BS Summary: This article contains 20 faulty reasoning types, including Negativity Bias, Status Quo Bias, and Anecdotal, with Confirmation Bias as the most egregious example at 8.6% saturation with 102 hits. Analysis detected 1,020 faulty-reasoning hits from 1,180 analyzed words, generating a BS Score of 24.1% and a BS Rank of 14% (24,270 of 28,108 articles). This article is better (less manipulative) than 86.30% of the article peer group.
Emily Bader at the Piscataquis County Jail in Dover-Foxcroft in March.
Photo by Greta Rybus for The Maine Monitor .
The Maine Monitor recently published a four-part series about addiction treatment in Maine’s jails.
The series was supported by the Pulitzer Center.
The first time I heard a county official call the requirement that Maine’s jails provide medication-assisted treatment an “unfunded mandate” was over two years ago, while I was reporting on how local governments were spending money they had received through settlements with pharmaceutical companies accused of fueling the opioid epidemic.
This was still top of mind when, a year later, I sorted through officials’ responses to another spending survey and noticed the same pattern: More than half of Maine’s 16 counties had used their funds to pay for medication-assisted treatment in the jails.
I got on the phone with the sheriff, jail administrator and jail health services administrator from Maine’s most populous county with two goals in mind: To understand how county-run jails are funded and to learn more about how prisoners’ medical needs, particularly when it comes to addiction, have affected county budgets .
During that call, Cumberland County Sheriff Kevin Joyce told me prisoners were "unprecedentedly sick” –– and their care was costing jails millions of dollars a year.
That conversation was the first of dozens I had with more than 50 county officials, law enforcement officers, jail administrators, health and addiction experts, community advocates and people who have been incarcerated in Maine jails to understand how Maine county-run jails’ approach to addiction treatment has evolved since a landmark 2019 court ruling.
Last July, I attended a panel at Gov.
Janet Mills’ annual Opioid Response Summit on the Franklin County Detention Center’s re-entry program, where I learned that the jail was about to launch an extended-release, injectable buprenorphine program to treat opioid use disorder.
I decided to focus much of my reporting on this facility, which is one of two in the state that offers the long-acting medication.
Inside the Aroostook and Piscataquis county jails.
Photos by Greta Rybus for The Maine Monitor .
Over the past year, I visited four jails, ranging from the largest facility in the state, Cumberland County Jail in Portland, to the smallest, Piscataquis County Jail in Dover-Foxcroft.
I went to the Franklin County Detention Center twice, where I observed the jail’s medical providers administer shots of the long-acting buprenorphine treatment.
And I went to the Aroostook County Jail in Houlton, where I spoke with nurses about what they see day in and day out.
One challenge was finding comprehensive data.
I sent records requests to the agencies that run the 15 jails, asking for financial information and prisoner demographics, and requested jails’ quarterly medication-assisted treatment reports from the Maine Department of Corrections.
But there were significant variations in how each jail tracked its spending, so I ended up relying heavily on a report by the Maine County Corrections Professional Standards Council, which had worked with counties to understand their spending on addiction treatment ahead of a debate in the Legislature earlier this year.
My reporting made clear officials are still working to understand the full impact of addiction on Maine jails.
But it also made clear that jails, as one source told me, can be a pivotal point of public health.
Here are three takeaways from the resulting four-part series:
Prisoners’ medical costs make up a significant share of jail budgets
As the lethality of drugs on the street –– synthetic drugs such as the opioid fentanyl and stimulant methamphetamine –– has increased, so, too, have the medical and mental health needs of the people in jails’ custody, officials said.
County officials estimated that approximately 75 percent of people in county jails have a substance use disorder, and approximately 60 percent have a mental health disorder.
Many of the people entering custody are not only dealing with severe addiction and mental illness but other medical needs, from untreated diabetes to necrotic skin wounds.
Coverage under MaineCare, the state’s Medicaid program, is immediately suspended at the time of arrest, per federal law, which means that jails are on the hook for all medical costs in their facilities.
In some cases, prisoners need to be sent to a hospital, at which point services are billed to MaineCare.
But even then, counties are racking up large overtime bills for 24/7 officer details.
County officials say they are struggling to meet the needs of prisoners in aging facilities that lack proper medical capabilities while financial support from the state has stagnated and statute caps the amount counties can raise in taxes.
The Mills administration told The Maine Monitor it has heard county officials’ concerns about funding and has worked with the Legislature to make additional appropriations.
But the state has limited authority over county-run jails.
Monthly shots offered by two rural jails have shown promise.
But they’re expensive
Maine’s 15 county-run jails have been required to provide medication-assisted treatment for opioid use disorder since a 2019 court order.
The majority of Maine’s jails provide a daily oral medication, while the Franklin and Somerset jails provide extended-release, injectable buprenorphine, largely considered the gold standard treatment for high-risk individuals such as those who are incarcerated.
The daily dose provides only 24-hour relief, or less, from cravings and withdrawal symptoms.
The shot, meanwhile, provides up to four weeks of protection.
The Franklin County Detention Center has already seen promising results in the switch it made just over a year ago: Morale has improved, and there are fewer violent incidents between prisoners and fewer officer use-of-force instances, according to the jail’s data.
But the shots are expensive –– Franklin County pulled together nearly $1.8 million in grants to pay for the first three years of its program –– and out of reach for many jails that are already struggling to pull together funding year after year.
Comprehensive re-entry planning goes hand-in-hand with addiction treatment
When law enforcement officials and medical and public health experts from Franklin County designed the jail’s extended-release, injectable buprenorphine program, they realized the medication would not be enough on its own.
They decided to prioritize re-entry planning — helping prisoners figure out their next steps once they’ve been released.
Left: Visitors at the Franklin County Recovery Center in Farmington.
Right: Emily Bader interviews recovery coaches at Aroostook Recovery Center of Hope in Houlton.
Photos by Greta Rybus for The Maine Monitor .
The Franklin jail hired a dedicated re-entry coordinator who assesses every prisoner when they enter custody, meets with them while they’re incarcerated and follows up with them after they leave.
The jail has strong connections with the local recovery network, such as the Franklin County Recovery Center and the OPTIONS program.
They were able to add the new positions thanks to a $1 million federal grant.
A growing number of recovery centers — including ones I visited in Houlton and Sangerville — are looking for ways to help with this re-entry work.
But coordination between jails and recovery centers varies across the state.
Speakers
4speakers7.9%attributed speech1,087writer words
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100%flagged-word coverageKevin Joyce
26 attributed words28% of attributed speech63% writer coverage
Attribution is sentence-level. Pattern percentages are calculated only from words assigned to that voice.
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Analysis
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