HJAR Jan/Feb 2021

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2021 41 Joseph W. Thompson, MD, MPH President and Chief Executive Officer Arkansas Center for Health Improvement the total number of days that the patients spent in jail dropped by 27.5% after CSU intervention. Our findings in the area of healthcare uti- lization were mixed, with undesirable events decreasing in some categories but staying virtually the same or increasing in others. Further studies are needed to understand the healthcare utilization behaviors of CSU patients and how they can be impacted by CSU intervention. These studies could in- clude longer observation periods, larger co- horts and data from other CSUs in the state. While our assessments to date are only preliminary, it is clear that for Arkansans with mental illnesses, a crisis stabilization unit is a much better place to be than jail. Read our 2020 report: https://achi. net/newsroom/incarcerations-decline- after-crisis-stablization-unit-intervention- achi-study-finds. n three or more bookings, more than 20% had six or more ED visits during the study pe- riod. In the most extreme cases, one jailed individual in Sebastian County had 48 ED visits, and one jailed individual in Pulaski County had 51 ED visits. It was clear from our baseline assess- ment that in both counties, opportunities for intervention existed among individuals with mental illnesses who had experience with both the healthcare and criminal jus- tice systems. In 2020, ACHI conducted another assess- ment, this time focusing on individuals who were patients of the Sebastian County CSU in its first year of operation. Again, using health claims and booking data, we looked at the healthcare utilization and jail involve- ment of a cohort of 235 Sebastian County CSU patients who had at least 12 months of continuous healthcare coverage. An overwhelming majority of the patients had coverage through the state Medicaid pro- gram, either through traditional Medicaid (70.6%) or the Arkansas Works Medicaid expansion program (15.7%). The patients were assessed for changes in jail involvement and healthcare utilization in the six months following CSU intervention compared to the six months prior to CSU in- tervention. Jail bookings, inpatient hospital stays, emergency department visits, hospital observation stays, and jail bookings were considered undesirable events for purposes of our assessment. Encouragingly, we found an overall de- crease in jail involvement after the patients were treated at the CSU. We found that the number of patients who experienced a jail stay in the six months after CSU interven- tion declined by 5.3% compared to the six months before CSU intervention, and the total number of jail bookings decreased by 12.2% after CSU intervention. Most notably, “We found an overall decrease in jail involvement after the patients were treated at the CSU. Most notably, the total number of days that the patients spent in jail dropped by 27.5% after CSU intervention.”