems that automatically detect and notify the operator when a subject is out of position. 5) CAN THE SCANNERS BE NETWORKED? Scanner networking is essential for institutions deploying multiple body scanners. Look for vendors that offer single point control and management, as well as

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providing a central database of subject information, scanning records, and scanned images. This is especially important for documenting the annual dose each subject receives, demonstrating compliance with the ANSI N43-17 standard. 6) IS THERE PHOTO MATCHING FOR EVIDENTIARY PROOF? Photo matching is important to prove that a particular scanned image belongs to a particular defendant. An electronic photograph is taken of each subject as they are scanned and the two are merged into a single encrypted computer file. Photo matching is not available on all body scanners. 7) HOW EASY IS THE SYSTEM TO INSTALL AND RELOCATE IF NEEDED? Installation should be fast—about two hours—and require as few tools as possible to minimize safety risks. Look for systems that come fully assembled, rather than being built on site. These

can generally be relocated within your facility by your own personnel, under telephone direction from the manufacturer if needed. State laws vary on relocation procedures. 8) WHAT TRAINING, CUSTOMER SUPPORT AND FIELD SERVICE IS PROVIDED? Operator training is critical after the initial installation, for future employees, and annual recertification. Look for training provided by certified radiology professionals who can help officers spot objects and irregularities. Ideal vendors have full-time service technicians that exclusively work on body scanners every day, not contractors that only see a scanner once a month. Vendors that provide expert witness testimony have your back on legal issues such as radiation safety and image interpretation. 9) WHERE IS THE PRODUCT MADE? Most body scanner manufactur-

How Does X-ray Body Scanning Work? Body scanners allow officers to find contraband without physical contact or removal of the clothing. Unlike metal detectors, x-ray body scanners can detect virtually any type of contraband— phones, weapons, drugs—beneath clothing and inside the body. These systems operate with ultra-low amounts of radiation, less than 1% of the dose used in medical x-ray exams. Subjects either stand in place or move on a conveyer while being scanned for approximately four to 14 seconds, depending on the system. The x-ray images appear almost instantly for officers to inspect. Scanning records and images can be saved on encrypted servers for future comparisons and used as evidentiary proof. Corrections investigators/law enforcement officials say that body scanners are a significant deterrent to would-be smugglers. —Steven W. Smith VISIT US AT WWW.CORRECTIONSFORUM.NET

ers are located overseas with only a limited number of employees in the U.S. for sales and support. Inadequate support can be disastrous, whether for repair, software issues, engineering or business related issues. Even more concerning, the National Security Council and the U.S. State Department have issued warnings about security equipment manufactured by companies heavily subsidized by authoritarian and adversarial governments, with the potential for covert surveillance and data theft. 10) WHAT VALUE-ADDED FEATURES ARE AVAILABLE? Covid remains a major concern for prison populations. Some body scanners include an FDAapproved thermal camera to measure and record the temperature of each inmate, providing an early indication of the Covid virus and other infections.

Body Scanners as Part of a Comprehensive Contraband Strategy No single technology will solve all contraband problems. A diligent and trained staff, employing the best-suited security technologies, can intercept contraband and create safer environments for everyone. X-ray body scanners are a proven technology for reducing contraband in jails, prisons, and other correctional facilities. % Steven W. Smith, Ph.D. is a global expert on x-ray body scanning technology. He developed the first commercial body scanner in 1992 and has helped develop safety and technical standards used in the U.S. and around the world. Dr. Smith has a master’s degree in physics and a doctorate in electrical engineering, specializing in medical imaging. He is currently the CEO and Chief Technology Officer of Tek84, Inc., a manufacturer of high-tech security scanning products based in San Diego. CORRECTIONS FORUM • DIRECTORY 2022 23

Continued from page 12 federal prisons. In 2021 federal law expanded the Pell grant program so that in the 2022-23 year incarcerated individuals in 42 states and Washington, D.C., can get federal grants to earn trade certifications, associate degrees and bachelor’s degrees. The U.S. Department of Education said it hopes the program will eventually expand to all 50 states.

Design Reform In addition to education reforms over the past 30 years, the architectural profession has advanced an immense body of knowledge on how the built environment impacts its occupants. “Evidence-based design principles, post-occupancy evaluations and research on the efficacy of our designs at every scale inform design endeavors,” says Gerry Guerrero, AIA, DBIA, global director of justice, HDR. Guerrero has over 30 years of experience in

26 CORRECTIONS FORUM • DIRECTORY 2022

architecture and project management with a specialization in criminal justice facility planning and design. He has worked on needs assessments, planning studies and designs of adult and juvenile facilities for local, state and federal clients. Guerrero notes that research has provided architects with a better understanding of the ways in which design “has the power to encourage rehabilitation, help reduce recidivism and change lives.” As a result, architectural decisions for correctional environments now incorporate normative, outcomes-focused design concepts that foster: empowering, educating and providing individuals with the training, skills development, proven interventions, and resources required for a successful transition and reentry into their community; focusing on pro-social behaviors and design that is conducive to professionals treating trauma; and evidence-based practices focused on

humane conditions, safety, and preservation of human dignity. A few of the specific architecture elements that can positively transform the lives of those within the facility, their families and communities, and the staff, are: Abundant natural light and biophilic design principles that provide connections to nature and are proven to reduce anxiety; educational spaces; welcoming family visitation areas; and staff amenities to enhance employee wellness. Greater focus is now placed on creating correctional health care environments that promote the healing process. A thoughtful, patient-centered architectural response can help destigmatize treatment, which is often the single greatest barrier to recovery, Guerrero notes. Safe and secure environments are also crucial for successful treatment in a correctional health setting, he underscores. Design Continues on page 45

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BY M.J. GUERCIO AND G.F. GUERCIO, CONTRIBUTING EDITORS

Managing the Front Lines in the Fight on Chronic Illness Battling the many fronts in the war to strengthen correctional health care requires careful thought and progressive policy.

lose to half of those incarcerated suffer from or have had a chronic illness. In 201011, an estimated 40% of state and federal prisoners and jail inmates reported currently having a current chronic medical condition while about 50% reported ever having a chronic medical condition—numbers a third to nearly double the national average of the country’s population, according to the latest figures described by the 2016 Bureau of Justice Statistics report. (Since then stats have been disrupted due to COVID’s impact but studies all agree the numbers have not diminished.) It’s common knowledge chronic illness has been a widespread problem for years among the incarcerated. The Prison Policy 38 CORRECTIONS FORUM • DIRECTORY 2022

Initiative says, “People in prisons and jails are disproportionately likely to have chronic health problems including diabetes, high blood pressure, and HIV, as well as substance use and mental health problems.” Meanwhile, speaking on health issues in “Incarceration and Health: A Family Medicine Perspective,” the American Academy of Family Physicians comments, “As a population, people in prison exhibit a high burden of chronic and noncommunicable diseases.” Likewise the CDC notes: “Health, mental health and substance abuse problems often are more apparent in jails and prisons than in the community.” Most of the sources referenced start with the baseline that the stress alone of being incarcerated plus the inherent inactivity of being confined increases the

chances of developing hypertension and obesity, among other conditions, which lead to a host of chronic ailments. Referring to a workshop summary on health and incarceration, “Impact of Incarceration on Health—NCBI” (National Center for Biotechnology Information), 2013, the poor ventilation, overcrowding, and stress can exacerbate chronic health conditions. The AAFP policy statement adds: “Inmates in correctional facilities have significantly higher rates of disease than the general population…. Their health can also be affected negatively by factors in their environment, such as violence or overcrowding.” The burden in this case falls to those within the facility to best manage these chronic conditions. W.C. “Bill” Quenga, deputy director, Nevada DOC, and acting pub-

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taken effect.” He says it’s very difficult in corrections now because pay is also going up for nurses. “We offer an opportunity for facilities to go the opposite way and cut spending. We don’t change anything as far as the providers that they work with, we basically help them get better negotiated rates with their providers.” To best dispense this care he says, “We work with jails to manage their out-of-the-walls medical spend. Anytime an inmate needs medical care outside the walls of the jail we include them in our national network of providers. Part of managing this care is also managing the cost, so the first step is to evaluate a sample of a facility’s claim “to see if they are paying a fair rate or if we can do better. We do this for free.” Within a week Urlocker says they share their findings, which are usually one of three results: “The jails is being treated fairly, they should keep doing what they are doing. Our services are not necessary.” Or, “We identify a segment or a set of providers with which we can assist and improve their savings.” Lastly, the findings can reveal that Heritage can save them a significant amount of money. “When we go to contract

At the Northern Nevada Correctional Center, W.C. “Bill” Quenga, deputy director, Nevada DOC, and acting public information officer, cites education and monitoring as key in the fight to better manage chronic illnesses in facilities.

lic information officer, observes that in the state of Nevada chronic illnesses remain steady with no particular illness increasing in prevalence. The top concerns within the department are obesity, diabetes and hypertension. First and foremost, Quenga says, in their battle with these consistent medical concerns the best weapon is educating the patient. Nevada DOC instructs those incarcerated “that they have control of their medical issues” and inform them of the consequences of noncompliance with their plan of care. They also instruct them on ways to manage their disease. After education, their second line of defense is monitoring. Quenga says laboratory testing as needed is key, as well as frequent follow-up visits in the clinic and with the provider. Based on their experience, he cites, the way to improve how facilities manage chronic health conditions is “more,” meaning “more educators to provide classes and one-onone teaching [and] more staff, both physicians and nurses.” The same cry for more is heard by companies that provide facili40 CORRECTIONS FORUM • DIRECTORY 2022

ties with medical services. Tim Urlocker, director of Partner Relations at Heritage Health Solutions (HHS) calls the shortage of trained staff, such as doctors and nurses, a big concern for facilities in providing health services. HHS specializes in managing outside-the-wall care for correctional facilities. “There’s a shortage of nurses and supply and demand has

Prevalence of chronic medical conditions of the jail population and the general population, 2011–12 Chronic Condition

Jail Population (%)

Hypertension

General Population (%)

26.3

13.9

7.2

4.5

10.4

1.9

Cirrhosis

1.7

0.1

Stroke-related Problems

2.3

0.5

20.1

11.4

1.3

0.3

Diabetes Heart Problems

Asthma HIV/AIDS

SOURCE: Health affairs Authors’ analysis of data from the BJS National Inmate Survey, 2011-2012. Notes: Difference with the general population value is significant at the 95% confidence interval. General population values were standardized to match the jail population by sex, age, race and Hispanic origin. Heart problems include angina, arrhythmia, arteriosclerosis, heart attack, coronary, congenital, or rheumatic heart disease, heart valve damage or tachycardia. VISIT US AT WWW.CORRECTIONSFORUM.NET

with a jail we become the payer, and guarantee a rate with the jail that supports savings for the jail or the county,” he adds. Looking at the bigger picture, Urlocker notes, “A jail’s primary responsibility is to keep people locked up, keep them safe and healthy and that’s a lot of work, whether that’s the medical or corrections staff.” He says it’s not reasonable they should also be

responsible for managing everything that happens outside of the jail such as when an individual needs care outside. “So to have a partner that can act on their behalf and guarantee them a rate is a very comforting thing.” It will save them money and allow them to better allocate their resources, he adds. “I think that’s a really key thing: They’re experts at what they do inside of the jail,

The State of Corrections Health Care and Chronic Conditions An Interview with Deborah Shelton Ph.D., RN, NE-BS, CCHP, FAAN, President, American Correctional Nurses Association

What are the current health care trends in corrections? Although there has been greater attention to the poor health status of inmates, little has changed. If we keep training officers the same way, keep designing prisons the same way, keep thinking about public health the same way, I fear these trends will continue. There may be some points of programming excellence, but implementation is challenging due to system barriers. What is required is a new model that starts from scratch because the system is broken. What is the top health care concern? The top concerns are substance abuse and mental illness co-occurring with serious physical health problems. Individuals with these conditions have severe dental and cardiac issues, hypertension, diabetes, and infections. They are in poor health and can deteriorate quickly. How do health care workers manage these concerns? Under-resourcing correctional health care encourages what we call in the industry “workarounds.” The system doesn’t work the way it is supposed to, so the employees work around the problem. Unfortunately, this may stray from established policy. How can the care of patients with chronic conditions be improved? Improvements can be made by training staff more consistently. There is a need for better supervision and better-educated health care staff. Currently, lower educated, unlicensed, and uncertified personnel are being utilized. It is a common misconception that this saves money, while it actually costs more in the long run. How are facilities coping with the nurse shortage? Poorly. Recruitment is limited by inadequate budgets and the utilization of less educated and unlicensed personnel. People don’t understand the ripple effect this has over time and the strain it places on the few educated and licensed health care providers left in the system. This illustrates the lack of care we provide for individuals who depend on correctional health care services. —M.J. Guercio 42 CORRECTIONS FORUM • DIRECTORY 2022

but they need an expert to help them manage everything that happens outside of jail in terms of health care.” According to a 2017 PEW Charitable Trusts article “Prison Health Care Costs and Quality” average health care costs in FY 2015 per inmate were $5,720 including medical, dental, mental health and substance use treatments. Pew’s research also found Departments of Correction collectively spent $8.1 billion on prison health care services for incarcerated individuals in fiscal year 2015—probably about a fifth of overall prison expenditures. Based on numbers like this, Urlocker says health care costs are some of the highest costs to an institution. “From what I understand outside-of-the-walls pharmacy can be anywhere from 20 to 30 percent of a facility’s overall costs. A large percentage of inmates are on meds so this contributes to the costs.” The ability to get the best pricing when negotiating with providers without changing providers or quality of care is an essential element of what HHS supplies, he adds. Despite staff and funds shortages, Urlocker says health care improves behind bars for a certain portion of the incarcerated population. Those in poverty, or in unstable environments, homelessness, suffering from addiction, mental instability or for those who are for other reasons are not able to get good health care, the correctional system supplies— sometimes their first—consistent, reliable health care and medications. Studies and papers like the AAFP “Incarceration and Health Study” support Urlocker’s findings: “For some inmates, incarceration may have a positive health impact in the short term by providing housing; making meals available; reducing access to drugs, alcohol, and cigarettes; and giving some access to health care.” NCBI’s “Impact of

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PER-INMATE SPENDING ON PRISON HEALTH CARE VARIED GREATLY

$5,720 49-state median of FY 2015 spending

Health care spending per inmate varied dramatically in fiscal 2015, as it had in past years—from $2,173 in Louisiana to $19,796 in California. The 49-state median of FY 2015 spending on inmate health care was $5,720. SOURCE: PEW CHARITABLE TRUSTS

Incarceration on Health” concurs: “For people living especially chaotic lives, incarceration can provide a respite and stabilization: available meals, a structured day, and reduced access to alcohol, drugs, and cigarettes, in addition to access to health care.”

Care Interrupted This balance of consistent health care that well serves certain individuals in the correctional system, suffers in two instances where new policies or programs are currently in the works. First, in the arrest cycle and subsequent possible initial stay in jail, care and medications for chronic conditions can be interrupted. The online journal Health Affairs.org reported in 2021 on the “Lack of Standardized Chronic Condition Screening for Individuals in Jail” saying “jails, unlike prisons, are operated and regulated by county or municipal authorities, and each entity can adopt and maintain its own set of standards for health care delivery.” Additionally, it notes, each correctional facility varies in its capacity to offer medical services. To combat the variable screening and continuity of care, Project HOPE, the global health and research organization behind 44 CORRECTIONS FORUM • DIRECTORY 2022

Health Affairs proposes “universal adoption and strict enforcement of the National Commission on Correctional Health Care (NCCHC) guidelines for basic health screens and health assessments.”

Continuity Post-release As for continuity of care upon release into the community, oftentimes formerly incarcerated individuals struggle to reacclimate back into the community and society, including into relevant health care. A policy or plan to extend, or offer continued medications and treatment is an ongoing area of concern. Dr. Emily Wang, associate professor at the Yale School of Medicine is co-founder of the Transitions Clinic Network (TCN) for former prisoners, explains TCN’s initiative online: “The Transitions Clinic Network is building an innovative health care model for individuals returning to the community from incarceration.” It lists about 50 sites currently in the country. The Transitions Clinic Network is described by the Health Affairs site as “a consortium of primary care clinics that

aim to increase access to health care services, improve health, and reduce recidivism among highrisk, chronically-ill people recently released from prison.” Other than entry and release continuation of health, for those still incarcerated concerns of chronic ailments eventually leading to aging concerns on top of the conditions, plus an eventual decline, are areas just beginning to be addressed in a study featured by an affiliate and official journal of the NCCHC. The program covered in the June 2021 issue of Journal of Correctional Health Care proposes a way those behind bars can be trained to help with geriatric and end-of-life care. Rather than face-to-face training, which carries a burden, even with the waning pandemic, this research content suggests computer-based training, referred to as Inmates Care training. Focus groups were conducted to identify priority training topics and modules were developed in consultation with an advisory board. After usability testing confirmed contextual relevance and feasibility of the training, the conclusion: “Inmates Care holds promise to complement nurse-led training with a standardized etraining package.” The opportunity for inmates to care for fellow inmates in later years, even for the dying, removes some burden from medical staff—a goal. Moving forward on the front lines in the battle on chronic care for the incarcerated requires skillful monitoring, education and training, standardization of policy and more medical staff—all weapons in hand to deliver the best care. % For further information see the BJS Special Report: “Medical Problems of State and Federal Prisoners and Jail Inmates, 2011–12 (revised in 2016)” at https://bjs.ojp.gov/content/pub/pdf/mpsfpji1112.pdf

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Continued from page 26 strategies such as unobstructed lines of sight, absence of blind corners, and well-lit spaces support a safe environment. An appropriate selection of durable, anti-ligature, and tamper-resistant furniture, fixtures and materials can enhance safety without compromising a welcoming and comfortable environment of care. “Stress leads to agitation and aggression, which in turn often leads to harmful behavior and increased length of stay,” Guerrero notes. “Natural light, views of nature, open spaces, opportunity for physical activity, choice and control, noise reduction, single patient rooms, and smaller group sizes are all proven strategies to reduce stress.”

Making Progress Today, while populations have dipped slightly, nearly 2 million individuals are incarcerated and an estimated 4.5 million adults are under community supervision, according to the Prison Policy Institute, March 2022. Although the criminal legal system “falls short,” says Dr. Karmen, he points to ways it has made some progress over the years. Reentry has become a “buzz word” and has made inroads in assisting individuals to get back on their feet and become productive members of society. Says Karmen: “We now ask in regard to someone being released, ‘what are his employment needs, housing needs, his state of mental health?’ In the past people were dumped out, given a metro card and dropped off by a bus station at Queensboro Plaza, saying ‘Go forth and sin no more.’ Within 10 minutes he was right back to hustling. Now we have services lined up before the person is released.” For example, the Prisoner Reentry Institute at John Jay, founded in 2005, recently received about $2.37 million over five years in coordination with the State University of New York education

system to help incarcerated individuals access college education and ensure they have the support they need when they return home. Changes in language signal we have become more sensitive to derogatory labeling, says Dr. Karmen. We attempt to steer clear of the insulting way we use the words convict, felon or even inmate, and instead use terms such as incarcerated individuals, justiceinvolved persons or for those being released, returning citizens. In 2022, reform is under way. Reentry programs are on the rise, modern facility design caters to improved mental health and lower stress levels, and diversionary programs shift people into alternatives to prison such as electronic monitoring and treatment—yet undoubtedly so much remains to be done to mitigate mass incarceration. Says Dr. Skotnicki: “We have found punishments diminish the humanity of those being punished; [incarceration] hasn’t done more than warehouse the poor to do menial labor or shuffle them in and out of the penal system. “Too many obstacles stand in the path of Black and brown students,” he furthers. We don’t have enough resources to handle it all, he says. “It’s almost impossible circumstances from which they come, it’s a failed social system to intercept, train and guide them into pursuits that keep them out of harm’s way.” Despite the hurdles, he notes that in his work delivering education in jails “we have helped a lot of people along the way; a few have called to thank us later, and it’s gratifying. “They have told me: ‘I’m in the carpenters union, I’m a supervisor at a supermarket, I went to college, I may not have finished’ they say, but just by attending some classes, it changes them,” he says. “They tell me: ‘I’ve realized that I’m smart,’ and that impact is incalculable. For the first time, they discover: ‘I’m not being judged by my jumpsuit.’” %

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