New York City established Pre-Arraignment Medical Screening Units (PASUs) in all boroughs’ central booking facilities, except Staten Island, as a result of a 1993 legal settlement requiring the city to establish a process for screening the health needs of people who are arrested, booked into police custody, and awaiting arraignment. Unfortunately, PASU protocols provide cursory assessments of people’s health needs, lack the capacity to treat common, non-urgent ailments, and miss opportunities to advance jail diversion for people with behavioral health needs. In 2015, the Enhanced Pre-Arraignment Screening Unit (EPASU) pilot was launched in Manhattan Central Booking to address these limitations. This report describes empirical findings of a process evaluation of the EPASU conducted over an 18-month span. Researchers used mixed methods, drawing on analyses of administrative data, in-depth interviews, surveys, and focus groups with key stakeholders to assess the EPASU’s implementation and whether it reached its principal goals.
The EPASU’s staffing and processes are promising improvements over the existing screening system in serving the health needs of people in contact with the justice system. Taking this program to scale is one important tool for addressing health disparities across the justice continuum and reducing the overrepresentation of people with behavioral and physical health disorders in New York City’s jails.
The EPASU staff, which includes a patient care associate and a nurse practitioner, can diagnose and treat many conditions, reducing needless hospital emergency room visits among arrested people.
The EPASU produced a systematic method for identifying behavioral health needs and, with consent, sharing relevant information with defense counsel pre-arraignment that can be used to advocate for diversion.
Expanding the array of medical services and number of social workers devoted to health promotion, jail diversion, and harm reduction will further enhance the operation of the EPASU model.