Data-Driven Justice Case Studies

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Alvin Blake Barrett
5 years ago
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1 Data-Driven Justice Case Studies Data provided by the Cambridge Police Department Mary M.* Mary M., a homeless woman with chronic alcoholism, cycles through the Cambridge Police Department so frequently that she is one of the 10 people in the city with the highest number of police engagements. Over many years of dealing with Mary M., Cambridge PD officers have learned that nobody whether law enforcement, hospital staff, or service providers has been able to respond effectively to Mary M. s needs because they are so complex: Her root issue is likely a serious mental illness for which she self-medicates with alcohol, usually a combination of vodka and mouthwash. In the last thirteen years, Cambridge PD has recorded 85 engagements with Mary M., ranging from arrests of which she has 25 to incidents in which she is the victim or an involved party. She has spent 872 days in jail during that time. Her lifestyle and age have created serious health issues such as pneumonia and other respiratory problems, broken ribs, and a battered face. In an attempt to remove her from the streets and into a continuum of care, Mary M. has been Section 35ed an involuntary hospitalization for substance use disorder by the Cambridge PD at least 15 times in the last five years, and Section 12ed involuntary hospitalization for mental illness by officers twice. Although Mary M. receives treatment whenever she is sectioned, the treatment periods are often too short, usually between 30 and 90 days. Those issues, and her substance use, have led her to get taken to local emergency departments an astounding number of times 1,076 over 13 years in Cambridge alone. There are instances when Mary M. checks into the emergency department six times in a single day. Over 3 ½ months in 2014, she logged 99 trips to the emergency department; over three month in 2016, she was hospitalized for alcohol-related issues 30 times; in 2017, she visited the emergency department 30 times in 31 days. With an average cost per ambulance transport of $550, that amounts to roughly $600,000 over 13 years. Mary M. has faced charges such as trespassing and assault after having issues with emergency department, mental health staff, and shelter staff, but arrests have intentionally been a last resort for CPD. The vast majority of case notes describe officers coming to help when she is unresponsive, sometimes lying outside in the freezing Boston winter. Many of the 911 calls that officers get actually come from Mary M. herself, a habit that led law enforcement to charge her with abuse of the 911 system at one point. Cambridge PD officers have exhibited great patience, creativity, and strategic thinking in hopes of developing a plan that will help divert her from the criminal justice system and place her into the most effective treatment. Officers, hospital staff, substance use treatment program staff, and shelter staff are collaborating and have developed of a variety of plans for Mary M., but they are struggling to figure out long-term options. Her condition continues to worsen and she continues to put a serious tax on city resources unless she is off the streets on a section, receiving treatment, or in jail on criminal offenses. Joe J.* Joe J., a homeless man with severe alcoholism and health problems, is well known to Cambridge PD officers. Of the 116 incidents that officers have logged in their case notes, many follow a familiar

2 pattern: Over and over again, officers are called to assist Joe J. in getting to a shelter or hospital when he is no longer able to get himself there. From 2013 to 2018, case notes indicate that Joe J. has been arrested only once part of a concentrated and strategic effort by the Cambridge PD to connect him to treatment. Because of his substance use issue and what officers suspect is an undiagnosed mental illness efforts to get Joe J. a neurological evaluation have been fruitless so far Joe J. also has many physical health problems. Officers have picked him up after he s fractured his leg in three places, and when he s suffering from hypothermia and frostbite. His case notes detail countless trips to local emergency departments for these conditions and for extreme intoxication. In just six weeks in 2017, Joe J. was taken to the emergency department 38 times. Over the course of two years 2016 and 2017 he had 371 EMS transports, with an average of three EMS transports every four days. Officers, hospital staff, and shelter staff want to find long-term treatment for Joe J., but they re struggling to figure out what the solution looks like. He has been Section 35ed an involuntary hospitalization for substance use disorder more than eight times in five years, but those experiences in treatment programs have been too short to provide long-term help. Steve S.* Steve S. is a homeless veteran with severe alcoholism who has had at least 87 recorded incidents with the Cambridge PD over the last five years, including seven arrests for offenses such as trespassing and disorderly conduct. Steve S. cycles repeatedly through jails, hospital emergency departments, shortterm substance use treatment programs, and shelters. The Veteran Affairs office tried to connect Steve S. to stable housing through a housing voucher, but his substance abuse issues prevented him from searching for an apartment before his voucher expired. As detailed in Cambridge PD case notes, officers, shelter staff, and emergency department staff are worried that Steve S. s health is quickly deteriorating. In 2016, he experienced a fall that resulted in a brain bleed, and often passes out outside, even in below-freezing weather. Officers are still trying to find him long-term housing and treatment. In the meantime, he continues to cycle through hospitals, jails, and shelters. *Names are fictitious to protect the identities of the individuals.

3 High Utilizer of Health Care & Criminal Justice Systems CASE STUDY: Mary M. Daily Calendar: EMS Transports, Civil Commitments, Incarcerations, Arrests, and Involvements w/ Police A = arrested/charged I = incarcerated IP = involved party (named in police report) Transports Feb C C C C C C C C C C C C Feb - Mar C C C C C C C C C C C C C C C C C C Mar - Apr Apr - May - - C C C C C C C C C C C C C C C C C C C C C C C C C C C C C May - Jun C Jun 1 Jul IP Jul 7 Aug A IP Aug 18 Sep A Sep 15 Oct Oct 12 Nov A Nov 27 Dec IP Dec Total 88 Jan A A Jan 22 Feb Feb 11 Mar A Mar 11 Apr Apr 3 May I I I IP May 17 Jun Jun 9 Jul 3 1 IP IP C C C C C C Jul 37 Aug C C C C C C C C C C C C C C C C C C C C C C C C C Aug 6 Sep IP A Sep 9 Oct Oct 10 Nov A I I Nov 11 Dec I I I I I I I I I I I I I Dec Total 146 Jan I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Jan - Feb I I I I I I I I I I I I I I I I I I I I I I I I I I I I Feb - Mar I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Mar - Apr I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Apr - May I I I I I I I I I I I I I I I I I I I I I I I I I I May - Jun Jun 3 Jul C C C C C C C C C C C C C C Jul 6 Aug C Aug 5 Sep Sep 5 Oct Oct 6 Nov Nov 1 Dec Dec Total 28 Jan Jan 2 Feb Feb 2 Apr I I I I I I I I I Apr 2 May I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I May - Jun I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Jun - Jul I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Jul - Aug I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Aug - Sep I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Sep - Oct I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Oct - Nov I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Nov - Dec I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Dec Total 6 Jan I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Jan - Feb I I I I I I I I I I I I I I I I I I I I I I I I I I I I Feb - Mar I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Mar - Apr I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Apr - May I I May 1 Jun Jun 1 Jul Jul - Aug Aug 1 Sep Sep 1 Oct Oct - Nov Nov 7 Dec Dec Total 17

4 High Utilizer of Health Care & Criminal Justice Systems CASE STUDY: Mary M. Daily Calendar: EMS Transports, Civil Commitments, Incarcerations, Arrests, and Involvements w/ Police A = arrested/charged I = incarcerated IP = involved party (named in police report) Transports Feb Feb - Apr Apr - May May 1 Jun Jun 1 Jul C C C C C C C C C C C C C C C C C Jul - Aug C C C C C C C C C C C C C C C C C C C C C C C C C Aug - Sep C C C C C C C C C C C C C C C C C C C C C Sep - Oct C C C C C C C C C C C C C C C C C C C C C C C C C C C Oct 1 Nov Nov - Dec Dec Total 3 Feb Feb - Apr Apr - May May - Jun C C C C C C C C C C C C C C C C C C C C - Jun - Jul I I I I Jul - Aug C C C C C C Aug - Sep C C C C C C C C C C C C C C C C C C C C C C C C Sep - Oct Oct - Nov Nov - Dec C C C C C C C C C C C C C C C C C C Dec Total 5 Jan C C C C C C C C C C C C 2 - IP IP 2 1 Jan 9 Feb C C C C C C C C Feb 8 Mar C C C C C C C C C C C C C C C C C C C C C C Mar 7 Apr IP Apr 19 May IP 3 A I I I I I I I I I I I I I I I I I I I I I I I May 7 Jun I 1 IP Jun 16 Jul Jul 20 Aug Aug 12 Sep A Sep 3 Oct Oct 23 Nov C C C C C C C C C C C C C C C C C C C C C C C Nov 10 Dec C C C C C C C C C C C C C C C C C C Dec Total 141 Jan C C C C C C C C C IP C C C C Jan 18 Feb C C C C C C C C C C C C C C Feb 6 Mar A A I I I I I I I I I I I I I I Mar 10 Apr I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Apr - May I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I May - Jun I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Jun - Jul I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Jul - Aug I I Aug 8 Sep I I I I I I I I I I I I I I I I I Sep 9 Oct Oct 11 Nov A A Nov 22 Dec 2 3 IP IP IP 1 Dec Total 94 Jan A 2 IP A I I I I I I I I I I I Jan 18 Feb I I I I I I I I I I I I I I I I I I I I I I I Feb 5 Mar - - IP Mar 28 Apr IP A Apr 23 May IP IP May 28 Jun 3 IP A I I I I I I I I I I I I I I I I I I I I I I Jun 15 Jul I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Jul - Aug I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Aug - Sep I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Sep - Oct I Oct 14 Nov IP IP Nov 10 Dec - 1 IP IP Dec Total 159

5 High Utilizer of Health Care & Criminal Justice Systems CASE STUDY: Mary M. Daily Calendar: EMS Transports, Civil Commitments, Incarcerations, Arrests, and Involvements w/ Police A = arrested/charged I = incarcerated IP = involved party (named in police report) Transports Jan IP IP C C C C C C Jan 20 Feb C C C C C C C C C C C C C C C C C C C C C C C C C C C C Feb - Mar C C C C C C C C C C C Mar 18 Apr C C C C C C C C C C C C C C C C C C C C C C C Apr 11 May C C C C C C C C May 8 Jun Jun 21 Jul IP Jul 23 Aug Aug 24 Sep C C C C C C C C C C C C C C C C C C C C C C C C C C C C C - Sep 1 Oct A IP C C C C C C C C C C C C C C C C C C C C C C C C 1 Oct 3 Nov IP Nov 5 Dec C C C C C C C C C C C C C C C C Dec Total 139 Jan C C C C C C C C C C C C C C Jan 9 Feb Feb 9 Apr Apr 17 May May 5 Jun Jun - Jul Jul 3 Aug Aug 20 Sep A Sep 10 Oct Oct 5 Nov 1 - A Nov 17 Dec Dec Total 95 Feb Feb 17 Mar - IP Mar 13 Apr Apr 5 May May - Jun Jun 10 Jul Jul 22 Aug A Aug 30 Sep Sep 23 Oct Oct 12 Nov Nov 5 Dec Dec Total 155 Transports over 13 years: Arrests: Involved Party w/ police: Days in civil commitment: Days incarcerated: ,076

6 High Utilizer of Health Care & Public Safety Systems CASE STUDY: Joe J. Daily Calendar: EMS Transports and Civil Commitments Transports while not committed Jan C C C C C C C C C C C C C Jan 3 17% Feb C C C C C C C C C C C C C C C C C C C C C C C C C C C C C Feb - - Mar C C C C C C C C C C Mar 8 38% Apr Apr 11 37% May May 7 23% Jun Jun 11 37% Jul C C C C C C C C C C C C C C C C C C C C Jul - 0% Aug Aug 14 39% Sep C C Sep 23 61% Oct C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C Oct - - Nov C C C Nov 19 67% Dec C C C C C C C C C C C C C C C C Dec 11 67% 2016 Total % Jan C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C Jan - - Feb C C C C C Feb 10 43% Mar Mar 27 74% Apr Apr 27 77% May May 26 71% Jun C C C C C C C C C C C Jun 15 63% Jul C C C C C C C C C C C C C C C C C C C C C C C C C C C C Jul 4 67% Aug Aug 42 84% Sep C C C C C C C C C C C C C C C C C C Sep % Oct C C C C C C C C C C C Oct 19 90% Nov Nov % Dec Dec 20 39% 2017 Total % Average transports over two years: while not being treated at court ordered inpatient civil commitment Transports over two years: 3 every 4 days % of total days transported by EMS % of days over two years patient transported by EMS

COMPARISON OF FIXED & VARIABLE RATES (25 YEARS) CHARTERED BANK ADMINISTERED INTEREST RATES - PRIME BUSINESS*

COMPARISON OF FIXED & VARIABLE RATES (25 YEARS) Fixed Rates Variable Rates FIXED RATES OF THE PAST 25 YEARS AVERAGE RESIDENTIAL MORTGAGE LENDING RATE - 5 YEAR* (Per cent) Year Jan Feb Mar Apr May Jun Jul