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How the City's New Jails Plan Accounts for Those with Serious Mental Illness


Rikers Island inmate detainee

(photo: Michael Appleton/Mayor's Office)


In an historic vote last month, the New York City Council approved the plan to close the Rikers Island jail complex and replace it with four borough-based jails by 2026. When the Council voted through the plan, estimated at $8.7 billion in new construction costs, it also announced, with Mayor Bill de Blasio, a $391-million package of citywide and community investments in criminal justice reforms and initiatives to responsibly accelerate the reduction of the city’s jail population.

For city officials, one of the most complex issues they face is ensuring that the new system is less punitive and more rehabilitative, particularly for the 43% of incarcerated individuals who suffer from some form of mental illness. Experts and advocates say the plan is taking an appropriate approach to that issue but also insist that it provides a novel opportunity to rethink how the criminal justice system deals with the mentally ill, especially those suffering from more acute problems.

Given that one of de Blasio’s signature programs as mayor is the ThriveNYC mental health “roadmap” spearheaded by his wife, Chirlane McCray, the mayor’s approach to services for those with severe mental illness, particularly those who wind up involved in the criminal justice system, has been the source of intense scrutiny, again heightened as the new jails plan was crafted.

With most major crimes at or near record lows in the city and recent shifts in law enforcement and prosecutorial policies, particularly around non-violent offenses, the number of people incarcerated in city jails has been consistently declining. That drop has been so sharp that the de Blasio administration projects the average daily jail population to fall to 3,300 by 2026, when Rikers is set to close, down from about 7,000 this year and aided by state bail reform that will go into effect in January.

The Rikers closure plan will involve building four new facilities in every borough except Staten Island, with roughly 885 beds each. The facilities are meant to be fairer and safer than the dilapidated jails on Rikers. Another 250 new beds will be created in existing public hospital facilities for those individuals who require continuing access to specialized medical services.

Mayor Bill de Blasio himself has acknowledged that the city has its work cut out for it when it comes to individuals with mental illness who are locked up in jails. The day after the Council’s vote, the mayor made his weekly appearance on WNYC’s The Brian Lehrer Show and a caller named Winston who was formerly incarcerated on Rikers prodded him on improving access to mental health services. De Blasio emphasized the decarceral aspects of the plan, which include greater investments in alternatives to incarceration, supervised release programs, and mental health initiatives.

“This thing is not in isolation. Six years of changing the approach to criminal justice and it’s all been consistent with reducing crime at the same time and I’m very convinced that this is the right approach,” said the second-term Democrat. “But you’re right, it will take some important adjustments and investments and getting people more access to mental health services, which is the whole concept behind the Thrive[NYC] initiative, is absolutely necessary going forward, and providing better and more consistent mental health for those who do happen to be incarcerated, which is also in this plan.”

One of the key elements of how things unfold will be the dichotomy of mental health services for those with serious mental illness who need treatment while serving jail time versus those who can be removed from or kept out of jail given appropriate treatment options and enrollment in such programming.

City Council Speaker Corey Johnson, in a statement to Gotham Gazette, said, “The time of locking people up because they're mentally ill has to come to an end. This is why we are creating new Intensive Mobile Treatment (IMT) teams to provide intensive treatment to adults with recent and frequent contact with the mental health, substance use, criminal justice, and homeless services systems. It is time to eliminate an unjust system that has criminalized mental illness and destroyed so many of our communities.” 

In a background briefing, an official from the Mayor’s Office of Criminal Justice, which took point on the jails plan, laid out the various pillars of the city’s approach. The official reemphasized what de Blasio said on the radio: that the administration’s focus is to minimize the number of people in jail with behavioral health, mental health, and substance misuse problems, and to prevent reincarceration by providing services that address their needs.

Correctional Health Services, an arm of NYC Health+Hospitals, is charged with providing medical services to the city’s jail system, from pre-arraignment through reentry. According to a H+H spokesperson, roughly one-third of the 43% of detainees who receive a mental illness diagnosis have severe mental illness – schizophrenia, bipolar or depressive disorders, and post-traumatic stress disorder – making up about 16% of the total jail population. For a population of about 7,000 detainees, that means just over 1,100 people with serious mental illnesses at any given time.

Currently, each jail has what H+H says is the equivalent of an outpatient clinic. For detainees with serious mental illness, intellectual disabilities, or who might be more vulnerable in the general jail population, there are 18 so-called mental observation (MO) units across the 10 jails and Horizon Juvenile Center. There are also inpatient psychiatric beds at Bellevue Hospital for men and at Elmhurst Hospital for women, all of whom are considered part of the city’s jail population while being treated.

The community investments package that the City Council and mayor agreed to includes an expansion by Correctional Health Services of two programs that provide discharge and reentry services to the formerly incarcerated, the Community Reentry Assistance Network (CRAN) and Point of Reentry and Transition (PORT) programs.

Though the city is hoping for the best, it is planning for the worst. About 40% of the beds in the new borough jails will be therapeutic housing units to account for the percentage of the jail population that suffers at least some kind of mental illness.

The city plans to reduce the population through various efforts, including implementing recommendations from the city’s Crisis Prevention and Response Task Force announced last month, which will change how police respond to people experiencing mental health crises. The city is putting $23 million in total towards those recommendations by 2023, which includes adding four Health Engagement and Assessment (HEAT) teams of clinicians and peers who have experienced mental illness to handle non-emergency responses, and six more mobile crisis teams (mental health professionals who respond to calls to the NYC-WELL hotline) to conduct home visits and respond to urgent situations.

These programs aim to ensure that people suffering from mental illness do not wind up in jail, or back in jail as the case may be.

Additionally, the city is investing $11.2 million to add 380 beds of “justice-involved supporting housing,” for a total of 500 across the city, and is increasing the number of post-release transitional beds for those with mental health needs and a history of homelessness to 500 with a $25 million investment.

About $27 million in new funding will go to mental health services (for a total of $37 million) through various programs. And the Council also passed the Get Well And Get Out Act, which will allow those with serious mental illness to push for their release from custody if they improve with treatment.

But the official from MOCJ conceded that there will inevitably be individuals with serious mental illnesses in jails, despite the city’s best efforts to reduce that population, which has stubbornly hovered in the 10-15% range even as the overall numbers of detainees have fallen. Almost all of the people held in city jails are either awaiting trial, locked up due to a parole violation, or serving sentences of under one year.

The new borough facilities and the Rikers plan account for the fact that some detainees will suffer from serious mental illnesses by expanding two key programs that address this population: Clinical Alternative to Punitive Segregation (CAPS) and Program to Accelerate Clinical Effectiveness (PACE).

The Council’s agreement with the mayor includes $12.8 million to double the number of existing PACE units by the end of the current fiscal year. The city has yet to decide the breakdown of those units in the borough facilities, the MOCJ official said.

The 250 new Outposted Therapeutic Units outside the jail system, however, will be dedicated to those individuals who have some form of substance abuse disorder, mental health or behavioral health issue as well as a complex need for medical care. The MOCJ official said they had identified a gap in the current continuum of care for these detainees, who don’t necessarily require inpatient hospitalization but benefit from proximity to specialized care. They can spend hours going to and from hospitals for even the shortest of check ups with specialists. 

The city is currently in the process of identifying vacant sites for those units and has contracted Lothrop Associates to conduct a feasibility study that is expected to be concluded by the end of the year, the MOCJ official said. The study will help determine the costs and needs of the new facilities and the city will then put out solicitations for redesigning the new spaces to accommodate incarcerated individuals. The project is separate from the borough-based jails plan and the official said it would likely move much faster since it would not require approval through the city’s land use process.

Insha Rahman, director of Strategy and New Initiatives at the Vera Institute, said a larger goal of the Rikers closure plan should be to minimize the harm that jails do to inmates, not just those with mental illness.

“If we're going to say, ‘We are still going to have incarceration in this city,’ which we are, for the foreseeable future, 5, 10, maybe even 20, 30 years from now, we should be constructing these new facilities as buildings first, and then outfitting them to be places of incarceration so that they're not built with just incarceration and jail design front and center,” she said in a phone interview. 

She cited the example of jails in countries like Germany and Norway. “To the extent that we're thinking about how do we address people's underlying needs and how do we provide therapeutic care and counseling for those who are in custody, anything that looks fundamentally like a jail is going to inflict some amount of harm and trauma,” she added, insisting that the city should look not to prison architects but to behavioral and mental health experts for ideas for the new jails.

Rahman also urged the administration and Council to invest further at the community level in permanent affordable housing, community-based treatment and counselling that can preempt interactions with the criminal justice system.

A stark reality that the city faces is dealing with those individuals with serious mental illness who pose a threat to themselves and others, a concern that was brought to the fore last month when a mentally ill homeless man killed four men sleeping on the street in Chinatown. It prompted the city to review how it implements Kendra’s Law, which allows courts to mandate involuntary “assisted outpatient treatment” for such individuals. That review is meant to be completed by next week. The number of individuals ordered into treatment under the law was 2,476 in fiscal year 2018, down from 2,517 in fiscal year 2017 but up from 2,368 in fiscal year 2016 and 2,176 in fiscal year 2015, according to data provided by the de Blasio administration.

Rahman warned against harsher enforcement of the law. “I think enforcing Kendra's Law more strongly is not necessarily going to get us fewer people in our jails that have serious mental health needs,” she said. “I think the most important initial response is more community-based treatments and figuring out how can we actually resource families and neighbors.”

There is some disagreement on that front, however. D.J. Jaffe, executive director of Mental Illness Policy Org, criticized the city’s ThriveNYC mental health initiative and called for an expansion of Kendra’s Law in an op-ed in the New York Daily News following the Chinatown murders.

Jaffe argues the City Council should require “the city’s Department of Health and Mental Hygiene to start evaluating all seriously mentally ill people being discharged from Rikers; all seriously mentally ill leaving shelters; and all mentally ill patients being discharged from city hospitals after an involuntary commitment. Those are the three highest risk groups; evaluate them all to see if they are eligible for Kendra’s Law and get them into it if they are.”

Minister, Dr. Victoria A. Phillips of the Urban Justice Center Mental Health Project echoed Rahman’s view, but also stressed that the new jails should prioritize interactions between detainees and health care workers, rather than with corrections officers.

“Behind correctional walls, it’s never the health staff that takes the lead, and I think the Department of Corrections has shown itself to be unable to change its culture of violence,” she said, pointing to the most recent report by a federal monitor with oversight of the city’s Department of Correction, which showed that use of force by corrections officers has risen dramatically while the jail population has dropped.

Former New York Chief Judge Jonathan Lippman, who led the independent commission that proposed the leading Rikers closure plan, praised the approach the city is taking, while acknowledging that the overarching objective is to keep people with mental illness out of jails. “If you have people who the system decides to incarcerate, then you have to deal with that,” he said in a phone interview. “In an ideal world...people who have serious problems with mental health should get help and not be incarcerated. But, you know, we don't live in the ideal world.”

[READ: 'No One Should Enter the Criminal Justice System for Something Related to Mental Illness']

***
by Samar Khurshid, senior reporter, Gotham Gazette
     

Read more by this writer.

Note - This article has been updated. 

First Deputy Mayor on Next Steps for Voter-Approved 'Rainy Day Fund'


control board bdb

(photo: Ed Reed/Mayoral Photo Office)


With voter approval of a city charter amendment to pursue the creation of a budgetary “rainy day fund” in New York City, de Blasio administration officials are now looking to change state laws so that the city can actually start one.

“We’re going to have to work together to make this happen,” said First Deputy Mayor Dean Fuleihan at a breakfast event hosted by the Citizens Budget Commission Wednesday morning, just a few hours after polls closed on Tuesday night.

Voters had overwhelmingly approved an amendment to the city charter that would allow the city to set aside revenue in a savings account meant to cushion the impact of a future economic downturn and city revenue dip — the inevitable rainy day. Until the charter amendment passed this week, provisions in both city and state law required the city to balance its budget every year, meaning savings cannot be carried over from one fiscal year to another. Now, only state law requires a balanced city budget.

While the city continues to enjoy a period of economic prosperity since the 2008-2009 fiscal crisis, economists say it must brace for potential dips, whether slowing growth or recession. In the last two national recessions, the city economy contracted significantly and took years to rebound, according to a Citizens Budget Commission report, “To Weather A Storm: Create a Rainy Day Fund.” According to the CBC analysis, the gross city product (GCP) fell 7.6 percent from 2000 to 2002 and took another three years to reach its pre-recession size; from 2007 to 2009 GCP fell 9 percent and did not reach its previous peak until 2013.

In situations like these, the city can quickly exhaust any reserves that may be available, and, in the absence of a rainy day fund, must cut services, raise taxes, and/or fall on short-term borrowing, all of which have consequences that are exacerbated in a recession.

Currently, the city is able to put public funds into “reserves,” which are created through budgetary maneuvers that, among other things, allow the city to prepay for certain resources, debt service, and retiree health benefits costs. But fiscal watchdogs say the reserves would not be sufficient to combat a serious dip in the economy or an emergency crisis, and are a fraction of what a rainy day fund could cover.

The city budget has grown tremendously since the last recession in 2008-2009. Since the beginning of Mayor Bill de Blasio’s tenure in 2014, it has risen nearly $20 billion to $92.8 billion in the current fiscal year. About $6 billion of the total is currently in year-of reserves.

“It’s a historic level of reserves,” which the city has not previously achieved, said Fuleihan, a former director of the Mayor’s Office of Management and Budget and a veteran fiscal policy advisor in the State Assembly. “But it is not a rainy day fund. It’s not a traditional way of doing that, and now we have the opportunity to do that.”

The rainy day fund amendment was one of 19 proposed changes to the city charter, which voters in New York City had an opportunity to approve or reject this fall based on the work of the 2019 Charter Revision Commission, to which the mayor had several appointees along with other citywide and boroughwide officials. The proposals came in the form of five questions covering elections, police oversight, ethics and governance, city budget, and land use. All five questions passed by wide margins.

The laws requiring New York City to balance its budget each year came out of the city’s 1975 fiscal crisis, in which the city’s debt obligations brought it close to bankruptcy. In response, the state enacted the Financial Emergency Act, which required a balanced budget and the use of generally accepted accounting principles as a way to ensure the city’s fiduciary obligations do not exceed its revenue. In 2005, those requirements were incorporated in the city charter.

With the charter amendments that remove those requirements, state laws are the only remaining statutes preventing New York City from adopting a rainy day fund. State Senator Brian Benjamin, a Manhattan Democrat who is considering a run for city comptroller, has introduced a bill that would authorize the city to create a rainy day fund (the fund is described in the bill as a “municipal contingency and tax stabilization reserve fund”). 

For the de Blasio administration, the issue at hand now is not simply a matter of changing the state law. Fuleihan says he hopes to work with the state to devise a partnership that gives the city ultimate control over its budget and rainy day funds. Budget watchdogs are also hoping state lawmakers include statutory restrictions on when the rainy day funds may be spent to ensure that they are used as intended during periods of economic hardship.

“The first step occurred [Tuesday] and now we need to talk about what that looks like,” Fuleihan told the CBC audience Wednesday, “and to make sure that the city is the determining factor in what this rainy day fund looks like.”

“I think we do have to be careful about that,” he added.

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by Ethan Geringer-Sameth, reporter, Gotham Gazette
     

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Williams Remains Public Advocate; Katz Next Queens DA; Ranked-Choice Voting on Its Way; & More: Election Results 2019


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(photo: Gotham Gazette)


After about 60,000 New York City voters took advantage of the first early voting period in city history, albeit during an especially quiet electoral year, more than 650,000 others went to the polls on Election Day 2019, providing mostly expected results and approving multiple controversial ballot proposals to change city elections and governance. This year provided a helpful initial test run for early voting and all that goes with it, such as electronic poll books and a lot of poll-worker training, before what is expected to be an incredibly tense and busy 2020 election year, with especially high turnout for the presidential election, as well as those for Congress and the State Legislature.

After winning a special election earlier this year, Public Advocate Jumaane Williams, a Democrat, was reelected Tuesday to serve the rest of the term through the end of 2021. Queens Borough President Melinda Katz, also a Democrat, was elected Tuesday to become the next Queens District Attorney, a four-year term beginning at the start of 2020. Council Member Farah Louis, who replaced Williams in the City Council after winning her own prior special election, also retained her seat and can serve through at least 2021.

And the relatively small number of New York City voters who turned out this fall (about 15% of the city's 4.8 million active registered voters) -- from the inaugural early voting period and on Election Day -- also approved 19 specific changes to city elections and governance with overall “yes” votes on five ballot proposals. Those changes include instituting ranked-choice voting for party primary and special elections; bolstering the agency that investigates and prosecutes certain allegations of police officer misconduct; and making several tweaks to ethics, budgeting, and land use laws.

Along with those candidate races, there were a variety of judicial elections around the city, and some candidates with regularly-scheduled elections -- namely Bronx District Attorney Darcel Clark and Staten Island District Attorney Michael McMahon -- ran unopposed. It was a slightly more exciting election year than expected given the special elections for Public Advocate and City Council, and the Queens District Attorney Democratic primary that ended with Katz winning in a recount.

Adding to the intrigue was the 2019 Charter Revision Commission, which put the 19 proposals in five questions on the ballot. With all the questions approved by voters, the following changes are among those that will be instituted (some of the language is directly from the charter commission’s materials):

-Ranked-choice voting for party primary and special elections for the offices of Mayor, Public Advocate, Comptroller, Borough President, and City Council Member. This will begin on or after January 1, 2021.

-The time to hold a special election after a city office is left vacant is extended to 80 days.

-Alters the structure of the Civilian Complaint Review Board (CCRB) by adding two members, one from the Public Advocate and a joint appointment by the Mayor and the City Council, who would also serve as chair.

-Provides that the Council directly appoints its members to the CCRB.

-Requires the Police Commissioner provides a detailed explanation to the CCRB when deciding to impose discipline on an officer that differs from the level of discipline recommended by either the CCRB or the NYPD Deputy Commissioner of Trials.

-Allows the CCRB Board to delegate its subpoena power to its Executive Director.

-Allows the CCRB to investigate potentially false official statements made by an officer it is investigating and to recommend discipline, if appropriate.

-Provides a minimum budget to the CCRB sufficient to fund CCRB staff equal to 0.65% of the number of uniformed police officers, unless the Mayor determines that fiscal necessity requires a lower budget.

-Extends the post-employment appearance ban for elected officials and certain senior appointed officials from one year to two years for employees/officials who leave city service on or after January 1, 2022.

-Amends the structure of the Conflicts of Interest Board (COIB) by replacing two members now appointed by the Mayor with one member appointed by the Comptroller and one appointed by the Public Advocate.

-Limits the political activity of COIB Board members by prohibiting participation in campaigns for local elected offices, and reducing the maximum amount of money that they can contribute to the amounts that candidates can receive from those doing business with the city ($400 or less, depending on the office).

-Requires that the Citywide M/WBE Director report directly to the Mayor and be supported by a mayoral office of M/WBEs.

-Requires advice and consent by the City Council for the Mayor’s appointment of the Corporation Counsel.

-Allows the city to use a “rainy day fund” to save money for use in future years, such as for addressing unexpected financial hardships. (Changes to state law will also be needed for this rainy day fund to be usable.)

-Sets guaranteed minimum budgets for the Public Advocate and Borough Presidents at or above their respective Fiscal Year 2020 budgets, adjusted in future fiscal years by the lower of inflation or the percentage change in the city’s total expense budget (excluding certain components), unless the Mayor determines that fiscal necessity requires a lower budget.

-Requires the Mayor to submit the revenue estimate to the City Council by April 26 (instead of June 5).

-Requires the Mayor to submit budget modifications to the Council within 30 days after the submission of any periodic update the city’s financial plan during the year.

-Provides a ULURP Pre-Certification Notice Period by requiring the Department of City Planning to transmit a detailed project summary of ULURP applications to the affected Community Board, Borough President, and Borough Board at least 30 days before the application is certified for public review, and to post that summary on its website.

-Provides Community Boards with additional time to review ULURP applications certified for public review by the Department of City Planning between June 1 and July 15, from the current 60-day review period to 90 days for applications certified in June, and to 75 days for applications certified between July 1 and July 15.

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by Ben Max, Gotham Gazette
     

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