May / June

MAY/JUNE 2020 VOL. 29 NO 3

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Publisher & Executive Editor

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Jennifer A. Kapinos

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Associate Publishers Peggy Virgadamo

Art Sylvie

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Pulse— COVID-19 News

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Editor-in-Chief

Northeast

Donna Rogers

Contributing Editors Michael Grohs, M.J. Guercio, Bill Schiffner, G.F. Guercio Art Director

Jamie Stroud

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Safe Medication Dispensing

Virtual Summer ACA Showstoppers

Profile Series: Securus Improving Lives

The State of the Justice-involved Seriously Mentally Ill

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(ISSN10729275) is published bi-monthly by: Criminal Justice Media, Inc 565 Pier Avenue PO Box 213 Hermosa Beach, CA 90254 (310) 374-2700 Send address changes to:

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33 OF 50 TOP COVID HOT SPOTS ARE IN PRISONS & JAILS On May 22, The New York Times published an updated report, “Coronavirus in the U.S.: Latest Map and Case Counts.” For weeks Times journalists had tracked clusters of cases and deaths across the country. The largest such outbreaks include state prisons in Ohio and Tennessee, a federal prison complex in California, meatpacking plants in the Midwest and an aircraft carrier that was docked in Guam. The deadliest outbreaks have been in nursing homes and other long-term care facilities.

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These following are the facilities across the U.S. with the most cases at the time of press.

The list contains some 500 prisons and jails, as well as food processing plants and nursing homes with at least 50 cases each.

Some agencies and facilities have refused to release the numbers of

CASES CONNECTED TO

CASES

Marion Correctional Institution — Marion, Ohio Pickaway Correctional Institution — Scioto Township, Ohio Trousdale Turner Correctional Center — Hartsville, Tenn.

Smithfield Foods pork processing facility — Sioux Falls, S.D. Tyson Foods meatpacking plant — Waterloo, Iowa Lompoc Prison Complex — Lompoc, Calif.

Cook County jail — Chicago, Ill. U.S.S. Theodore Roosevelt — Guam Cummins Unit prison — Grady, Ark. Harris County jail — Houston, Texas Lansing Correctional Facility — Lansing, Kan. Tyson Foods meatpacking plant — Logansport, Ind.

2,439 1,791 1,308 1,095 1,031 1,020 1,018 969 960 947 913 900

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cases or deaths. More than 1,500 inmates and guards have tested positive across New York City’s 10 jails, and 13 deaths have been tied to those facilities, but officials have refused to provide a breakdown for each jail, the article reports.

The Times has counted more than 44,000 coronavirus infections and 462 deaths in inmates and staff at state prisons, federal prisons and local jails. The country’s three largest known coronavirus clusters are in prisons that have more than 1,200 cases each.

Nearly every state prison system has at least one infection among either inmates or staff, reports the paper. Many of the infections have been asymptomatic, suggesting that

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the problem is more common than is understood. Fear and pessimism has settled in among inmates. Riots in Kansas and Washington State were led by inmates worried about contracting the coronavirus, prison officials said.

Inmates say that they have not been kept informed by prison administrators about correctional officers who have tested positive.

That has left prisoners saying they feel especially vulnerable and also concerned that they might be infected and unwittingly passing the virus on to other inmates.

During interviews with more than two dozen inmates across the nation, prisoners say that correctional facilities are responding to

the crisis far too slowly. At Wyoming Correctional Facility in Attica, N.Y., Tracy White, 30, said that only workers on the serving line in the prison’s mess hall are required to wear masks covering their nose and mouth.

“A lot of people are nervous, tense, scared,” Mr. White said.

Social distancing, he said, is impossible. Beds are placed three feet apart. As Mr. White spoke over a prison telephone, he said another inmate was on another phone less than two feet away. He said he had cleaned the phone as best as he could, but that he was also wearing a sock on his hand to protect himself from germs.

Elijah McDowell, an inmate in

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Connecticut, said the sweep of coronavirus through his prison— including the death of several inmates—had made a bleak existence even more grim.

“Every day is nerve-racking,” he said. “I already have to fight things every day, but fighting the coronavirus, it’s not a fair fight because they keep us in the dark about a lot of things.”

At Cook County Jail in Chicago, where nearly 1,000 inmates and staff have been infected, Antonio House said he washed his hands regularly and tried to be as sanitary as possible in order to stay healthy.

But he said the strain of being unable to maintain six feet of distance from guards and other

inmates who do not always wear masks was at times overwhelming.

“Mentally, it’s rough,” said Mr. House, 45. “It’s scary. I’m fearful because I don’t know how my body will respond if I catch it.”

ACLU FILES SUITS IN TEXAS & TENNESSEE JAILS OVER COVID-19 The American Civil Liberties Union recently filed two cases, one in Dallas, Texas, and the other in Shelby County, Tennessee, to protect those most vulnerable to COVID-19 infection in the nation’s jails. The jails in both cases have some of the highest rates of COVID-19 infection in the country, including the death of jail staff.

“Our epidemiological model

predicts that COVID-19 could claim the lives of approximately 100,000 more people than current projections stipulate if jail populations are not immediately reduced,” said the ACLU, and a recent survey of the most active hot spots for infection shows that 33 of the top 50 are prisons and jails across the country (see The New York Times survey above).

In the Dallas County jail, the ACLU filing states that more than 209 individuals have already tested positive for COVID-19, including people who are detained and jail staff. Due to lack of testing, the true number of those infected may be significantly higher.

“People in the Dallas County jail are stuck in close quarters with sick individuals, with no means to protect themselves from the COVID19 virus that is wreaking havoc on the jail. This is unacceptable. We are asking that the sheriff and county ensure that the jail is required to adopt sufficient public health protocols, such as regular testing, physical distancing, and free access to soap and masks,” stated an ACLU press release.

“The ACLU, the ACLU of Tennessee, and our partners have filed a class-action lawsuit against Shelby County and the Shelby County sheriff to protect medically vulnerable people and people with disabilities detained at Shelby County Jail who are at high risk of severe injury or death from COVID-19,” stated a press release.

As of April 30, 192 people at the jail had tested positive for COVID19, and one jail employee had died.

The lawsuit asks for identification of medically vulnerable individuals held at the jail; the Continues on page 41

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BY G.F. GUERCIO, CONTRIBUTING EDITOR

Protective Security Measures Everything in a facility must have a security or safety component to minimize injuries or damage inflicted on personnel and vital infrastructure.

Focusing on the infrastructure and accoutrements to keep a facility running, these specifically designed products help keep staff and inmates protected. Starting with the structure itself, including ceiling and concealment systems, then fixtures inside like furniture and mattresses, and necessary cleaning and kitchen supplies and equipment, to inmaterelated items for outfitting and hygiene, and finally to mental health-vital games and exercise equipment, all can be found below. Here are measures, pre-emptive and protective, that will help to fortify your facility.

Detention-specific Fasteners/Locks

Flexible Secure Toothbrush A four-inch flexible toothbrush should be “normal” in institutional settings, says Kyle Roberts, VP of Sales at OraLine. “We have heard it time and time again, ‘inmates don’t like short-handled toothbrushes.’ Reducing the handle size and incorporating flexibility reduces the ability of an inmate to weaponize the toothbrush, keeping his fellow inmates and officers safer.” As product 10 CORRECTIONS FORUM • MAY/JUNE 2020

to help a wide range of facilities meet their safety goals while providing effective dental tools.

“Our four-inch toothbrushes may have a reduced handle, but they are flexible and offer the same performance as the national brands,” he says.

888.296.6730, kroberts@oraline.net, www.orabrite.net/OraBrite-Secure-CareProducts

development specialists, OraLine works to identify ongoing facility safety concerns and develops products to address those issues, combining multiple technologies

Sentry Security Fasteners Inc. is a stocking distributor of tamperresistant fasteners, Southern Folger detention locks, and specializes in the needs of jails and prisons throughout the United States. Along with a selection of security screws, nuts and anchors, the warehouse is stocked with locks, lock parts, switches, motors, hinges, door pulls, locks and keys. Whether it is stainless steel, zinc, or alloy, button or flat

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head, oval or truss head, sheet metal or machine thread, selfdrilling or thread forming, or hinge specific, if used for locks, lighting, windows or weather stripping, Sentry carries the inventory and is certified by Southern Folger as an Authorized Repair Center for Southern Steel and Folger Adam locks.

888.693.2646, sales@sentrySF.com, www.sentrysf.com

Wall/Ceiling Intrusion Detection ECSI International developed a security solution for a client who required a facility that could not be breached without immediate detection and assessment at their central communication and command center. “Our Fiber Optic Intrusion Detection System (FOIDS) was selected to be imbedded in the walls as well as the ceiling of the facility to detect any attempt to penetrate the concrete and brick structure,” says President Arthur Birch.

FOIDS can be zoned in 25, 50, 75, and 100-meter zones integrated with CCTV and VMD (video motion detection) tech-

nologies affording a layered as well as redundant method of detection and assessment.

973.574.8555, www.ECSIInternational.gov

Arson-resistant Bedding CR Safguard detention mattresses from Chestnut Ridge Foam, Inc. offer elevated fire performance characteristics specific to the detention environment.

When exposed to ignition sources, the fire-resistant mattresses form a stable char in the area exposed to flame, effectively eliminating the mattress as a fuel source within the cell. “Every year, numerous incidents of correctional facility fires occur, and many are fueled by a detention mattress,” says Justin Head,

Pre-emptive Measures: Moniteau County Sheriff Office/Missouri DOC Tipped Off The case of Jessi Jayne Bull is one example of a crime that was prevented with Securus Technologies’ Guarded Exchange non-private call monitoring. The Moniteau County Sheriff’s office was tipped off by a call from a Missouri Department of Corrections (DOC) investigator saying that Securus had been monitoring calls about a drug drop at Tipton Correctional Center. “Guarded Exchange had latched on to a series of calls from Bull that she was going to be attempting to deliver on February 15, 2019,” Sheriff Tony Wheatley explains.

Due to the tip, DOC investigators were waiting for the suspect’s arrival on that date. Meanwhile, Wheatley and his detectives kept the suspect under surveillance in the parking lot and followed her inside the institution. “She did admit that the drugs were administered inside her person,” Wheatley states. He adds that she was going to pass the contraband to her incarcerated male friend.

She pled guilty to delivery of a controlled substance and was placed on Suspended Imposition of Sentence (SIS) with five years of probation. “This case would’ve never been caught before our use of Securus’ Guarded Exchange,” states Wheatley. “Securus saves us on K9 costs and staff for those investigations, as well as cell phone extractions. It saves us a lot of time, and time is money.”

Facility Furnishings sales manager. At present detention facilities follow regulations for mattress flammability designed for residential applications, not including the potential for vandalism and limited to horizontal testing.

Detention-specific fire performance utilizes a Roll Test. When synthetic or natural/blend fiber mattresses are tested in this manner, they frequently burn or smolder for extended periods, emitting thick, black smoke and/or melt. The CR Safguard, comprised of a fire-resistant cushioning Neoprene compound, does not melt, drip, or ignite, and self-extinguishes once the fuel source (e.g., newspaper) has burned away.

724.537.9000 ext. 265, 724.972.1260 (cell), jhead@crfoam.com, www.crfoam.com

Cautious Recreation The unique pattern on the VisiTect basketball reduces the likelihood that a ball is replicated or purchased from a standard store. This helps increase security by reducing the potential of contraband entering a facility through an ordinary basketball.

The vibrant colors are also easily seen from a distance and do not blend in with surroundings.

Flexible silicone game pieces

—SECURUS TECHNOLOGIES LLC, WWW.SECURUSTECHNOLOGIES.TECH 12 CORRECTIONS FORUM • MAY/JUNE 2020

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and game sets, such as one shown for chess, create a safer and quieter environment for your facility, says Erin Howell, product manager. These resilient board and pieces return to original shape when bent, stretched, or pressed. The pliable material reduces the possibility of weaponizing. They are unable to be melted and molded into various shapes and are lightweight and safer than heavy pieces, she says, as well as quiet when slammed or dropped.

800.334.9880, www.bobbarker.com

Plumbing Protection Real-Tite Pinned and Hooked Security Expansion Plugs help address a common, fundamental and costly problem in correctional facilities—the flushing of items by inmates to create a disturbance or to

avoid sanction for contraband possession. When a pipe becomes clogged, it can lead to flooding and other damage, which is exacerbated if an inmate continues to flush the toilet repeatedly, notes Bob Lins, sales/Real-Tite Inc. A Pinnned Plug incorporates a stainless-steel bolt that protrudes from the end of the plug and when installed into the horizontal sewer pipe catches large items before they can make their way to the main sewer line. A Real-Tite Hooked Security Plug used in vertical line applications incorporates the same Pinned Plug fitted with a 20-inch cable rope and a number 7-treble hook. Real-Tite Security Plugs reusable no-leak design features a gasket that seals iron or plastic pipe openings even if the threads are fouled or damaged from multiple inspections.

800.877.0610, sales@real-titeplugs.com, www.real-titeplugs.com

Meal-Delivery Cart Safety Designs The new Rhino 630-G-87 was designed to fit the Cook’s brand Gator or Grizzly Trays, or any 15- by 13-1/2-inch meal tray. Just like the original Rhino carts, its fully insulated double-walled, polyethylene construction adds rigidity and strength to the cart and doors. The door hinges allow the doors to swing out 270 degrees to be flush with the sides of the cart, making for easy access to the interior when in tight spaces. The hinge pins are molded in and cannot be removed, “not even by the most ingenious of inmates,” says Jeff Breeden, CEO of Cook’s.

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While the doors are designed to open wide for quick loading and unloading, they were also designed to stay shut during transport. Used with a lock or not, a heavy-duty hasp comes down over the doors and a pin slides into place to keep the latch in position. You can easily add a lock for added security or transporting off site, he says.

800.956.5571, Candace Meneou 708-2539100 (cell), cmeneou@cooksdirect.com

Sight & Sound Suppression Blinds Patented magnetic privacy blinds and screens were designed to assist facilities and specialty units to control what inmates see and how they communicate. As the original developer and only authorized manufacturer, Wild Buffalo Technologies & Innovations, LLC provides correctional agencies with a solution for concerns such as: PREA, HIPAA

and Sight and Sound Separation requirements.

Custom b l i n d s include regular blinds, blinds with view ports, and noise suppression blinds. The patented sight and sound suppression works for doors and grates, eliminates inmates’ non-verbal communication, and is applicable for medical and intake areas as visual blockers where males and females are being housed. All models cannot be used as a weapon and are easily cut with an emergency 911 knife.

239.822.0345, wildbuffaloti@gmail.com, www.wildbuffaloti.com www.jailblinds.com

Hardware-free Jumpsuit SoloSuit is a hardware-free jumpsuit with no snaps, zippers or hook and loop. Closures can cause headaches for facilities due

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to inmate misuse. The patentpending SoloSuit design helps prevent indecent exposure and the lack of metal prevents false reads on metal detectors. The newly-introduced design, explains Lonny Carter, product manager “needed to be durable, affordable and surpass the safety and comfort of today’s uniforms.”

800.334.9880, www.bobbarker.com

Traywasher with Security Package Insinger manufactures commercial warewashing equipment specifically designed for corrections environments. The Insinger tray washer was developed to wash and sanitize compartment trays and is the only NSFapproved (National Sanitation Foundation) tray washing system in the industry. By using a vertical spray pattern, tray washers remove debris that standard warewashers leave behind, compartment trays come out clean and sanitized on the first pass.

Insinger’s security package is specifically designed for high-risk facilities, says Annemarie Fisher, director of marketing, and the security package replaces standard parts on the dishwasher with theft-proof components.

800.344.4802, www.insingermachine.com

secured to the substrate with specially-designed heavy-gauge spring steel shield clips installed every 24 inches on center and are demonstrated as each being able to resist a force of 200 pounds uplift at the free end. The enclosure system possesses the unique CON-SEALIT security caulk-retaining groove.

The groove serves to feed and firmly retain the security sealant along the length of the soffit/construction surface, ensuring a clean, tightly sealed and contrabandresistant system.

888.933.2248, sales@jgius.com, www.JGIUS.com

Pipe/Mechanical Concealment JG Innovations’ Soffi-Steel Concealment System is a virtually indestructible, anti-ligature, tamper and contraband resistant concealment system designed to conceal pipe and mechanicals for security in correctional settings, says President Allen Stowers.

Produced with USA made A60/G90 galvannealed steel, it is

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BY DONNA ROGERS, EDITOR-IN-CHIEF

KEEPING TABS ON MEDS A methodical dispensary process reduces staff time as well as pharmaceutical and financial waste, while increasing safety of those incarcerated.

Omnicell XT Automated Dispensing Cabinets (ADCs) provide several safety benefits for both the health care worker and the inmate.

if dispensing medications was ever easy, pharmacy delivery systems just got that much more difficult due to COVID-19.

Preparing medications for a transient population is time consuming and labor intensive.

Medication inventory management and delivery to the patient must be accurate to prevent missing medications, unlabeled doses, undelivered meds and dosing errors. Of course, carrying too large an inventory can go to waste when an offender is moved or released, resulting in financial losses for the facility.

AS

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“The act of writing the prescription may be the least complicated process in a correctional facility’s medication use system,” points out Deleca ReynoldsBarnes, PharmD, vice president of Pharmacy, with Wellpath (formerly known as Correct Care Solutions), a healthcare company focusing on corrections based in Nashville, Tennessee.

Filling regular prescriptions quickly and efficiently when health care workers may be short staffed and population are falling sick is all the more important in today’s environment.

Dispensing medications

methodically in corrections facilities requires a comprehensive and multi-faceted process, says Reynolds-Barnes. It all begins at intake, she adds. Before putting pen to paper (or actually typing the prescription into the electronic health record), the medication history is imperative to ensure the appropriate medications are prescribed.

Following a review of the intake medication records, medication reconciliation should be completed, which is the comprehensive evaluation of patient’s medication regimen, due to a transition in care, to avoid med-

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ication errors such as omissions, duplications, dosing errors, or drug interactions, as well as to observe compliance and adherence patterns, she asserts.

The second key to ensuring the availability of medications is having an inventory system that ensures par level management of non-patient specific and patient specific medications. Medications kept in the medication room and on medication carts should be included, as well as tools to easily track the locations medications within the facility.

Reynolds-Barnes furthers that barcode technology, while often used in the medication administration process, is also an important tool for the inventory process. She says multiple medication dispensing systems are available to correctional facilities based on individual state board of pharmacy and federal regulations. “There is no single perfect dispensing system and often a combination of systems offer the best option to ensure availability of all medications at the scheduled administration system.”

Blister cards/bubble packaging, the most common correctional facility medication packaging system, use little space and offer an efficient medication cart storage

state specific licensure requirements addressing the need for an onsite pharmacy and/or pharmacist would need to fully vetted.”

Another implementation option, notes Reynolds-Barnes, is receiving medications from your pharmacy in compliance packaging. This would require receiving significantly less than a 30 days’ supply (usually 1-7 days), and having appropriate medication storage system. Inhouse processes to manage this system are essential and the facility often loses the opportunity for returns and credits. Frequent patient medication changes are often cited as the reason these systems are not frequently used.

The third option is the use of automated point of care dispensing machines in conjunction with a licensed pharmacy (i.e., Pyxis, Omnicell, MedDispense, etc…).

Again, the ability to use these systems require an in-depth review of state board of pharmacy regulations. If allowed at a facility, you often gain the benefit of a perpetual inventory system with barcode technology. These systems can alert the nursing staff and pharmacy prior to the administration of the needed medications.

The following are examples of a variety of these systems—both

The “Eight Rights” of Medication Administration The nurse will give the right dose of the right medication to the right patient via the right route at the right time for the right reason, perform the right documentation, and get the right response from the medication.

—WEXFORD HEALTH

option. The use of compliance packaging is another packing system option. While it has been shown to decrease the time the nursing staff spends in the medication administration process, it is imperative that nursing has a system to review for medication changes prior to the administration cycle. Wellpath’s pharmacist cautions that “The implementation of these system would require installing these systems on site and 20 CORRECTIONS FORUM • MAY/JUNE 2020

manual and automated—that prisons and jails employ to streamline the process and maintain control of their inventories.

Celebrating its 50th year, MediDose/EPS has been working with pharmacists and health care professionals to design and support cost-effective products solving the specific needs of their practices.

Its Medi-Dose System is used by correctional facilities of all sizes to package solid oral, unit dose med-

Swisslog Healthcare’s InSite InFacility Medication Packaging and Dispensing System stores up to 240 different medication types.

ications. The company’s EPS division provides liquid packaging, tamper evident bottles, tapes and other ancillary items.

Working with pharmacists and technicians, the company reports the Medi-Dose system has been designed to be an easy and costeffective way to unit dose and bar code medical inventory. Because of its cold seal technology, it doesn’t require special inservice training and staff can easily package blister packs with only inhouse supervision. “It’s all manual and easy to do and learn,” says Bob Braverman, president. “The technician or pharmacist takes the blister, places it into our template, dispenses the medication into the blisters, peels the label, places it on the blisters and, just like that, they’ve just packaged 25 doses of medication.

With the Medi-Dose system, all of the meds can be identified with the medication name, generic name, right down to a bar code and expiration date… whatever is pertinent,” he says.

The optional software is inexpensive, he says—about $500 to purchase new—and is easy to learn. Tech support is free and continues for the life of product.

Custom written for pharmacies, it offers flexibility, and a variety of bar coding options that can be customized by the customer, with

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any font or graphic, for example, and that format can be automatically saved for the next time the medication is selected. Designed with security in mind, only supervisors with permissions can change the fields. The software provides accountability—it records all labels and allows reports to be generated on types of medications packed, on lot numbers in case of a recall, on meds packed by a particular employee and more. “A variety of checks can be turned on or off— they are all optional,” notes Braverman.

The system works for both large and small facilities, he explains. “We’ve been told by countless hospitals, pharmacists, nurses, that we offer a time saver and have reduced medical error.

Perhaps it’s a testament to the company that “50 years have come and gone and we’re still here,” he says. “We offer new blisters, new shapes, different plastics, enhanced options, but the general nuts and bolts of system are the same, and we add new customers every day.” In fact, he adds, “we’ve become a go-to for people, particularly in these uncertain times.”

Comprehensive Pharmacy Another option agencies deploy is system of overarching pharmacy care.

Diamond Pharmacy Services has been providing these types of services to state, county and juvenile correctional facilities since 1983.

Currently, it serves nearly 700,000 correctional patients in 46 states.

Diamond’s comprehensive pharmacy services program entails prescription dispensing, pharmacy management and a strong clinical program to ensure patients receive the proper drug therapy for the best clinical outcome at the most competitive price. “This means more than just medications,” says Mark Zilner, 22 CORRECTIONS FORUM • MAY/JUNE 2020

COO. Outside of prescriptions and medical supplies, Diamond offers overnight delivery, 24/7 pharmacist consultation, formulary management, robust reporting services, credit on returned medications and free electronic ordering and record management through Sapphire eMAR (electronic Medication Administration Record) as well as offer Sapphire EHR (electronic health record), both developed solely for the correctional market. (Ed note: SapphireHealth is the maker of Sapphire eMAR/EHR, the electronic system provided by Diamond Pharmacy Services.)

Diamond offers several ways to order. Traditional phone or fax methods are available, but many facilities are looking for an electronic solution, which is where Sapphire comes in, the company explains. Orders are transmitted to Diamond via Sapphire, where it is processed by a technician and then reviewed by a clinical pharmacist. Once orders are packed and processed, they are once again reviewed by a pharmacist to further ensure accuracy, they note. This system, with numerous staff checks as well as a barcode driven component, helps to ensure the right inmate at the right facility receives the right medication. Facilities also use Sapphire to check in their order and to return medications.

“Quite simply, the benefits of a

system like this,” says Zilner, “are accuracy and overall medication management. Accurate orders arriving to our facilities on time lead to better patient outcomes, save staff time, and keep a correctional facility’s health care program running at the best possible level.”

Sapphire screens for allergies, drug interactions, proper dosing, refills ordered too soon In addition to a stringent quality control system for the ordering process, Diamond offers a prescription reconciliation program at the facility level. This allows a facility to scan all prescription orders to verify that what was ordered was indeed received.

Zilner notes: A good eMAR system should provide an additional layer of quality control and accountability. The Sapphire eMAR, which is fully HIPAA compliant, enables for an accountable paperless med pass, which is barcode enabled permitting staff to verify that the right inmate is receiving the right medication at the right time.

Point of Care Automation Omnicell, a Mountainview, Calif., company likewise provides comprehensive pharmacy solutions including central pharmacy dispensing, intelligence and point of care automation. In the latter category, Omnicell XT

With the Medi-Dose cold seal system, the technician or pharmacist can quickly package 25 doses of medication.

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Automated Dispensing Cabinets (ADCs) provide “a smarter, safer process for getting the right medication to the right patient. They offer improved nurse-pharmacy workflows, medication inventory management capabilities, as well as enhanced medication safety and security, according to Len Hom, director of Product Marketing, Point of Use, Omnicell.

Omnicell’s XT ADCs provide several safety benefits for both the health care worker and the inmate.

All medication orders written by a physician are reviewed and profiled by a pharmacist and are interfaced (via electronic health records) with the dispensing cabinet at the facility, he furthers. This allows real-time dispensing at the prison.

The XT also provides reports, ensuring accountability for all transactions including documentation on anyone who entered the high-security, doublelocked ADC. “All controlled substances require a second witness to allow dispensing and a ‘blind count,’ meaning that the authorized person obtaining the medication has to count back and enter a quantity into the system,” Hom details. “If the count varies from the amount that is supposed to be in the bin, a report is generated and must be addressed before end of shift.”

As another safety benefit, when restocking, Omnicell’s Safety Stock barcode verification ensures

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proper placement of medications. This includes the use of “guiding lights” to direct users to specific locked bins for restocking. External return bins allow medications to be returned safely to the pharmacy. The bins in the XT ADC are not removable, thus preventing infection control issues to and from the facility to the pharmacy, important at any time, but even more so today.

Automation Solutions Swisslog Healthcare combines advanced transport and pharmacy automation solutions with integrated, accessible software to enhance performance and workflow efficiency, improve accuracy and enable better patient care. Parent company, Swisslog, a global company with Swiss roots, is one of the world’s leading logistics automation companies.

Swisslog Healthcare’s InSite® In-Facility Medication Packaging and Dispensing System is utilized in numerous corrections settings, including many prisons and jails, packaging over 32 million doses annually to over 25,000 inmate patients. It stores up to 240 different medication types in a single medication dispensing unit, providing automated, on-demand compliance packaging for oral solid medications prior to administration. The pharmacy delivers bulk canisters of medications to be stored within the system.

Patient medication orders are transmitted to the pharmacist for clinical review. After approval, the orders are electronically sent to the InSite system and medications are immediately available at the corrections facility. Nursing or pharmacy staff runs the system for the medication call and it dispenses only the medications needed for the patients of that call. The medications can be dispensed by various sorting options, including inmate location. The orders are dispensed from the system in unit or multi-dose, patient-specific packaging. Medication is administered to the inmate at the inmate bedside or at the medication call line by the nurse. The InSite system keeps a record of each dispense.

“Our flexible automated solutions can meet a facility’s changing requirements and enable them to meet the unique challenges of a transient patient population,” says Mike Carmody, vice president of Long-Term Care at Swisslog Healthcare. “By adopting the InSite in-facility medication packaging and dispensing, correctional facilities benefit from improved workflows and a more secure, efficient and accurate medication management process.”

For example, the act of enabling automated packaging and dispensing within a correctional facility improves staff efficiency, reduces medication waste and saves time. The average InSite canister holds about 300 doses and can be filled and processed in roughly the same time it takes to create a single 30day blister pack. “Traditional blister packaging of medications is an error-prone, labor-intensive medVISIT US AT WWW.CORRECTIONSFORUM.NET

ication management process, which is time-consuming.

Automating packaging and dispensing dramatically reduces the time needed to prepare medication, by packaging up to 60 does per minute and providing a broad variety of sorting options,” he says.

Wasted medications cost correctional facilities hundreds of thousands of dollars every year, according to Swisslog. Due to the transient nature of patients when people are transferred to other facilities, paroled or released, many medications go unused.

“Our automated solutions enable you to manage pharmacy inventory more effectively by packaging and dispensing medications on demand. The automated system provides complete visibility by tracking inmates’ current location based on the latest data— even if they are off-site or at court,” Carmody points out.

“The InSite System transforms the process of medication dis-

26 CORRECTIONS FORUM • MAY/JUNE 2020

pensing in corrections facilities from a tedious, error prone set of tasks to an efficient, automated workflow. This ensures adherence to strict regulatory requirements as well as the legal rights of inmates,” says Carmody. “Ondemand medication access helps correctional facilities improve inmate care and nurse satisfaction through efficiency gains, while offsetting the financial burden of rising drug costs and reducing medication waste.”

Effective eMARs Dispensing medications methodically remains a constant challenge, concurs Martha Ingram, RN, CCHP, CPHQ, director of Quality Management & Performance Improvement, Wexford Health. “The sheer volume of medications to be received, checked, and administered to inmate patients is the number one challenge,” she says.

She adds it is of utmost impor-

tance that correctional facilities and nursing staff have an organized, effective method in place for safely administering high volumes of medications to inmates on a daily basis.

One of the issues of medication dispensing is that it takes up the time of custody staff, she points out. While medication distribution and administration is typically the responsibility of nursing staff, custody officers are often required to accompany them. Facilities are looking for the most efficient method of medication administration to limit the amount of time that custody personnel are tied up with each medication distribution. Of course it is also important that the medication is accurately given to each person and appropriately documented, she continues.

To meet this challenge, for the majority of its clients, says Ingram, MEDS: Continues on page 41

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COMPLIED BY BILL SCHIFFNER, CONTRIBUTING EDITOR

Show Stoppers for the “New Normal” Print, web and social media “get the word out” in publicizing new products in age of COVID-19.

ue to the coronavirus and its possible impact on the health and safety of attendees and exhibitors, conference organizers all over the country have canceled just about every trade show and conference during the spring and summer months. It’s anyone’s guess if it will be safe to have major public gatherings by the fall. In addition, many companies and agencies are also restricting their executives’ travel plans over fears of contracting the virus and are placing a freeze on all staff travel due to the virus. Zoom has become the new way to interact.

For administrators looking to add new products and technologies to their facilities during these challenging times, Corrections Forum offers this latest crop of new products and services to check out. Browse as you social distance, keeping yourself safe!

D

28 CORRECTIONS FORUM • MAY/JUNE 2020

Re-entry Resource

AtoZ Pathways is a database reentry tool to help offenders return to their communities. It is a one-stop source to help offenders find successful resources to reenter and transition back into the mainstream. The service helps clients find jobs and community services in three easy steps.

877.428.0101, atozdatabases.com

Cold Storage Solutions Lowe Rental is a leading refrigeration rental specialist with a

comprehensive range of frozen storage options available for hire across the U.S. If a facility is extending retail food storage capacity with back of house cold storage, Lowe can provide a storage freezer, walk-in cooler or display freezer rental to meet a facilities requirements. The company also supplies food service providers with commercial display freezers and frozen storage to facilitate cold food storage

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required during food preparation and large volumes of meal preparation.

844.655.1320, www.lowerental.com

JMS Automation Systems Law enforcement and corrections agencies use ATIMS software to achieve greater efficiency, improve communication, and to reduce costs while increasing

in criminal justice administration. This degree program prepares criminal justice professionals to make rational decisions and informed responses to the daily challenges in law enforcement and prepares students to pursue a career in law enforcement, courts and corrections.

1.800.355.4977, www.ColumbiaSouthern.edu

Professional Certifications

safety. Their solutions work together, work with their partners and other vendors, or stand alone, depending on your requirements. You can choose local hosting or cloud solutions.

Prompts take staff step by step through intake, booking, sentencing, and release. Use forms and easily update them as your processes change. Use biometrics to streamline your workflow and ensure correct identification.

ATIMS gives facilities robust customization tools in the industry for your system, your departments, and your users.

Administration and IT departments can customize everything from workflows and fields to separate operations by facility.

818.428.6190, www.atims.com

Online Degrees Columbia Southern University’s online Bachelor of Science in criminal justice administration is suitable for both entry-level and seasoned professionals who are pursuing careers

As the premier provider of educational resources, materials and programs to help attract and develop a strong industry workforce, ServSafe has been the restaurant industry's leading association since 1919.

since 1979, and the only domestic manufacturer in the United States.

Their products are engineered for consistency in structure, material composition and conform to federal, state and industrial specifications. The Razor Ribbon line of barbed tape products is the optimal choice for perimeter security protection. Manufactured for use in the most secure and restricted environments, Razor Ribbon has enhanced security protection for a variety of industrial, military, and institutional facilities. The products are razor sharp and can create serious cuts on anyone trying to climb over the barrier. The products are not only used as a physical barrier but also work as a psychological deterrent.

800.882.5543, www.razorribbon.com

Corrections Product Source The ServSafe Food Safety Training program leads the way in providing current and comprehensive educational materials to the restaurant industry. More than 4 million foodservice professionals have been certified through the ServSafe Food Protection Manager Certification Exam, which is accredited by the American National Standards Institute (ANSI) Conference for Food Protection (CFP). ServSafe training and certification is recognized by more federal, state, and local jurisdictions than any other food safety certification.

800.765.2122, www.servsafe.com

Perimeter Protection Solutions Razor Ribbon is the world’s leading and longest standing manufacturer of barbed tape products

Real Time Detention is a manufacturers’ representative agency with a focus on correction facility consulting in the Criminal Justice market. All the products they represent and all the services they

offer are designed to meet the unique challenges of the corrections industry. The firm provides consulting and budget support for products, such as controls integration, detention hollow metal doors and frames, detention screens, high performance coatings, inmate telephone services, correctional furniture, security gates, security glass, security metal ceilings, security windows and steel cells.

317.567.0087, www.realtimedetention.com

Health Care Strategies VitalCore Health Strategies has been serving correctional institutions and their oversight boards for many years. The company 30 CORRECTIONS FORUM • MAY/JUNE 2020

VISIT US AT WWW.CORRECTIONSFORUM.NET

Cellphone Detection Cell Detect is committed to eliminating illicit cell phones in all correction facilities. Their cell phone detection and identification system, Cell Trax, identifies the individuals who are holding a cell phone as the phone is powknows how to deliver safe, highlevel correctional health care at a lower cost. The company’s patient-first approach ensures safe, high-quality care aimed at optimizing outcomes and mitigating risk. They focus on preventive care, outcomes-based behavioral services and treating the whole patient.

785.246.6840, www.vitalcorehs.com

tough. It also features customizable escalating energy, faster shock times and dual-language capability.

800.426.0337, www.cardiacscience.com

Tamper-resistant Security

Laser Tattoo Removal

Tanner is a single-source industrial supplier for more than 20,000 products including fasteners, anchors and sealants. Their

ered up or in use. A small, lightweight bracelet is securely attached to each inmate’s ankle and detects the RF signature emanating from the cell phone and transmits a message to the company’s cloud computer system. Cell Detect immediately notifies prison officials that a cell phone is in use and who is using it. In addition, Cell Trax will report an accurate inmate count each and every hour. The company is also currently developing technology that will emit a low-power, short burst, jamming signal precisely timed to prevent the illicit cell phone from receiving responses from the tower, effectively rendering inoperable only this one device.

888.576.9609, www.celldectect.com

Inkoff.me began in response to needs in the community for tattoo removal for ex-gang members and sex trafficking branding. The company has opened three locations in California and has treated over 100,000 tattoos since 2012.

916.600.4428, www.inkoff.me

Treating Liver Disease The FibroScan family of products offers a quick and non-inva-

CPR Feedback Device commitment is to provide superior value and help customers get their jobs done better and faster.

Products include self-drilling screws, one-way screws and female tamper resistant barrel nuts. Tanner security products are available in a wide variety of diameters, lengths, materials and finishes.

800.456.2658, www.tannerbolt.com 32 CORRECTIONS FORUM • MAY/JUNE 2020

Cardiac Science has introduced the Powerheart G5 + ICPR. The easy-to-use Intellisense CPR feedback device works in combination with the Power G5 AED to deliver potentially life-saving CPR and defibrillation therapy. Light enough to travel anywhere but strong enough to pass military standards and receive an IP55 rating for protection from dust and water, the Powerheart G5 is built

sive aid in the treatment of patients with liver disease in a facility. The shear wave speed and stiffness, and Controlled Attenuation Parameter may be used as an aid to diagnosis and Continues on page 34

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BY PERLA JOHNSON PROFILE FROM SECURUS TECHNOLOGIES, NO. 2 IMPROVING LIVES FROM THE INSIDE OUT

Community Tablet Helps Incarcerated Individual Prepare for Success Jacob Currey, an incarcerated individual at the Kendall County Sheriff’s Office in Illinois, is hopeful for his opportunity to study computer networking and get a job when released.

This profile series will feature interviews with incarcerated individuals who have been empowered with educational technology and communication tools provided by Securus Technologies to help prepare for successful reintegration to society upon release. The second installment highlights Jacob Currey, an incarcerated individual at the Kendall County Sheriff’s Office in Illinois.

Since the Sheriff’s Office introduced the Securus Technologies SecureView® Tablet in July of 2019, unproductive idle time has been replaced with opportunities to build both knowledge and inspiration, according to Sherrif Dwight Baird and the incarcerated individuals themselves.

Currently 140 tablets have been distributed to residents since the program launched.

“The incarcerated individuals have time on their hands. With the educational, job search and mental health content available on the community tablets, they can put that time to constructive use,” says Baird.

Nationwide, Securus Technologies provides over 60,000 incarcerated individuals equal access

to critical content on the complimentary SecureView® community tablets with programs such as education, overall betterment, mental health and religion. The wide variety of content has helped Currey envision a path to rebuild his life with education, self-help and employment that gives him hope for the future.

“I plan to earn my degree in a field that provides good employment options. Using the SecureView Tablet, I have started looking at job opportunities, testing my skills and begun taking classes,” he states. “I got knowledge and the learning skills to gain employment.”

Currey’s favorite programs on the community tablets are those that help him sharpen his skills in math, science, history and civics.

He especially enjoys the self-paced learning and testing. He has set

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high goals and the digital resources have educated him on everything from the college AP process to obtaining financial aid, grants, and even scholarships.

“I want to study computer networking, get certified as a Cisco network associate,” Currey adds.

However, he is not only focused on his career aspirations.

The tablets have helped him focus on what is important through its religious programming. He has learned life is not just about helping yourself, but also about aiding others as well.

“I want to assist youth to get them in the right direction,” Currey states. “Having spiritual guidance helps me stay positive and maintain a good mindset.

Through spiritual growth, I can help others. It gives me a sense of fulfillment.”

According to Sheriff Baird, opportunity is the key factor in aiding incarcerated individuals improve their lives and build success and that is why he was excited to add the SecureView Tablet to his facility.

The Kendall County Sheriff’s CORRECTIONS FORUM • MAY/JUNE 2020 33

Office houses about 90 federal incarcerated individuals and, as a result, receives routine inspections. A recent tour included a federal judge. “He wanted to get a look at the environment of the federal inmates. He was absolutely elated with the tablets and commended us on its betterment opportunities. He was singing praises about them,” Baird details.

The tablets have also had a positive impact on the jail environment in another way. Both the Sheriff and Currey believe the tablets have exceeded expecta-

tions by helping to lower the noise in the facility and also help drastically reduce inmate-oninmate violence.

“They look at a tablet as a work environment. It grants them opportunities, so they don’t feel helpless or jealous of one another,” states Baird.

For Currey, the tablets are an escape from negativity. “You’re going into your own world to prevent physical altercations.

And in my case, I also love to learn. The tablets take me away from TV life, card games, defiance and arguments.”

Currey reflects on how he wound up in jail to begin with.

He was young, shaped by his environment, which he thought was the world and the only way.

But now, he knows better and has a plan.

“I want a job that allows me to contribute to society and that I can feel good about at the end of the day.” %

Continued from page 32

laboratories. Cara Print 4.0 is designed to meet the needs of dental technicians for a faster, more economical method of producing polymer-based dental appliances in-house. Not only does it provide a cost effective alternative to milling for certain indications, it is priced more competitively than other 3D printers on the market while still meeting all accuracy requirements.

800.431.1785, www.kulzerUS.com

Dome Radar

monitoring of adult patients with liver disease, as part of an overall assessment of the liver. The lineup includes the FibroScan Touch 502, FibroScan Compact 530 and FibroScan Mini+ 430.

781.790.0845, www.echosens.us

Dental Restorations Kulzer has been manufacturing dental acrylics since the 1930s, and has developed a tradition of quality, reliability and excellent

aesthetics within the field of dental prosthetics, the firm states.

The company offers the cara Print 4.0, a 3D printer capable of printing a wide and expanding range of dental appliances for dental 34 CORRECTIONS FORUM • MAY/JUNE 2020

Corrections Communications Technology Smart Communications is a pioneer in the inmate-communications industry and serves over 100 correctional facilities across more than 20 states. The company developed and provided the first kiosk-based electronic-messaging system for correctional facilities, and its groundbreaking postalmail-elimination technology enables facilities to stop the infiltration of drugs and other dangerous contraband. The company also offers SmartTablet products to facilities.

888.253.5178, www.smartcommunication.us

Contributed by Perla Johnson, marketing communications manager, Securus Technologies.

SpotterRF Perimeter Surveillance Radars is an advanced Compact Surveillance Radar (CSR) system for perimeter, ground, land, air, sea, drone detection, artificial intelligence radar surveillance security systems. The solution at its core is wide-area detection and tracking—which provides advanced warning and response through automated alarms. Using cutting-edge radar technology, the system can pinpoint the location of potential intruders.

801.742.5849, www.Spotterrf.com

Intelligent Security Representing the latest innovation for intelligent security, Salient Security Platform is a unified platform that is scalable and secure.

With a newly designed user interface, multi-point monitoring capabilities, and seamless third-party integration for access control, license plate recognition, and analytics, Salient is said to deliver a comprehensive management solution to meet your security needs— today and tomorrow.

844.725.4368, www.salientsys.com

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BY DONNA ROGERS, EDITOR-IN-CHIEF

The State of The JusticeInvolved Seriously Mentally Ill What are best practices correctional departments are engaging to address this crisis?

According to the American Psychological Association nearly 4% of all inmates are schizoid; 18% suffer major depression. It is also reported the 2%-4% are bipolar and 72% of inmates have multiple disorders. It has often been said that correctional facilities serve as today’s mental health institutions—with disastrous effect on those they are meant to treat.

To better understand this crisis in correctional facilities nationwide, Corrections Forum asked sev36 CORRECTIONS FORUM • MAY/JUNE 2020

eral medical directors, mental health providers and prison advocates how they best address this medically challenged population.

“Sixty years of failed mental health policies and misplaced incentives have forced law enforcement onto the front lines of mental illness crisis response.

Jails and prisons are now our de facto mental health institutions, as psychiatric bed capacity has reached its lowest point in our nation’s history,” states John Snook, executive director, Treatment Advocacy Center, in testimony before the President’s

law enforcement commission this past spring.

Law enforcement officers do not sign up to be mental health practitioners and using them as such wastes precious resources, damages law enforcement-community relationships, unnecessarily criminalizes a medical issue and ultimately ill serves both the person in need and the system attempting to provide care, he furthers.

Snook points out that an estimated 8.3 million adults in the United States live with a severe mental illness (SMI).

Approximately half go untreated

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every year (Treatment Advocacy Center, 2017). The consequences of failing to care for the most severely ill are devastating and have significant implications for law enforcement and the effective administration of justice, he says. As a result of limited community treatment options and a dire shortage of psychiatric treatment beds, those in need of mental illness care frequently only receive care once a crisis occurs that necessitates law enforcement involvement. He points out that, though numbering somewhat fewer than 4 in every 100 adults in America, individuals with SMI generate no less than 1 in 10 calls for police service (Chappell, D., Editor, 2013).

The National Alliance on Mental Illness, or NAMI, the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness, points to similar sobering statistics. It is estimated that nearly 11.2 million adults (NIMH, Feb. 2019) in the U.S. have a SMI yet only 64% received treatment in 2018 (Substance Abuse and Mental Health Administration, Aug. 2019).

“There are many reasons why people don’t receive treatment, but one is that there is an absence of a community-based mental health system that can meet the needs of people with mental illness. Without a robust mental health system, we are forced to place an overreliance on the criminal justice system to address the mental health crisis,” according to Daniel H. Gillison, Jr., CEO of NAMI. “Mental illness is not a crime,” he furthers, “we should not treat it as one. When someone is experiencing a medical emergency, such as a heart attack or a stroke, it is almost guaranteed that if they call for help, they will be provided with the medical care they need.

However, when someone is in a mental health crisis, they often get a cop, not a doctor.”

We know that when people with serious mental illness don’t get adequate treatment they can end up in hospital emergency rooms, in jail, or on the streets with worse long-term outcomes.

“People with mental illness in a crisis need help, not handcuffs.

“Jails and prisons are expected to provide treatment in a system that is not structured to provide the therapeutic environment necessary to treat mental illness, and we turn to the courts to connect the most seriously ill with the services and supports they need.

“NAMI is fighting to ensure that people with serious mental illness can access the treatment they need and deserve so they do not end up in hospital emergency rooms, in jails, and homeless on the streets. Creating an effective mental health system that has the services and supports to help anyone with a mental health condition is the number one thing we can do to reduce our reliance on the criminal justice system,” asserts Gillison.

High Cost of Lack Of Treatment As a result of the lack of public health treatment for those with SMIs the high cost of treatment falls to public safety and corrections. According to Snook, a 2019 survey done by Treatment Advocacy Center in conjunction with the National Sheriffs Association on the role and impact on law enforcement of transporting individuals with SMI found that at least one-fifth of total law enforcement staff time was used to respond to and transport individuals with mental illness, at an estimated cost of $918 million.

Another survey by the Treatment Advocacy center showed that law enforcement officers nationwide drove a total of 5,424,212 miles to transporting individuals with serious mental illness in 2017 (Sinclair, E., et al., 2019).

“This poses a significant financial burden on law enforcement

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and county budgets,” Snook underscores. Mentally ill inmates cost more than other prisoners for a variety of reasons, including increased staffing needs. “In Broward County, Fla., in 2007, it cost $80 a day to house a regular inmate but $130 a day for an inmate with mental illness. In Texas prisons in 2003, the average prisoner costs the state about $22,000 a year, but prisoners with mental illness range from $30,000 to $50,000 a year.”

Psychiatric medications are a significant part of the increased costs. The cost of settling or losing lawsuits stemming from the treatment of mentally ill inmates also adds considerable costs.

(Treatment Advocacy Center, 2016, Serious Mental Illness Prevalence in Jails and Prisons.)

Current Prison Strategies How are health care providers inside prisons and jails addressing these individuals with SMIs within their populations?

Wellpath says its focus in responding to its large population of patients diagnosed with serious mental illness is grounded in a model of proactive care, from identification, to provision of evidence-based treatment, to planning for release back to the community. Charlene Donovan, Ph.D., RN, MSN, PMHNP-BC, vice president, Behavioral Health Services, says that a solid intake process is necessary to start each patient on a trajectory of proactive care, and including behavioral health professionals in the intake process can be particularly valuable. Identifying mental and behavioral health issues, along with recognizing the need for a more thorough assessment of clinical need as quickly as possible starts a thorough treatment process, she adds.

In order to quickly triage, “The Wellpath Receiving Screen provides guidance for users in terms of determining the urgency status of the referral. Our team members receive training in issue-spotCORRECTIONS FORUM • MAY/JUNE 2020 37

ting more time sensitive clinical presentations and are encouraged to use their clinical judgment when the status of a referral needs to be escalated in terms of urgency of response.”

Assuring patients that we are aware of their health care needs and are working to initiate services for them can go a long way to addressing any anxieties they may have about whether their needs will be met while incarcerated, she furthers. “Engaging in these initial visits as soon as clinically indicated sets the tone for the patient that he or she is working with a health care team who cares about patients.”

Collaboration between health care team members is another essential feature of a health care program that successfully manages a large and clinically challenging population, according to Donovan. “Daily meetings to review high-risk patients should include all health care stakeholders. Specialized units should also utilize a team meeting approach, and when appropriate, custody staff should be involved as well.”

Donovan says that the opioid cri-

sis and the suicide crisis has been a particular challenge for our patient population and for correctional health care providers.

“Effective treatments for both of these issues require additional resources and the need to ramp those resources up very quickly.”

Utilizing technology such as tablets, computerized psychoeducation applications, and virtual interventions, can also increase the efficiency of mental and behavioral health care efforts in correctional settings. “Notably, telehealth has been increasingly implemented in rural settings in the free world with success,” she says. “Its use in the correctional setting allows for expeditious mental health care by allowing highly qualified professionals provide service at facilities in rural and hard-to-service areas.”

Finally, Donovan tells of how her perspective has shifted on the subject of medication assisted treatments (MAT). “For those of us who have been involved in correctional health care for many years, it seems like we may be seeing indications of a paradigm change in the approach to care behind

the walls. The introduction and gaining acceptance of [MAT] in our facilities offers our patients opportunities at approaches to care that can be life-changing for them, reducing the risk of relapse and recidivism significantly. In behavioral health, the changing focus to the risk-needs-responsivity model of care encourages our providers to focus on several fronts of treatment, including reducing risk of recidivism.”

The dual challenges of the opioid and suicide crises will likely change the approach of correctional care for years to come with even greater focus on evidencebased treatments and clinical programming at higher levels than seen previously, believes Donovan. “These are exciting times to be involved as a correctional health care provider, and our challenge is clear—to continually evolve to meet the clinical needs of our patients as their needs change over time.”

There has been a paradigm change in how behavioral staff conducts their work, concurs Ronald J. Smith, PsyD, CCHP-MH, corporate vice president,

It is widely accepted that telepyschiatry has the same benefits as face-to-face visits, and can guarantee continuity of care even from the most remote locations.

38 CORRECTIONS FORUM • MAY/JUNE 2020

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Behavioral Health Clinical Services of Wexford Health Sources, Inc. Over the last 10 years, he says, it has become necessary for behavioral health staff to not just respond to the needs of inmates, but to become proactive in the development of services and activities that meet the needs of the inmates and keep everyone safe and secure. “Wexford Health’s behavioral health staff has become a vital front line team in the life of the correctional setting,” he notes. “Our behavioral health programming is a robust set of services and protocols that allows for maximization of resources and enhanced quality clinical services across all facilities and all levels of care.”

3 Keys to Quality Training is a key in Wexford’s overall plan, details Smith. “It is essential that all correctional facilities and systems develop and implement an ongoing comprehensive behavioral health training program, focusing on all facility staff, including custody and administration,” he says. “Such training should be geared toward the specific duties of the attendees. It is vital that trainings be conducted routinely and that there be an experiential ‘handson’ component involved.

Wexford Health has established an in-depth training library utilizing various modalities of learning-classroom, practical firsthand, online, and self-guided. It is also critical that behavioral trainings be ‘frontloaded’ and provided to all in employees during orientation or while attending Academy,” he emphasizes.

Tele-psychiatry is another area that holds promise. “Wexford Health has found that tele-psychiatry and tele-psychology can increase the quality, communication, and consistency of behavioral health care in correctional facilities,” says Smith. “In our experience we have found that the quality of psychiatric services in tele-health visits is at least as 40 CORRECTIONS FORUM • MAY/JUNE 2020

good as face-to-face. Our experience is consistent with research that indicates that some patients speak more freely (and disclose much sooner) when using telepsychiatry than they do in faceto-face encounters.

Pharmocology should be part of an overall plan, Smith continues. “Years of evidence-based, best practice standards lead Wexford Health’s strong advocacy for the prudent use of psychotropic medications in correctional facilities.” When coupled with provider evaluations and appropriate patient inmate review, behavioral health pharmacotherapy is an extremely effective way to help inmates with serious mental illness.

However, he cautions: “While medication can provide immediate and life-changing results, we recognize that pharmacotherapy is only one aspect of the continuum of necessary services, so we couple them with cognitivebehavioral therapies, support services and case management.”

Community Strategies NAMI provides advocacy, education, support and public awareness for those with mental illness in communities across the U.S. Its initiatives seek to reduce the number of justice-involved persons before they enter the system.

NAMI maintains that estimates reflect that 6%-10% of all calls to law enforcement involve someone with an SMI, according to a 2016 study “Contact Between Police and People with Mental Disorders: A Review of Rates,” in Psychiatry Online.

“Many of these calls are for someone in crisis who needs mental health care, not jail,” says Gillison, NAMI’s CEO. By bolstering crisis services in every community, it creates an alternative to calling police and allows the mental health system to intervene and provides law enforcement with an alternative to taking someone to jail, he continues.

Gillison explains that core

components of any crisis system include 24/7 crisis hotlines, warm lines, mobile crisis services, crisis stabilization programs and peer support services. All these services are resources for law enforcement and other first responders. They can be used as referrals to address situations that do not require a police response. They also shift responsibility from law enforcement back to the mental health system. “Simply put, robust crisis response systems can mean the difference between receiving help or handcuffs during a mental health crisis,” he says.

Many of the more than 640 NAMI state and affiliate organizations are involved with Crisis Intervention Team Programs in their communities, helping expand CIT programs to over 2,700 communities. CIT programs throughout the U.S. and worldwide are implemented in order to promote and support collaborative efforts to create and sustain more effective interactions among law enforcement, mental health care providers, individuals with mental illnesses, their families, and communities.

In addition, Gillison furthers, one of the cornerstones of NAMI’s work is providing support and educational programming.

Many NAMI organizations are involved in providing peer support programs directly in jails and prisons. These support groups are led by someone with a mental illness and provide information about mental illness and training in skills to cope with certain mental health symptoms.

NAMI Western Nevada, for example, has seen “great success” with the program they operate out of the Northern Nevada Correctional Center, Gillison says. “Because of the support being provided through the program, the prison psychiatrists have seen a decrease in requests for appointments, which has freed up their resources to focus on those who have more serious mental health conditions.” %

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Pulse Continued from page 8

who pose little threat to society. Attorney General William Barr has directed the Bureau of Prisons to make significant releases. I applaud these leaders for acting quickly to diminish the risk of transmission.

Finally, across the state, counties can greatly reduce the chance of an epidemic in local jails by removing people who pose no real public safety risk. About two thirds of the people in a typical jail are being held pretrial, many because they cannot afford a few hundred dollars. Some local leaders have already reduced their jail populations by removing people held for low bail amounts. They are not releasing people held for serious offenses, just those who would already be out on bond if they had the cash. The governor should encourage each county to follow suit, he said.

Hillsborough’s former jail director wrote an opinion piece in a Florida newspaper on how to cool down the hot spots in correctional facilities. In the May 11 edition of the Tampa Bay Times Col. David Parrish (Ret.) wrote: “During this

global pandemic, we must do all we can to slow the spread of COVID-19 and flatten the curve.

Unfortunately, Florida’s prisons and jails are poised to incubate and spread the virus. Fifty-four prisons already have positive cases, including 180 just discovered at Liberty Correctional Institution. Gov. Ron DeSantis can assist in slowing the spread by taking executive action to (1) remove prisoners who pose little threat to public safety, (2) encourage local authorities to do the same thing for people held pre-trial in county jails and (3) direct that all inmates and staff in correctional facilities be tested.”

In order to prevent the cases in our prisons and jails from spreading like wildfire behind bars and out into the surrounding community, we need to know who has the virus.

When testing was mandated at the Marion Correctional Institution in Ohio, approximately 2,000 out of 2,400 inmates, and almost 200 staff, tested positive, he pointed out. Tennessee Gov. Bill Lee just announced that every corrections officer and incarcerated person in his state will be tested. Florida should follow suit.

The governor needs to ensure that correctional administrators can conduct universal testing. The staff, incarcerated people, and general public deserve no less, he opined.

Florida should also reduce the prison population, as other states have done. North Dakota granted early parole to 50 people and Ohio’s governor released 100 individuals

MEDS: Continued from page 26 Wexford Health uses electronic Medication Administration Reports (eMARs) to help streamline the organization and administration of the medication pass. “EMARs are a safer, more reliable, and accurate form of documenting medication administration,” Ingram notes. For clients who do not have an eMAR, she says they use standard paper MARs, doing things manually, which is also a viable option. “The bottom line is to ensure the continuity of an inmate’s medication upon his/her arrival at a facility ac-

cording to ACA and NCCHC standards; to provide uninterrupted medication throughout the inmate’s incarceration; and to confirm proper documentation of medication administration in the inmate’s medical record.”

An eMAR provides high security and protection for patient information while ensuring compliance to HIPAA regulations. Nurses can set up multiple med-passes by unit, wing, room, and bed with eMARs through interfaces with many different offender management systems. With the use of currently

available barcode technology, nurses can identify patients and their medication blister cards to ensure the “eight rights of medication administration.” (See box page 20.)

During this unprecedented time, when Covid-19 is adversely impacting prisons and jails, all these tools can offer relief. They help to reduce the labor intensive process of passing out medications, get meds to those who need them quickly and lower the financial burdens of providing the necessary drugs to those in your custody. %

immediate release of inmates who are detained solely on the basis of their inability to satisfy a financial condition of pretrial release, or solely on the basis of a technical violation of probation or parole; and inspection of the jail by a qualified public health expert to document the actions needed to prevent the spread of COVID-19 in the jail, including to enable social distancing among those living and working in the jail.

WEBINAR ON REOPENING READINESS The American Jail Association partnered with jail administrators across the country to hold a webinar on May 20 that tackled reopening readiness. During the hourlong webinar, corrections leaders shared their plans for reopening their facilities during the pandemic, and discussed the steps their agencies are taking to make staff care a priority.

The recording is available through the AJA home page.

‘WE NEED TO STEM THE SPREAD OF COVID-19 AMONG INMATES’

VISIT US AT WWW.CORRECTIONSFORUM.NET

AJA ESTABLISHES COVID-19 RELIEF FUND The American Jail Association, in conjunction with its generous business partners, has established a Corrections Officer Relief Fund to assist those affected by the pandemic. To be considered for assistance, complete and submit an application form (americanjail.org), along with a letter from your jail administrator or sheriff confirming your eligibility. All applicants will be evaluated by the AJA Corrections Officer Relief Fund committee to determine eligibility and award amount.

There is also a place on the site to donate to the fund. %

CORRECTIONS FORUM • MAY/JUNE 2020 41

AD INDEX

Page No.

ACFSA ...........................35 Black Creek Integrated Systems Corp. ........4,15 Bob Barker....................43 Buford Satellite Systems .....................31 California Coast University ....................4 Centurion .......................2 Chestnut Ridge Foam, Inc.....................8 Correctional Cable TV....................27 Diamond Drugs Inc. .....25 Endur ID Incorporated .............16 Institutional Eye Care ...42 Keefe Group .................44 Keytrak, Inc...................13 Ketrak advertorial ........17 Medi-Dose Company.............17, 21 NCCHC .........................39 OraLine, Inc. .................26 Pellerin Milnor................6 Securus Technologies ...36 Sentry Security Fasteners, Inc. ...........11 StunCuff Enterprises, Inc. ........14 Swisslog Healthcare .....19 Trinity Services Group, Inc. ..................5 Western Detention.........7 Western Union .............29 Wexford Health Sources ......................23 This advertisers index is provided as a service to our readers only. The publisher does not assume liability for errors or omissions.

42 CORRECTIONS FORUM • MAY/JUNE 2020

COMPLETE EYEGLASSES

$14.95

RX Eyeglasses On-Site Optometry On-Site Ophthalmology Testing

1000 Facilities Nationwide 44 States - Federal in all 50 States Correctional Vision Care Since 1983

EcoSecurity™ Utensil helps prevent injury to staff, inmates or residents The new EcoSecurity™ Utensil is made from a slick, moisture-resistant paperboard, like a milk carton.

In one fold, it becomes the perfect sturdy scoop for any soft or bite size foods that don’t require cutting.

1-800-334-9880 www.bobbarker.com

Institutional Eye Care LLC website: institutionaleyecare.com email: info@ institutionaleyecare.com

Pair-It™ EVA Unifoot Sandal reduces inventory by replacing one broken sandal versus a pair Unique design is interchangeable to fit right or left foot comfortably and the lightweight material reduces the risk of being used as a weapon. Solid, one-piece construction for greater comfort and durability.

1-800-334-9880 www.bobbarker.com

Clearly identifying medications requiring special handling, such as those covered by USP <800>, is important for the safety of your staff and patients.

Medi-Dose has now added 5 more brightly colored Lid-Label Covers – Blue, Red, Orange, Green and Pink - to help you call attention to specific classes of drugs.

www.MediDose.com.

VISIT US AT WWW.CORRECTIONSFORUM.NET