By Anna Anderson

This National Consumer Law Center (NCLC) report provides an overview of the carceral medical debt problem and policy recommendations and solutions to address the issue. The report provides background on the nature of the carceral medical debt, including the complex healthcare needs of people who are incarcerated, what fees are assessed and why, how these fees impact health outcomes and lead to medical debt, how carceral medical debt affects families and reentry, and private equity and for-profit contractors’ roles in this problem. The report includes an extensive review of the common sources of medical debt and how these debts are collected. It details recent policy victories in the effort to eliminate carceral medical debt, as well as some troubling setbacks. The report concludes with consumer-focused policy reforms to address medical debt related to incarceration.

Boston: National Consumer Law Center, 2024. 46p.

By Antje du Bois-Pedain

The prevalent criminal justice practices in the U.S. have produced levels and patterns of incarceration that fewer and fewer politicians, scholars, and citizens care to support. There seems to be widespread consensus that the system is indicted as unjust by its outcomes no matter how these outcomes came about. But if that is so, how can it be turned back? Who should be eligible for release, and on what grounds? This article addresses the position of black prisoners serving very long sentences. Many of these prisoners are at risk of missing out under current legislative and administrative proposals designed to reduce overall levels of imprisonment. Partly this is because the wrong of mass incarceration is often understood as a wrong suffered at the collective level by what has come to be referred to as “overpunished communities.” It is unclear how the existence of that collective wrong affects the permissibility of continued punishment at the individual level. This article develops an argument that, at the individual level, being a black prisoner serving a very long sentence gives rise to a moral entitlement for a review of the need and justification for continued incarceration. The article outlines the basic shape of a clemency scheme devised especially for these prisoners as a moral imperative for a reform process intended to remedy penal injustice.

New Criminal Law Review (2021) 24 (4): 655–688.

By Brandon L. Garrett & Lee Kovarsky

The COVID-19 pandemic blighted all aspects of American life, but people in jails, prisons, and other detention sites experienced singular harm and neglect. Housing vulnerable detainee populations with elevated medical needs, these facilities were ticking time bombs. They were overcrowded, underfunded, unsanitary, insufficiently ventilated, and failed to meet even minimum health-and-safety standards. Every unit of national and sub-national government failed to prevent detainee communities from becoming pandemic epicenters, and judges were no exception. This Article takes a comprehensive look at the decisional law growing out of COVID-19 detainee litigation and situates the judicial response as part of a comprehensive institutional failure. We read hundreds of COVID-19 custody cases, and our analysis classifies the decision-making by reference to three attributes: the form of detention at issue, the substantive right asserted, and the remedy sought. Several patterns emerged. Judges avoided constitutional holdings whenever they could, rejected requests for ongoing supervision, and resisted collective discharge—limiting such relief to vulnerable subpopulations. The most successful litigants were detainees in custody pending immigration proceedings, and the least successful were those convicted of crimes , 

110 California L. Rev 117 (2022)   

By Sheena Liberator and Maria Jose (MJ) Vides

In March 2020, the Los Angeles County Board of Supervisors (BOS) unanimously adopted the “care first, jails last” vision, a transformative framework for safety grounded in support and services as alternatives to incarceration or bail.1 Three years have passed and people of color, people experiencing homelessness, and those with unmet mental health needs continue to languish in county jails.2 County staff attribute implementation delays to a shortage of community-based behavioral health workers. The Vera Institute of Justice’s (Vera’s) conversations with community-based providers—detailed in this brief—document how the COVID-19 pandemic, long-standing difficulties with contracting, and chronic underinvestment in infrastructure have resulted in the current workforce shortage. To effectively implement a “care first” vision and meet the demand for community-based pretrial services, Vera recommends immediate action steps to remedy ongoing issues with the county’s contracting processes, lower barriers to entry for small providers, and invest in urgent capacity-building and workforce development beginning this budget cycle.  

To effectively implement a “care first” vision and meet the demand for community-based pretrial services, Vera recommends immediate action steps to remedy ongoing issues with the county’s contracting processes, lower barriers to entry for small providers, and invest in urgent capacity-building and workforce development beginning this budget cycle.

Publication Highlights

• Local providers across the spectrum of services and service planning areas are experiencing staffing shortages resulting from the COVID-19 pandemic and competition with Los Angeles County.

• Capacity-building support is needed to strengthen community-based service providers, as are changes to contracting, billing, and reporting procedures.

• To expand capacity, Los Angeles County should, among other things, implement pretrial services by increasing budgetary allocations for community-based service providers and restructuring county contracting processes and technical assistance programs.

To effectively implement a “care first” vision and meet the demand for community-based pretrial services, Vera recommends immediate action steps to remedy ongoing issues with the county’s contracting processes, lower barriers to entry for small providers, and invest in urgent capacity-building and workforce development beginning this budget cycle.

Publication Highlights

• Local providers across the spectrum of services and service planning areas are experiencing staffing shortages resulting from the COVID-19 pandemic and competition with Los Angeles County.

• Capacity-building support is needed to strengthen community-based service providers, as are changes to contracting, billing, and reporting procedures.

• To expand capacity, Los Angeles County should, among other things, implement pretrial services by increasing budgetary allocations for community-based service providers and restructuring county contracting processes and technical assistance programs.To effectively implement a “care first” vision and meet the demand for community-based pretrial services, Vera recommends immediate action steps to remedy ongoing issues with the county’s contracting processes, lower barriers to entry for small providers, and invest in urgent capacity-building and workforce development beginning this budget cycle.

Publication Highlights

• Local providers across the spectrum of services and service planning areas are experiencing staffing shortages resulting from the COVID-19 pandemic and competition with Los Angeles County.

• Capacity-building support is needed to strengthen community-based service providers, as are changes to contracting, billing, and reporting procedures.

• To expand capacity, Los Angeles County should, among other things, implement pretrial services by increasing budgetary allocations for community-based service providers and restructuring county contracting processes and technical assistance programs.

 New York: Vera Institute of Justice, 2023. 8p.

By Maria Rafael

The United States’ criminal legal system is often described as a two-tiered system that treats people differently based on their social status, wealth, and power.1 In a two-tiered criminal legal system, those with money, social connections, or political influence may receive preferential treatment in the form of lighter sentences, leniency with respect to court-ordered obligations, or even freedom.2 Meanwhile, people without those advantages are likely to face harsher punishments, limited access to legal resources or representation, and even mistreatment from system actors.3 In the context of fines and fees, having the resources to settle court-imposed charges can make the difference between a quick resolution of a case or an extended entanglement with the criminal legal system. Those who struggle to pay their debt extend the length of time of their involvement with and obligations to the courts, which can require regular payments, court appearances, community service, and even incarceration. All of this creates chances for people to fail at meeting these obligations, which can trigger a host of legal and collateral consequences that extend the period of surveillance further still. In short, those without money have far more punitive experiences than those who have the resources to quickly pay off their debts 

New York: Vera Institute of Justice, 2024. 37p.

By The U.S. National Institute of Justice 

Title I of the First Step Act of 2018 (FSA) required the Attorney General, in consultation with the Bureau of Prisons (FBOP) and the National Institute of Justice (NIJ), to develop and implement a risk and needs assessment system. In 2020, the Prisoner Assessment Tool Targeting Estimated Risk and Needs (PATTERN) was developed and implemented, with the intent of assessing recidivism risk and determining eligibility for early release time credits outlined by the FSA. Also mandated was the development of a dynamic needs assessment system. Utilizing existing and validated assessment items and scales, the FBOP created Standardized Prisoner Assessment for Reduction in Criminality (SPARC-13), which consists of 13 domains: Anger/Hostility, Antisocial Peers, Antisocial Cognition, Education, Family/Parenting, Finance/Poverty, Medical, Mental Health, Recreation/Leisure/Fitness, Substance Use, Trauma, Work, and Dyslexia (Federal Bureau of Prisons, 2022). Section 3631 of Title I of the FSA requires that both the PATTERN and SPARC-13 be reviewed and validated on an annual basis. To help fulfill these requirements of the FSA, NIJ announced a competitive Consultant Statement of Work (SOW) and selected three consultants to conduct the annual review and revalidation of the SPARC-13. NIJ contracted with Dr. Grant Duwe, Dr. Zachary Hamilton, and Dr. Alex Kigerl to review and revalidate the SPARC-13. This report reviews and validates the SPARC-13 by conducting analyses relating to internal content, convergent/divergent, latent structure, and concurrent validity. It also presents the results from a process evaluation of the FBOP’s development and implementation of the SPARC-13.

Washington, DC: U.S. National Institute of Justice, 2024. 69p.