Jails

Jails are typically county institutions. They usually operate under the authority of the county sheriff, or in some states, under a warden. Jails typically house people after they are arrested and are waiting to post bail or awaiting trial. Also jails will typically house people after they are convicted and have received a sentence of one year or less.

Difference Between Prisons and Jails

Prisons are state or federal institutions. People who have been convicted of a crime and serving a sentence of more than one year are transferred from jail to prison. In some smaller states prison and jails are combined: Vermont, Connecticut, Rhode Island, Delaware, and Hawaii. In jails, it is not uncommon for 60% of the population held in jails to enter and leave within 2 to 4 weeks. Only 4% of a jail’s population will go onto a prison. There are about 11 to 13 million people who cycle through jails each year, as opposed to about 2 million people in prisons.

Jails and Healthcare

It is not well understood that jails are an important locus of health care for the populations cycling through them. Compared to the general population, people in jail have high rates of mental illness, substance use disorder, and chronic and infectious diseases, including hypertension, diabetes, tuberculosis, HIV/AIDS, and hepatitis B and C.

To address these health challenges, jail healthcare needs to be a combination of emergency room, outpatient clinic, and hospital. A jail resembles an emergency room, during the booking process. Detainees may be injured, mentally decompensated, disoriented due to drug or alcohol use, or suffering from some unknown condition that requires immediate attention. For less pressing healthcare needs there are clinics that provide services similar to outpatient clinics in the community. For people needing long term care, some jails will have infirmaries that provide the type of care that is associated with hospitals.

Health Intake, Assessment, and Routine Care Processes in County Jails
An in depth explanation of healthcare delivered within jails. Prepared by COCHS for a webinar sponsored by the National Association of Counties (NACo).
Jail Medical Intake
How does a health provider identify health issues of people who are arrested and booked into a jail? This flow chart details the medical intake process at both pre-booking and post-booking.
Sick Call
What happens to a person who falls ill within a correctional environment? This flow chart explains all the possible steps involved in the sick call process within jails.
Discharge Planning
When a person leaves jail, some correctional institutions may assemble a discharge packet which often include medications. This flow chart describes the steps involved in the discharge planning process.
How does jail medicine differ from prison medicine?
There is much that is similar between healthcare provided between jails and prisons but there are significant differences between the two.
Health Coverage and Care for the Adult Criminal Justice-Involved Population
An issue paper on different correctional environments, the populations in jails and prison, the healthcare available within these facilities, and the impact of the Affordable Care Act (ACA) on justice involved populations.