About 170 local and national judges, attorneys, social workers, probation officers, health care providers, community members, and researchers, as well as state, county, and city and officials, gathered at the High Country Conference Center at Northern Arizona University on Sept. 26 for a workshop entitled “The Consequences of Juvenile Justice System Involvement on the Health and Well-Being of Adolescents, Families and Communities of Color.”
The one-day event, sponsored by the Center for Health Equity Research (CHER) at Northern Arizona University, in partnership with the Roundtable on the Promotion of Health Equity of the National Academies of Sciences, Engineering, and Medicine (NASEM), The NARBHA Institute, and the Arizona Biomedical Research Centre, examined strategies to transform the juvenile justice system throughout the nation. More than 250 also attended the event by video conference.
Keynote speakers were Scott Bales, executive director of the Institute for the Advancement of the American Legal System (IAALS) of Denver and former Arizona Chief Justice, and Judge Kathleen Quigley, from the Pima County Juvenile Court and a Northern Arizona University alumna, along with three panels of juvenile justice experts in Arizona and from across the nation. A special group of young adults, counselors, and parents also shared their experiences in the juvenile justice system with attendees during a lunch session.
CHER Director Dr. Julie Baldwin, and Dr. Mark Carroll, chief health officer and vice president of discovery and development at The NARBHA Institute, moderated the workshop along with other members of the NASEM Roundtable on the Promotion of Health Equity.
“We see this as a critical launching point for dialogue and action around this topic, both locally and nationally,” Dr. Baldwin said in her introduction.
Throughout the day, experts in their fields discussed challenges in the juvenile justice system, especially for communities of color, and they also highlighted successful, established programs and policies that serve as models for the nation.
During his keynote, Justice Bales gave statistics for Arizona youth in the juvenile justice system. He said that African American youth are referred to the juvenile justice system 3.7 times more often and American Indians are referred 1.8 times more often than Caucasian youth. About one in five referrals resulted in detention; however, youth who are American Indian had a detention rate of two and a half times that of white juveniles. He said that African American youth are charged five times more often and Hispanic youth are charged three times more often than white youth.
In her address, Judge Quigley said that one of the key goals of the Arizona courts was to reduce the number of juveniles in detention and to connect families to services. She said that there have been positive changes recently in Arizona for youth in the juvenile justice system and that the state has reduced admissions to detention by 50 percent. She said a few of the Arizona counties reduced their numbers so effectively that they were able to close their detention centers and turned them into youth recreation centers.
As an example, Judge Quigley said that in Apache County there are 320 youth registered in the converted youth center —95 percent of the students from the local high school. She said some of the centers have counseling services on site and that the centers have positively affected youth who attend—some resulting in up to 55 percent reduction in youth referrals to the juvenile justice system.
“Navajo County and Apache County are leading the way and there really have been impressive outcomes,” Quigley said.
In the third panel discussion, titled “What do we still Need to Learn? Where Should we go in the Future?” Michal Rudnick, a project manager with the Arizona Health Care Cost Containment System (AHCCCS), which serves as the Medicaid agency in Arizona, said that their agency is dedicated to listening to the community and learning from experts. She said that she admires AHCCCS leaders who have been courageous in “pushing the limits and the boundaries on what is possible.”
As an example, she said that several years ago, Pima County told AHCCCS about their problem with continuity of health care coverage for people who are or who had been incarcerated.
“They shared with us the very real and unfortunate situation of jails and prisons becoming health care facilities and the adult cycle back into their system,” Rudnick said.
In response, Rudnick showed a video of a program AHCCCS created that she called “one of the most innovative” programs she has seen—13 integrated “health homes” across the state where people on probation or parole could see their probation or parole officer and in the same visit receive medical visits, behavioral health services and assessments for behavioral health. The program also offers them assistance with food insecurity, housing, and obtaining a job.
Other panel discussions included “What we Know about the Effects of Involvement with the Juvenile Justice System on Health Outcomes for Vulnerable Populations,” and “Alternatives to Juvenile Detention in Building Systems of Justice and Equity.”
The workshop was the last in a series of three workshops hosted by the NASEM Roundtable on Promotion of Health Equity: the first focused on incarceration as a structural determinant of health and the second examined how race, ethnicity, drug control laws, and policies intersect within the criminal justice system.
The presentations are available on the workshop website.