Mental health and corrections: towards a working partnership

This paper describes the development of mental health services to the courts and correction facilities in the City of New York. The origins, structure, and functions of the interagency New York City Task Force on Prison Mental Health Services are explained. The Task Force's role in the development, promulgation, and implementation of the Minimum Standards for Mental Health Services in New York City Correctional Facilities are outlined. These standards, enacted by the New York City Board of Correction, are described and discussed.     

Back to the future? Diabetes, HIV, and the boundaries of public health

The control of infectious diseases has traditionally fallen to public health and the clinical care of chronic diseases to private medicine. In New York City, however, the Department of Health and Mental Hygiene (DOHMH) has recently sought to expand its responsibilities in the oversight and management of chronic-disease care. In December 2005, in an effort to control epidemic rates of diabetes, the DOHMH began implementing a bold new plan for increased disease surveillance through electronic, laboratory-based reporting of A1C test results (a robust measure of blood-sugar levels). The controversy A1C reporting produced was relatively contained, but when Dr. Thomas Frieden, New York City health commissioner, called for the state to begin tracking viral loads and drug resistance among patients with HIV, both the medical community and a wider public took notice and have started to grapple with the meaning of expanded surveillance. In the context of the past century of medical surveillance in America, we analyze the current debates, focusing first on diabetes and then HIV. We identify the points of contention that arise from the city's proposed blend of public health surveillance, disease management, and quality improvement and suggest an approach to balancing the measures' perils and promises.     

A tailored anger management program for reducing citizen complaints against traffic agents

Anger management programs have been used to address a range of clinical problems, but empirical tests of their effectiveness in the workplace have been limited. This study presents the results of a cognitive-behavioral anger management program employed with New York City traffic enforcement agents. Traffic agents issue summonses for vehicular and parking violations and have frequent conflicts with members of the public who are angry about receiving these summonses. Conflicts with the public are a significant source of job stress for agents and may increase their risk for physical injury. When members of the public are dissatisfied with the agents' actions, they can file a complaint with the agents' employer, the New York City Police Department. Complaints can reference the agent's interpersonal behavior or an administrative problem. The multi-component group intervention was provided to 114 agents, with a group of 184 agents served as the untreated comparison group. There was a significant Group (Treatment versus Control) by Time (Pre-test versus Post-test) interaction for the total rates of civilian complaints against agents (p<.03) and, more specifically, for the rates of civilian complaints related to the agents' interpersonal behavior (p<.01). Rates of civilian complaints against agents who participated in the treatment program decreased significantly over the testing period, whereas rates of complaints for agents in the control group did not change. The results suggest that this manualized program can produce changes in behavior relevant for the individual as well as the agency. Authors' Note: The authors wish to thank the many individuals at the New York City Police Department and the New York City Department of Transportation who provided support for this project. The project was funded through a grant from the New York State Department of Labor to the Communications Workers of America. We would also like to acknowledge the statistical advice of Joseph Schwartz, Ph.D., of SUNY Stonybrook.     

Making the Health Insurance Flexibility and Accountability (HIFA) waiver work through collaborative governance

This paper argues that collaborative governance should be an essential component in any HIFA waiver proposal, due to the fact that the health care system is moving away from a federal and hierarchical program design and implementation towards a more local, collaborative approach. As several current collaborative projects demonstrate, collaboration may overcome barriers to health expansion program success, such as stakeholder buy-in, notice, and state access to private health coverage information. Furthermore, collaboration within the context of the HIFA waiver process may maximize the strengths of current collaborations, such as providing: (a) access to greater and more stable funding sources; (b) access to a facilitator that can collect and distribute data; and (c) an avenue for accountability. Multiple challenges in ensuring collaborative governance are reviewed. Ms. Zabawa argues that these challenges are not insurmountable if states adopt a truly collaborative approach to designing and implementing programs under the HIFA waiver; there may be hope in expanding and improving health coverage, since collaboration is the most appropriate mechanism to address the complexity of health system reform.     

Building Bridges for Babies in Foster Care: The Babies Can't Wait Initiative

In 2001, the New York State Permanent Judicial Commission on Justice for Children, chaired by New York State's Chief Judge Judith Kaye, developed the Babies Can't Wait Initiative to maximize the well‐being and permanency prospects of infants in foster care. This court‐based innovation became a path to healthy development for babies in foster care, a bridge to unprecedented collaboration among the New York City Family Court, child welfare system, and service providers and merged knowledge about child development with court and child welfare practice. This article tells the story of the Babies Can't Wait Initiative—its creation, implementation, successes, and lessons.     

Substance abusers in jail: Health service breakdown in five New York jails

The New York State Commission of Correction Medical Review Board studied five inmate mortalities which occurred between 1986 and 1989 in different New York State jails. The jails varied in size and in health care delivery capacity, but shared several characteristics, particularly severe overcrowding, high annual rates of population growth, and high concentrations of substance abusing inmates. Each inmate mortality case revealed an unprepared failure in health care delivery in which, absent such failure, the outcome may have been different. Influx of ever-increasing numbers of acutely and chronically ill substance abusers under overcrowded conditions intensifies demand on unprepared health care systems which increasingly break down. Jail health care systems should be evaluated in light of current population size and changing inmate health care needs.     

THE IMPACT OF ORDER‐MAINTENANCE POLICING ON NEW YORK CITY HOMICIDE AND ROBBERY RATES: 1988‐2001*

Local officials and national observers have attributed the New York City drop in violent crime during the 1990s to the aggressive enforcement of public order, but relevant research is limited and yields contrasting conclusions regarding the effects of order‐maintenance policing (OMP) on violent crime trends in New York City. The current study investigates the effects of order‐maintenance arrests on precinct‐level robbery and homicide trends in New York City with more reliable crime and arrest data, longer time series, and more extensive controls for other influences than used in prior research. We find statistically significant but small crime‐reduction effects of OMP and conclude that the impact of aggressive order enforcement on the reduction in homicide and robbery rates in New York City during the 1990s was modest at best.     

New York City's approach to problem-employee counseling

Employee problems such as alcohol and drugs (and the emotional turmoil that leads to them) continue to slow productivity and increase turnover. For nine years, New York City has been an innovator in this area of personnel concern, abandoning the traditional warn-and-terminate method for the centralized and cost-effective outreach program that is outlined here.     

The Metropolitan New York Ethics Committee Network: coming together at a time of concern

Approximately two years ago, colleagues at some of the major teaching hospitals in the New York City area began to consider the possibility of pooling resources and providing the opportunity for the over 100 hospital-based ethics committees currently in existence in and around New York City to come together. It was thought that by joining together in a network type of organization, committees could exchange experiences and wisdom, and jointly examine and develop responses to some of the more unique, as well as the more conventional, ethical dilemmas they confronted. Those efforts culminated in the start-up of the Metropolitan New York Ethics Committee Network.     

Casino-related deaths in Atlantic City, New Jersey 1982-1986

The first legalized casino-hotel opened in Atlantic City, New Jersey in 1978. Annually, more than 30 million people visit the "Gambling Capitol of the East Coast." As a result of this growing influx of people, the Atlantic County Medical Examiner's Office began compiling statistics in 1982 of casino-related deaths. Data on 398 casino-related deaths occurring in 1982-1986 were collected and analyzed: 83% of the total number of fatalities were sudden cardiac deaths. Most of the victims were elderly white retired men who had previously diagnosed medical conditions. Many of the victims' underlying medical problems are of a type known to be associated with compulsive gambling. The majority of deaths occurred during the afternoon hours on weekends in October, January, and May. Of the victims, 86% were from New Jersey, New York, and Pennsylvania. For Atlantic City, a gambling community known to have a relatively high rate of crime and drug-trafficking, only 1% of all deaths were homicides. We speculate that the stress of gambling activities may induce sudden cardiac death. We therefore recommend that communities planning to legalize casino gambling mandate that gambling establishments provide emergency health care services for their patrons.     

Owning ASFA

As New York and many other jurisdictions struggle to comply with the timelines of the Adoption and Safe Families Act (ASFA), the experiences of the Expedited Permanency Part of the New York City Model Court under the direction of Judge Sara Schechter may provide helpful approaches for overcoming unnecessary delays and obstacles. Despite resistance to change, scarce resources, and a shortage of attorneys for indigent respondents, the New York City Model Court has been able to implement ASFA without sacrificing due process in the handling of child protective and permanency proceedings. Some of these strategies include extensive case conferencing, the use of specially trained conference facilitators, time‐certain appointments, and compliance reviews conducted by a referee. The New York City Model Court has found that integrating these new approaches has markedly improved the permanency outcomes for the children within its jurisdiction. Innovations piloted in the New York City Model Court are being replicated throughout the five boroughs of the city.     

试论美国纽约市法庭科学工作

纽约市是美国第一大城市,人口众多,经济发达,其法庭科学在国际上也享有声望。纽约市法庭科学部门主要分布在警察局(NYPD)和法医局(OCME)两大机构,警察系统的法庭科学机构主要负责毒品、微量物证、指纹、痕迹、枪弹及文件检验,法医局则进行DNA、毒化、法医病理、法医人类学方面的检验。本文首先介绍美国的警察制度及纽约市警察局概况,然后分别从警察局和法医局两个部门对纽约市法庭科学的部门隶属、部门设置与工作职能情况进行介绍。     

Could Innovations in Policing have Contributed to the New York City Crime Drop even in a Period of Declining Police Strength?: The Case of Stop,Question and Frisk as a Hot Spots Policing Strategy

Available data make it impossible to reach strong conclusions about the role of policing in the New York crime decline. Instead, we examine whether innovations implemented in New York fit with what is known about effective policing strategies. Our main analysis focuses on how the New York City Police Department (NYPD) could have continued to contribute to the crime drop over the last decade when the number of police declined significantly. We examine geographic data on crime and stop, question and frisks (SQFs) to show that SQFs are concentrated at crime hot spots. We also show that the NYPD increased these specific hot spots policing strategies despite declining numbers. In our discussion, we speculate on whether this “doing more with less” could be an explanation for the continued crime drop in New York, noting the limitations of drawing conclusions from existing data. We also raise concerns about possible backfire effects of SQF hot spots approaches.     

Whose business is your pancreas? Potential privacy problems in New York City's mandatory diabetes registry

This article examines a recent New York City health regulation that mandates the compilation and storage of individual medical data from nearly all diabetics in a centralized registry. The authors distinguish this novel registry from prior health registries and scrutinize its potential to compromise individual privacy. In order to address privacy and other concerns, the authors offer suggestions for changes to the current statutory framework of the registry that will also be useful when considering the creation of similar public health registries in other cities.     

World Trade Center Health Program; addition of certain types of cancer to the list of WTC-related health conditions. Final rule

Title I of the James Zadroga 9/11 Health and Compensation Act of 2010 amended the Public Health Service Act (PHS Act) to establish the World Trade Center (WTC) Health Program. The WTC Health Program, which is administered by the Director of the National Institute for Occupational Safety and Health (NIOSH), within the Centers for Disease Control and Prevention (CDC), provides medical monitoring and treatment to eligible firefighters and related personnel, law enforcement officers, and rescue, recovery, and cleanup workers who responded to the September 11, 2001, terrorist attacks in New York City, at the Pentagon, and in Shanksville, Pennsylvania, and to eligible survivors of the New York City attacks. In accordance with WTC Health Program regulations, which establish procedures for adding a new condition to the list of covered health conditions, this final rule adds to the List of WTC-Related Health Conditions the types of cancer proposed for inclusion by the notice of proposed rulemaking.     

Citizen Orientations Toward State and Non-State Policing*

In contemporary Western societies, policing has become associated with the state although this practice is of recent origin and by no means universal. Even within post-industrial states, non-state forms of policing exist and may be a rediscovered source of social control. A survey of subway riders in New York City provides information about citizen dispositions toward policing by state and non-state sources. It was found that respondents are substantially more supportive of a self designated citizen anti-crime organization, the Guardian Angels, than they are of the New York City Transit Police although a sizable number of respondents support both sources of policing. Differential assessment is related to perception of crime trends, the degrees to which respondents believe bystanders will intervene on their behalf in the event of a crime, fear of victimization and the reported likelihood that respondents will intervene. Such findings are useful in addressing general theoretical issues respecting the basis for support of state and non-state policing and their relative role in social control.     

POLICING,DRUGS, AND THE HOMICIDE DECLINE IN NEW YORK CITY IN THE 1990s*

This research reassesses the role of policing and drugs in the sharp homicide decline in New York City in the 1990s. Drawing on theoretical arguments about “broken windows” policing and lethal violence associated with the diffusion of crack cocaine, we estimate the effects of measures of misdemeanor arrests and cocaine prevalence on homicide rates with pooled, cross‐sectional time‐series data for 74 New York City precincts over the 1990–1999 period. The results of mixed regression models reveal a significant negative effect of changes in misdemeanor arrests and a significant positive effect of changes in cocaine prevalence on changes in total homicide rates. Additional analyses of homicide disaggregated by weapon indicate that the effects of misdemeanor arrests and cocaine prevalence emerge for gun‐related but not for non‐gun‐related homicides. Overall, the research generally supports influential interpretations of the homicide decline in New York City but also raises questions about underlying mechanisms that warrant more inquiry in future research.     

Evaluating Contemporary Crime Drop(s) in America,New York City,and Many Other Places

This paper describes and evaluates some fundamental facts about the contemporary crime drop, summarizes the major explanations that have been offered for it, and assesses the validity of these explanations in light of observed trends. In contrast with much of the recent literature, we argue that the locus of the crime drop in the 1990s is not wholly consistent with the available data and that while New York City experienced substantial crime decreases, its uniqueness has been exaggerated. We suggest that it is important to partition the crime drop observed in New York City and elsewhere into global and more localized shifts, and we offer some observations about the factors that appear most germane to driving these different dimensions of recent crime drops. We conclude with some suggestions for future inquiry.     

Health care joint ventures between tax-exempt organizations and for-profit entities

Health care exempt organizations have many options regarding their structure and affiliations with for-profit entities. As long as any joint ventures are carefully structured and the nonprofit retains control over the exempt health care activities, the Internal Revenue Service should not question the structure. However, as outlined above, if the for-profit entity effectively gains control over the activities of the venture, the structure is not likely to be upheld by the IRS or the courts, and either the exempt status of the nonprofit will be denied or revoked, or health care income will be subject to the unrelated business income tax. In summary, the health care industry has been severely impacted by many economic forces, including uncertainty in the area of joint ventures between nonprofits and for-profit health care systems. The uncertainty as to whether the joint venture would negatively impact the nonprofit's tax-exempt status undoubtedly caused many nonprofits to form for-profit subsidiaries and otherwise expanded operations in a for-profit marketplace. Fortunately, with the guidance that is currently available in the form of Revenue Ruling 98-15, Redlands, St. David's, and now Revenue Ruling 2004-51, health care institutions can move forward with properly structured joint ventures with greater confidence that the joint venture will not endanger the tax-exempt status of the nonprofit.     

Administrative interventions on police shooting discretion: An empirical examination

In August, 1972, the New York City Police Department promulgated administrative shooting guidelines and shooting incident review procedures far more restrictive than former statutory “defense of life” and “fleeing felon” justifications for police shooting. Using a data base that includes all reported New York City police firearms discharges and serious assaults on police between 1971 and 1975, this article examines the effects of the new guidelines and procedures on shooting frequencies, patterns, and consequences.Great decreases in “fleeing felon” shootings, “warning shots,” and shooting-opponent injuries and deaths were found to be associated with the new rules. This change also appeared to have a favorable effect on line-of-duty officer deaths and serious injuries. The implications of these findings are discussed.