If you’re leading a jail today, you already know the reality.
The population in our facilities is more medically and behaviorally complex than it was even five or ten years ago. We are seeing more individuals with serious mental illness, more substance use disorders and withdrawal, and more chronic disease (often untreated), along with the challenges that accompany them. At the same time, we are managing it all with staffing shortages, tightening budgets, and increasing public scrutiny.
When something goes wrong — especially an in-custody death — the questions come quickly:
• Were policies followed?
• Were checks completed on time?
• Was care provided promptly and correctly?
• Can you prove it?
Recent advances in technology may help address some of these challenges. Technology does not eliminate risk. But when implemented thoughtfully, it can reduce liability exposure, improve operational efficiency, and strengthen defensibility.
1. Monitoring and Tracking: Supporting Staff and Strengthening Documentation
Visual checks are foundational to safety. However, they are vulnerable to fatigue, staffing strain, and documentation gaps — all of which create potential liability.
Today’s monitoring technologies can supplement traditional supervision by tracking location in real time, monitoring vital signs for high-risk individuals, sending alerts when conditions begin to decline, and recording data to demonstrate timeliness of response.
These tools do not replace staff. But when used properly, they reinforce supervision and give leaders stronger documentation when it matters most. From a custody perspective, the value is straightforward: objective documentation of checks, earlier identification of suicide or medical risk, reduced reliance on manual logs, and better prioritization of high-risk housing all enhance safety and reduce risk.
2. Telehealth: Reducing Transports and Operational Disruption
Every custody leader understands the impact of transports, whether inside or outside the facility. They require escorts, create overtime, pull staff from regular operations, and, introduce additional risk.
Telehealth services can reduce the number of unnecessary off-site visits, decrease escort and overtime demands, limit internal movement, expand specialty access, and speed up consultations.
Even modest reductions in transports can translate into meaningful savings — and fewer operational disruptions.
3. Electronic Health Records: Protecting the Agency
Paper systems can undermine defensibility through missing documentation, illegible handwriting, and delayed entries.
Electronic health records strengthen agencies by improving documentation accuracy, creating audit trails, supporting HIPAA compliance, integrating with jail management systems, and generating data that allows for better analysis of system performance and outcomes.
From a custody standpoint, electronic health records enhance the facility’s ability to identify gaps, mitigate risk, and reduce potential liability.
4. Body Scanners: Safety and Deterrence
Contraband — especially narcotics — continues to drive violence, overdoses, and instability inside facilities.
Body scanners are 100% effective at identifying metallic weapons, serve as strong deterrents at intake, provide valuable screening after court or hospital returns, and offer stored images for investigative documentation.
They are not perfect and require consistent training. However, when implemented properly, they improve facility safety and strengthen defensibility.
5. Data and Artificial Intelligence: Leading Proactively
Most jails collect data. Far fewer fully leverage it. When data is used, issues are often identified during after-action analyses or mortality reviews. Data can help identify the series of small incidents that contributed to a critical event.
Modern systems collect valuable information, but they often operate independently of one another. The promise of artificial intelligence lies in its ability to integrate data from multiple systems, analyze trends, and identify potential issues before they escalate into critical incidents.
Technology has the potential to be a game-changing factor in corrections. It is not intended to replace staff, but it can create efficiencies that allow staff to be better deployed and supported in their daily duties. Most importantly, it gives leaders the ability to proactively analyze operations and identify gaps and emerging risks.
When leaders identify trends proactively, they can align staffing and resources with operational needs, strengthen quality improvement efforts, and justify budget requests for necessary resources. Collectively, these efforts reduce liability and make our communities safer.
The future holds significant promise. The potential applications of technology in correctional facilities and their health care systems are just beginning to emerge. Technology can save lives, protect careers, and improve facility operations.
The question is: Where does your facility stand in leveraging technology?
Richard Forbus, MBA-HCM, CCHP-A, is the NCCHC vice president of program development. You can reach Rich through [email protected].
]]>For decades, the default response to someone in crisis inside a correctional facility often relied on force to quickly gain control. While these tools may sometimes be necessary, overreliance on force—without a crisis intervention framework—has contributed to injuries, in-custody deaths, and other adverse outcomes for both staff and people in custody.
A Cultural Shift: From Control to Crisis Intervention
The implementation of Crisis Intervention Team (CIT) programs in correctional settings represents a meaningful shift in both philosophy and practice. Instead of asking, “How do we control this situation?” staff are trained to ask, “Why is this person in crisis—and how can we safely de-escalate it?”
A core component of CIT is collaboration. Effective crisis response requires strong communication and working relationships among custody, medical, and mental health professionals. When these disciplines work together, the need for force can often be mitigated, leading to safer outcomes.
Facilities that have embraced CIT report a cultural change: individuals in crisis are recognized early, de-escalation strategies are prioritized, and staff feel better equipped to respond calmly and effectively. The result? Fewer unnecessary uses of force, fewer injuries, and safer environments for everyone.
Beyond the Jail Walls: Community Impact
CIT programs also extend beyond facility operations. When implemented comprehensively, they require partnerships with community mental health providers, public health agencies, and other stakeholders to ensure continuity of care after release.
These partnerships:
Ultimately, coordinated care can help reduce recidivism, decrease jail utilization for individuals with untreated mental health conditions or substance use disorders, and contribute to safer communities.
An Opportunity for Leadership
CIT implementation is also an opportunity for leadership to foster open, judgment-free dialogue about mental health, substance use, and trauma—both among those in custody and among staff.
Correctional officers experience disproportionately high levels of stress, trauma exposure, and mental health challenges due to the nature of their work. Any meaningful discussion about crisis intervention must also acknowledge and address staff wellness.
Facilities should ensure:
A Transformational Approach
Widespread CIT training has changed more than tactics—it has changed mindset. Officers are trained to understand the “why” behind a crisis and to apply communication and de-escalation skills that reduce physical injuries and mitigate emotional harm.
Effective CIT programs:
In short, CIT is not just a training—it is a transformation in how facilities respond to crisis.
Find out how NCCHC Resources can support your CIT training. Based on “Crisis Intervention Team Training in Jails” in American Jails magazine by Richard Forbus, MBA-HCM, CCHP, NCCHC, and Claire Wolfe, MPH, MA, CCHP, NCCHC Resources.
]]>I often hear people say, “Jail is not a place for the mentally ill.”
That statement is 100% true—but it misses the real issue.
The problem isn’t that people with mental illness are in jail.
The problem is how they get there.
Nothing becomes a priority in our systems until it turns into a crisis. Long before someone reaches a jail intake, there were warning signs—missed appointments, untreated symptoms, escalating behavior, and a lack of meaningful access to care. Over time, those gaps lead to arrests, then more arrests, and eventually to serious offenses where release is no longer possible. It should never get to that point—but too often, it does.
This cycle is not the exception. It’s the rule.
Jails Inherit All the Risk—Whether We’re Ready or Not
Here’s the truth that matters most for custody leaders:
We have no control over what comes in the front door—but we have all of the risk and responsibility once it does.
Jails across the country have become the de facto mental health system. Not because that was the plan, but because community-based care is limited, fragmented, and often only available once someone is already in crisis. As a result, people frequently arrive at jail with untreated mental illness, substance use disorders, trauma histories, or all three—often compounded by chronic health conditions
The jail environment is essentially “ground zero,” where elevated risks converge: medical emergencies, self-harm, use-of-force incidents, staff injuries, and liability exposure. Custody leaders are expected to manage all of this—often without adequate staffing or resources.
Why CIT Training Matters Inside the Jail
Crisis Intervention Team training is often associated with patrol and community response, but it is just as critical—if not more so—inside jails.
Custody staff are the eyes and ears of the facility. They are usually the first to notice behavioral changes, decompensation, withdrawal, or emerging mental health crises. How staff respond in those first moments can determine whether a situation stabilizes or escalates.
CIT training gives officers the knowledge, skills, and confidence to:
When implemented well, CIT training doesn’t just improve outcomes—it makes facilities safer and more manageable for everyone
Leadership Means Acting Before the Headline
CIT training is not a cure-all for a broken system—but it is a practical, proven step custody leaders can take right now. It helps shift the response from reactive to proactive, from force-driven to care-informed, and from crisis management to risk reduction.
The Bottom Line
Jails didn’t create the mental health crisis—but we inherit it every day. With that reality comes responsibility.
CIT training is not optional. It’s not a luxury.
It’s a leadership decision—one that protects staff, reduces harm, and helps fulfill our constitutional duty to those in our care.
And after decades in this field, I can say this with certainty:
We can do better—and we have to.
Read more about CIT Training in American Jails magazine.
By Richard Forbus, MBA-HCN, CCHP-A
NCCHC Vice President of Program Development
NCCHC Resources can help you with CIT Training. Contact us at [email protected] or set up a time to talk to Rich.
]]>As someone who has worked in correctional leadership for many years, I have said repeatedly that collaboration is not a “soft skill.” It is a safety strategy.
We’re All Facing the Same Pressures
Both custody and health care professionals operate in challenging conditions:
Despite different training and roles, our missions overlap far more than they diverge. We are both responsible for ensuring that the people in our care remain safe, healthy, and treated with dignity. When we work together, outcomes improve—across the board.
Shared Communication Prevents Small Issues From Becoming Emergencies
Custody staff often see early warning signs—changes in behavior, withdrawal symptoms, or signs of distress. When communication channels are open and trusted, these observations reach clinical staff quickly, allowing for timely intervention.
Unified Policies Create Predictable, Safer Responses
Policies built collaboratively—rather than in silos—ensure that both teams understand roles during intake, emergency response, segregation decisions, and ongoing care. Clarity prevents hesitation and reduces risk during critical moments.
Joint Training Builds Competence and Confidence
Interdisciplinary drills and practice scenarios expose gaps before a crisis does. Training together normalizes teamwork under pressure and ensures that when a true emergency occurs, staff respond as a cohesive unit.
Leadership Drives Culture
Leaders set the tone. When leaders model partnership, prioritize open discussion, and “inspect what they expect,” staff follow suit. Facilities where leaders intentionally bridge custody and health services consistently experience fewer adverse outcomes.
Collaboration Reduces Liability by Reducing Risk
Most adverse events involve breakdowns in communication, screening, or continuity of care. When we operate as one team, these breakdowns become far less frequent—and the entire facility becomes safer.
Practical Steps Any Facility Can Implement Now
Reinforce a Shared Mission
Remind teams regularly that care, custody, and control are interdependent responsibilities. A safe facility requires all three working in sync.
Hold Regular, Meaningful Administrative Meetings
These meetings should be solution-focused, with clear follow-up. Use them to address trends, review incidents, and align expectations.
Make Interdisciplinary Drills Routine
Man-down, medical emergency, and mass-casualty drills ensure that teams understand each other’s roles and can respond quickly and confidently.
Create and Review Policies Together
Whether it’s intake screening, suicide prevention, or medication continuity, co-authored procedures build clarity, buy-in, and consistency.
Encourage Empathetic Communication
Listening to understand—rather than to react—reduces friction, builds trust, and allows both teams to work toward shared goals.
The Bottom Line: Collaboration Saves Lives
A collaborative culture is built through everyday actions: a conversation at lineup, a joint review of a difficult incident, a drill that improves confidence, a shift where custody and medical staff problem-solve side by side. These small moments build trust—and trust is the foundation of safety.
When custody and health care professionals work together as one team, everyone benefits: staff feel supported, patients receive better care, operations run more smoothly, and the risk of adverse events is significantly reduced.
We share the same mission. We face the same pressures. And when we collaborate with intention and respect, we achieve the same outcome: a safer, healthier environment for all.
By Fred W. Meyer, MA, CJM, CCHP
Managing Director, NCCHC Resources, Inc.
The NCCHC Resources Board of Directors for 2026 is:
Aynsley Mull, JD, deputy chief legal officer with Centurion Health, is new to the board. She replaces Deana Johnson, JD, Centurion Health’s general counsel, who served on the board from 2019 – 2025. Also new to the board is Jeffrey Alvarez, MD, CCHP-CP, CCHP-A, physician executive consultant for NaphCare. He joined the board in August 2025, replacing Ronald Charpentier, MBA, who served since 2021.
With a deep bench of consultants experienced in both clinical and operational settings, NCCHC Resources provides customized consulting and technical assistance to correctional systems and facilities across the country, including some of the most complex systems nationwide.
Social Determinants of Health Applied to Corrections urges a shift away from recidivism as the primary performance measure. Research shows that recidivism is shaped by factors far beyond correctional control—laws, supervision policies, and even pandemic disruptions.
Instead, CLA recommends metrics based on Social Determinants of Health (SDH), such as education, employment, housing, and health care access. Tracking outcomes like post-release employment, Medicaid enrollment, and educational achievement provides a more accurate, timely, and actionable view of system success—aligning correctional and health care efforts to improve safety, rehabilitation, and community reintegration.
]]>Facilities undergoing Mental Health accreditation or reaccreditation must comply with the 2026 Mental Health Standards beginning April 1, 2026.
Navigating these updates can be complex, especially as mental health needs and suicide attempts continue to rise in correctional settings. That’s where NCCHC Resources comes in. Our experts help correctional systems understand, implement, and maintain compliance with the 2026 Standards—turning new requirements into opportunities for operational improvement and safer outcomes.
How NCCHC Resources Supports Your Compliance and Quality Goals
Program Reviews and Readiness Assessments
Our consultants evaluate your facility’s alignment with the 2026 Standards, identifying gaps, risks, and strengths. With the new Supporting Survey Documentation requirements, we help you prepare the evidence needed for a successful survey—especially in high-risk areas such as suicide prevention, emergency response, and intake screening.
Staff Training and Professional Development
NCCHC Resources offers tailored training to ensure mental health, medical, and custody staff understand their roles in suicide prevention, crisis response, and interdisciplinary communication. Our programs strengthen confidence, consistency, and collaboration across disciplines.
Policy and Procedure Alignment
We review and revise existing policies to reflect 2026 requirements—covering suicide risk assessment, housing decisions, and post-incident reviews—to ensure your documentation supports both daily operations and survey readiness.
Mock Surveys and Accreditation Coaching
Our mock surveys replicate NCCHC’s process, providing a realistic assessment of compliance with the 2026 Standards. Facilities gain insight into performance and strengthen readiness before the official survey.
Ongoing Support and Continuous Quality Improvement
For systems seeking long-term guidance, NCCHC Resources provides monitoring and vendor oversight to maintain compliance, address incidents promptly, and sustain mental health program quality.
Why Choose NCCHC Resources?
Set Your Team Up for Success
The 2026 Mental Health Standards advance the field of correctional mental health care through stronger prevention, collaboration, and accountability. With NCCHC Resources as your partner, your facility will have the tools, training, and expert support to meet compliance expectations, enhance suicide prevention efforts, and deliver safe, high-quality care for every patient.
While we all know that suicide is the leading cause of death for individuals held in jails and one of the most prevalent in our prisons, we sometimes forget about the increased risks for those working in our federal, state, and local correctional systems.
Medical and custody staff face many of the same stressors while on the job.
In addition, medical and custody professionals face the same personal risk factors.
There are several warning signs and behaviors that we can look for in ourselves and others.
In my travels throughout the United States, it’s abundantly clear that there is no city, state or region that is immune from the tragedy of suicide. So, what can we do to reduce the risk of suicide for ourselves, our coworkers, and all those important to us?
We can focus our efforts on situational awareness at all levels. For medical and custody professionals, that may be paying attention to your own feelings and actions and those of the people around you. We are trained to monitor the patient or the person in custody, but how much effort are we placing on how to monitor our co-workers and ourselves?
Medical and custody leaders at all levels, let’s dedicate more time and resources to communicating with others. Take a few moments to talk with your co-workers and check in. Talk a little about yourself and they will likely do the same. It’s not always about just the job; the people are what make our correctional facilities operate as safely and humanely as possible.
Life skills, social support, and work-life balance are not just words. We all have ups and downs in our lives and sometimes all it takes is a listening ear and a willingness to help that can save a life. Sometimes it takes more and that’s OK, help is available.
Urgent – Available 24/7
Web-based Resources
Let’s all do our best to take care of each other and remember that we are all valuable and important. Talk to someone if you need help and open up an ear to someone in need.
Life, liberty, and the pursuit of happiness…sounds good to me!
Thanks for everything you do, stay safe and healthy.
-Fred
Fred W. Meyer, MA, CJM, CCHP
Managing Director, NCCHC Resources, Inc.
Facilities seeking NCCHC accreditation must comply with the updated Standards beginning January 1, 2026.
For many correctional systems, navigating these updates can be complex. That’s where NCCHC Resources, the consulting arm of NCCHC, comes in. Our expert team helps correctional leaders understand, implement, and maintain compliance with the Standards—turning new requirements into opportunities for operational improvement.
How NCCHC Resources Supports Your Compliance Journey
Our consultants provide independent assessments to evaluate where your facility stands against the 2026 Standards. Using historical performance indicators and current operational data, we identify strengths, uncover risks, and create actionable roadmaps for improvement. Relying on the new Supporting Survey Documentation requirements, our assessments help facilities build the right records and evidence well in advance of surveys.
NCCHC Resources designs and delivers customized training programs to prepare custody and health care staff for the new Standards. With expanded interpretive guidance now included in each standard, our training ensures your teams fully understand compliance expectations and best practices. Training will build knowledge, confidence, and consistency across disciplines.
Updated and compliant policies and procedures are critical to meeting NCCHC Standards. Our consultants work directly with facilities to review and align documents with the latest requirements, including mental health screenings, safety protocols, and chronic disease management. With the 2026 Standards’ new focus on documentation, we help ensure your policies reflect both operational reality and survey readiness.
For facilities seeking NCCHC accreditation, we conduct mock surveys that mirror the accreditation process. These exercises test your systems against the new Standards and highlight areas needing attention before the official survey. With our guidance, facilities gain clarity, avoid surprises, and feel confident in their ability to demonstrate compliance.
For systems transitioning between health care vendors or seeking long-term support, NCCHC Resources provides ongoing monitoring of health care services. This ensures continuous compliance with the contract and NCCHC Standards, timely correction of deficiencies, and appropriate documentation.
Why Partner with NCCHC Resources?
Get Ready for 2026
The release of the 2026 Jail and Prison Health Standards marks a significant step forward for correctional health care. With NCCHC Resources as your partner, you don’t have to navigate these changes alone. Whether you’re preparing for accreditation, revising policies, or training your team, we provide the tools and expertise to help you succeed.
Contact NCCHC Resources today to learn how we can support your compliance journey with the 2026 Standards.
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Key Challenges Include:
Budget Pressures and Funding Realities
Rising costs from inflation, material shortages, and potential tariffs are driving up construction expenses. Updating large facilities to meet modern codes and standards can require tens of millions of dollars.
Designing for Compliance and Care
The Americans with Disabilities Act (ADA) mandates accessibility in all areas, including cells, hallways, doorways, bathrooms, and showers. The Health Insurance Portability and Accountability Act (HIPAA) impacts facility design by requiring private spaces for intake and other functions to ensure patient confidentiality.
Specialized Needs
Contractors and builders must have experience working in secure environments to navigate the complexities of correctional health care settings.
Technology, Efficiency, and Observation
There are many considerations in this area that did not exist with these facilities were first built. Reliable connectivity is critical for telemedicine and mobile medication carts. High-security architecture can interfere with signal strength, so technology planning is essential. Design considerations should include egress, sightlines for nursing staff, and input from health professionals. Housing units with built-in medical triage rooms can reduce movement and delays. Suicide-watch cells should be centrally located for optimal visibility.
Early Communication and Planning Are Critical
Finalizing designs and budgets without input from health care leaders and staff can result in inefficiencies, higher staffing costs, and risks to safety and patient care.
Engaging experienced health care professionals early in the process helps ensure compliance with national standards and legal requirements. NCCHC Resources can help guide your facility toward safer, more effective health care environments.
Schedule an appointment to discuss your construction or renovation challenges and questions.
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