Policy Goal 1: Formulate a statewide data strategy.
1. Has the state developed a strategy to improve data collection and information sharing across health and justice systems?
RATIONALE: Some states are exploring ways to advance this work according to a set roadmap rather than through ad hoc reforms and investments to confront the challenges of collecting, sharing, and analyzing health and justice data within and across systems at state and local levels. A coordinated statewide data strategy can
- Advance data sharing between state agencies;
- Support and align local efforts to collect, analyze, and share data;
- Create consistency in data collection, retrieval, and analysis; and
- Direct resources where they are most needed to bridge gaps.
A unified state response in support of IT infrastructure will create consistency across agencies in data collection, retrieval, and analysis for a population that cuts across systems. This unified response may also provide counties with IT technical support (including data analysis) for sites that do not have infrastructure and staff capacity.
Ways to do it
- Issue a statewide commitment through executive order or administrative action to develop a strategic plan for improving data collection, sharing, and analysis capacity at the state and local levels.
- Convene a work group to develop a statewide data strategy. This group could be convened by leadership from a cross-system state data and IT office, or similar state office tasked with coordinating data and IT across state agencies and systems, or by a regulatory agency such as a state’s behavioral health agency.
- Pass legislation and secure requisite funding for intra- and interbranch information sharing of local data so that branches can have an easier time understanding what’s happening collectively at the local level.
- Reallocate existing funding streams or staff time to align and support cross-system work, leverage analytical capacity, or fund staff at the local level to increase capacity.
- Develop a roadmap for local jurisdictions to replicate other jurisdictions’ ongoing efforts to collect, analyze, and share data.
Things to consider
- Limit the number of data systems that exist. Creating multiple data entry systems that one system must use leads to staff burnout. Multiple systems also lead to a competition for time, and some systems may fall out of use. Ideally, promote IT infrastructure that can tap into existing systems to unify datasets or strategies.
- Involve regulatory and IT agencies early in the process. This avoids backtracking on what is possible after decisions have been made and helps lay the groundwork for future success.
- Involve not only agency leadership or technical staff but also local agency or organizational staff that use/will use the strategy and people with lived experience in the systems involved (criminal justice, behavioral health, homelessness, etc.). This helps avoid silos, makes the data strategy relevant to local needs, and helps data work for the people impacted by these systems.
- Consider hosting a clearinghouse of guidance, housed in one easy-to-navigate website, to give local jurisdictions a strong starting point. Rather than having counties dedicate staff time to researching how to collect, analyze, or share data, states can help facilitate these actions and save counties time and money.
State Examples
2. Has the state identified key criminal justice and behavioral health metrics that local agencies should report on to help inform local and state policymaking?
RATIONALE: Providing specific metrics (i.e., jail bookings, length of stay, homelessness rate) and the protocol for tracking them at the state level ensures consistency and accuracy in data collection. It also provides direction for baseline measures to inform local policy, as well as higher-level aggregate data to inform state-level policies, determine capacity needs, and identify efficiencies through shared resources.
Additionally, once baseline measures are established, reduction targets can be set to track progress against using defined measures, informing local and state decision-making and providing vital information on whether actions and investment are achieving intended outcomes.
Ways to do it
- Work with varied local stakeholders to understand existing reporting requirements and key data of interest to inform the identification of key state metrics.
- Use the Justice Counts metrics to capture key criminal justice data. States can become a founding Justice Counts state in a number of ways.
- Promote collection of a core set of metrics as part of agency and budgetary policy (e.g., setting reduction targets). Issue guidance on establishing metrics and collecting data.
- Elevate a county-based program (i.e., Stepping Up) through a statewide commitment encouraging and incentivizing collection of the program’s key metrics.
- Provide technical assistance to support counties/jurisdictions that voluntarily collect key metrics and recognize communities that use data to make improvements at the local level.
- Pass legislation that requires certain local data to be reported to the state and creates a mechanism for that reporting. This more robust option is likely to require funding and technical assistance to ensure that counties have the capacity to collect the required cross-system data. As noted above, any additional data collection requirements should consider existing requirements and ensure that all data collected and reported add significantly to inform policy.
Things to consider
- Any effort to promote collection of key metrics statewide should be paired with ample technical assistance to ensure that communities with limited data collection capacity have sufficient support and are not prevented from accessing funding opportunities.
- States can support local initiatives by helping to scale and/or replicate them statewide. This may include learning from counties with replicable models of metrics collection and providing targeted support for other counties to do the same.
- Strategies for identifying key metrics:
- States should identify simple metrics that capture key data points while also accounting for the fact that agencies collect, define, and maintain data in different ways and that data quality may vary by agency or metric.
- Metrics should be feasible for localities and reflect the data points communities already collect. The number of recommended metrics should be manageable to promote uptake.
- States should ensure that metrics can be gathered by staff using as few IT systems as possible. This both reduces staff time in moving between data entry systems and creates seamless transfers of information to avoid information gaps between systems.
- States can prioritize equity by disaggregating data by race, ethnicity, gender, and other characteristics to understand and address disparities.
- States should consider metrics identification processes that are authentically community driven and informed by what community members want to know, measure, and understand. States should build in considerations for and participation from people with lived experience from the start. This attention to process is particularly relevant when collaborating with Tribes, Pueblos, and Tribal Nations.
- States should consider how metrics relate to a discreet set of desired outcomes,.
- Metrics should complement, rather than try to replace, federal metrics that many programs rely on for funding and should fit into existing systems.
- Metrics should be reported on a regular basis, making analysis of them useful and timely for performance evaluation and funding streams.
- Justice Counts is an initiative led by the U.S. Department of Justice’s Office of Justice Programs’ Bureau of Justice Assistance (BJA), The Council of State Governments Justice Center, and a first-of-its-kind national coalition of 21 partners to develop and help implement consensus-driven metrics for criminal justice agencies to provide policymakers with more accurate, accessible, and actionable data. The Justice Counts metrics were developed in partnership with a wide range of experts across the criminal justice system, representing officials at every corner of our nation’s state, county, and municipal justice systems. The metrics strive to be simple, feasible, and effective and cover the sectors of law enforcement, prosecution, defense, pretrial/courts, jails, prisons, and community supervision. They are also paired with technical implementation guides to support implementation.
State Examples
3. Is the state leveraging all available federal Medicaid administrative funds to support improvements to information technology infrastructure, data collection, and coordination across state agencies? Are criminal justice populations and metrics considered in these efforts?
RATIONALE: By partnering with state Medicaid agencies, corrections agencies can help inform eligibility and enrollment processes as well as use of the state’s Medicaid Management Information Systems (MMIS). Departments of Correction (DOCs) and individual jail systems can advocate for limited or read-only access to eligibility and enrollment information included as part of the state’s MMIS and potentially leverage federal funds to design systems to support gaining this access.
In sharing information, some states have taken steps to improve integration between their corrections systems and Medicaid (typically starting with state DOCs), while others simply share Excel files containing booking information with Medicaid state agencies.
Ways to do it
- Partner with state Medicaid agencies to help corrections agencies gain access to appropriate information in the MMIS and electronic health records.
- Use demonstration programs to pilot models of cross-systems information sharing; implement IT infrastructure; and better align limited, relevant health and justice data.
Things to consider
- According to guidance issued by the Centers for Medicare and Medicaid Services (CMS), state Medicaid agencies can leverage enhanced federal funding to develop new systems or make modifications to existing systems to facilitate placing someone in a suspended status. In many states, Medicaid eligibility is terminated when a person is incarcerated. It can take months for people to get reenrolled in Medicaid upon their return to the community, a barrier to care that is particularly relevant for people with SMI, SUD, and co-occurring disorders. This contributes to people with behavioral health needs cycling between crisis systems, ERs, and local jails. CMS encourages states to suspend rather than terminate eligibility to limit delays in access to care upon reentry. State Medicaid agencies may receive 90 percent Federal Financial Participation (FFP) for design, development, or installation and 75 percent FFP for operation of state mechanized claims processing and information retrieval systems subject to approval from CMS.
- To support continuity and coordination of care, Health Information Exchanges (HIEs) can facilitate information flow for health services by allowing participating health care providers—including jail providers that have access within federal and state privacy protections—to access health records from other providers. Some HIEs rely on sharing handwritten or printed patient information.
- However, most health information exchanges rely on Electronic Health Records (EHR) to digitally share information with other health care providers. EHRs allow providers using the EHR to access health records entered by other participating providers.