Responding to the coronavirus poses particular challenges for many rural counties, where people are incarcerated at the highest rates in the United States, and residents have only a fragile or fragmented public health safety net. Since 2013, the rural jail population has grown 27 percent. Simultaneously, a hospital closure crisis has accelerated in rural America; 2019 was the worst year on record, with 19 closures. Actors and authorities in rural counties have a unique and critical role to play. The following provides guidance on how communities can be better protected during this current crisis: Prioritizing prevention first and foremost To reduce contact between people: Law enforcement should preemptively plan for and equip 911 call-takers and dispatchers to divert calls-for-service to available health resources when they do not require police response, including regional health facilities, health centers, portable clinical care, community care workers, telemedicine, and air medical services that can transport patients to critical care facilities. Many rural counties operate with limited court days and judicial resources. In these counties especially, court administrators should work with jail administrators, public defenders, prosecutors and supervision officers to immediately identify people who are detained while awaiting appearances, hearings, bail reviews, trials, plea colloquies, or sentencing, and identify for immediate release people who do not pose an immediate and identifiable risk to physical safety. Those who are at high risk of being infected by coronavirus should be prioritized. Jailers, wardens, sheriffs, and other detention administrators should exercise their authority to release as many people from their custody as possible. States that do not allow for discretionary releases should adopt these policies on a temporary basis and implement medical furloughs. All justice system stakeholders should partner with community providers to connect people leaving custody with medical care, behavioral health resources including medication-assisted treatment, housing, and other essential services. Executive offices and agencies should consider emergency investments in health, temporary housing, air medical services and other supportive services to enable swift responses to calls-for-service and connectivity to care.. Courts should automatically reschedule the next court appearance for at least six months for any pending cases in which a person is released pretrial or pending adjudication. Courts should create a website where cases can be resolved remotely for pending municipal cases, ordinance violations, traffic tickets, or other criminal offenses. In rural areas that lack broadband, courts should instead consider staffing phone lines to enable the remote resolution of such cases. Containing the possibility of spread To protect especially people who are at high risk—those who are 55 years and older, pregnant, or have serious chronic medical conditions—all rural justice system actors should: Use a CDC-informed screening tool for anyone who is brought to or from a police station, detention center, or court to identify people with possible exposure and people at higher risk of infection. Develop written policies and training to separate people who are symptomatic from others and to maximize the distance between people at higher risk of infection from people who may be infected but asymptomatic. The protocol should outline how to safely transport someone to a hospital or other health facility or to request telemedicine screenings, air medical services, or other forms of support if there is no hospital in the region. It should also include guidance for taking steps to prevent all system actors from exposure during and after transport and provisions for connecting them to care. Suspend the collection of criminal justice fees indefinitely to accommodate for lost wages and to encourage people in financially precarious situations to observe social distancing. This includes medical co-pays for incarcerated people, supervision fees, room and board charges, electronic monitoring and drug testing fees, public defender fees, and diversion fees. Ensure that system- involved people are advised that nonpayment will not result in sanctions, including reincarceration. If in-person visits to incarcerated people must be limited, provide free phone and video calls and increase access to videoconferencing and other measures so that contact with family and loved ones can be maintained until in-person visits can resume. In counties with overcrowded jails or with no local jail facilities, system stakeholders should work collaboratively to avoid transportation and outboarding of incarcerated people to other counties by proactively identifying opportunities for release and non-contact, non-custodial supervision. Responding swiftly to active cases while preserving due process To help infected people and prevent transmission from or to the local community, prosecutors, defenders, and courts should: Develop a policy for cases where intensive or acute care is needed by having a plan to take incarcerated people to the hospital, including a plan for air medical services in communities without nearby hospitals. Access to regional hospital beds, including intensive care beds and respirators, should be tracked as symptomatic patients are identified. Develop a comprehensive policy that provides paid sick leave and a plan for staffing substitutions and triage when personnel test positive for coronavirus. Develop a data collection plan to index all suspected cases of coronavirus and track people through diagnosis, treatment, quarantine (when indicated), and release. Communicate actively with the local health department about all active and suspected cases. Source: https://www.vera.org/downloads/publications/coronavirus-guidance-rural-justice-systems.pdf
