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‘Our system was literally broken’: How Indiana lawmakers hope to fix overcrowded jails and mental health treatment
The Gist
State Rep. Greg Steuerwald, R-Avon, has garnered bipartisan, widespread support for a bill that aims to ensure Hoosiers receive mental health treatment in medical settings instead of inside their local county jails.
What’s Happening
The majority of Indiana’s jails have been overcrowded for years because they have become the de facto mental health facilities in most counties.
When law enforcement officers encounter someone experiencing a mental health crisis, they typically have two options: bring them to the emergency room or take them to jail.
In addition, sheriffs are seeing a big spike of people being held because they were arrested on non-violent, low-level crimes that were driven by their addiction or other mental health issues. Drunken driving, possession of a drug or syringe and drug dealing are common examples.
Taken together, jail overcrowding can lead to poor health outcomes for incarcerated Hoosiers, but especially so for ones who have a mental illness. It’s also costly for county budgets because of how expensive it is to keep someone locked up and to pay for their health care. That’s money that could otherwise support other local government services, such as roads or parks.
“Our system was literally broken,” said Steve Luce, a former sheriff who is now executive director of the Indiana Sheriffs' Association. “The jail is not set up to take care of these individuals. It’s for pretrial individuals. Our facilities cannot handle these types of individuals over time.”
Steuerwald began working on a new bill in January 2022 to address the problems. That’s when he started meeting with Gov. Eric Holcomb's office and Indiana Supreme Court Justice Christopher M. Goff.
He also convened representatives from all corners of the criminal justice and health care systems, which resulted in support from groups that are often opposed to each other in the courtroom. Associations representing judges, public defenders, prosecutors, police officers and sheriffs testified in support during a House committee last week.
House Republican leadership introduced Steuerwald’s bill — House Bill 1006 — at the start of the current legislative session as one of their priority bills.
Why It Matters
Roughly 20,000 people are held inside Indiana's county jails on any given day, according to data contained within state inspection records. The population turns over quickly because jails are primarily temporary holding facilities, so the number of Hoosiers who end up behind bars each year is even higher.
If only a handful of counties were struggling to keep up with crowding and health care concerns, perhaps the state would not intervene.
One in five Hoosiers, though, experience a mental health issue each year, according to the state’s Behavioral Health Commission.
And jail overcrowding is widespread — with at least 70% of the people in Indiana's jails believed to have a mental illness or addiction, according to estimates by Indiana sheriffs.
Many simply need access to drug treatment and medicine, such as buprenorphine or methadone, which are used to treat opioid addiction. Even then, a great burden is placed on sheriffs who run the jails. They are tasked with finding medical providers and, in some cases, clearing space for health care and programming inside cramped, aging jails that weren’t designed for either. The alternative is another expensive proposition: asking local taxpayers to build bigger jails.
Additionally, a smaller but not insignificant number of people in jail have been diagnosed with a severe mental illness.
“With those individuals, they obviously require so much more one-on-one when you're taking care of them in the jail because they're susceptible to being taken advantage of and they have so many requirements,” Steuerwald told State Affairs. “It just takes an inordinate amount of resources in a jail setting.”
Resources — particularly staffing — are already hard to come by inside many jails. Staffing shortages are exacerbating other challenges around mental health and addiction.
And then when counties fail to provide the necessary resources, the outcomes can be devastating.
A yearslong IndyStar investigation in 2021, for example, found that Hoosiers were dying inside county jails on average every two weeks over more than 10 years. Not all of those deaths were the result of gaps in mental health treatment, but many were. The leading cause of death was suicide, IndyStar found, which amounted to 42% of the deaths. Three in four of those deaths occurred in jails that were flagged by state inspectors as overcrowded, understaffed or both.
And at least 19% of the deaths were directly tied to substance use, including overdoses.
What’s the Legislation?
One of House Bill 1006’s priorities is focused on mental health referrals for people who are in jail.
The bill would enable sheriffs, prosecutors and defense attorneys to petition the court to request a mental health assessment on someone who has been booked into jail.
After an assessment, a judge could refer a defendant to a mental health provider as a condition of release prior to a trial or plea agreement. The goal is for people to receive the treatment they need and for counties to absorb fewer costs associated with the burdens of overcrowded jails.
And if the defendant is accused of committing a violent crime, the services would occur inside a secure facility, such as ones operated by the Department of Correction or the Division of Mental Health and Addiction.
“We wanted to make sure they got treated but in a secure environment,” Steuerwald said. “We've made provisions for anybody with a mental illness to be treated.”
Nothing in the bill would interrupt the prosecution of a case, but Steuerwald said he expected someone’s mental health treatment would be factored into any considerations about plea agreements.
Just as importantly, counties would not be on the hook for paying the costs of mental health assessments. The state budget would pick up that tab, enabling smaller and rural counties to participate.
Asked if he’s faced any pushback from his colleagues in the House or Senate, Steuerwald told State Affairs: “None.”
“I've had full support from the speaker and Ways and Means from the very beginning of the process," he said. "When I said the sheriffs are making this request and it's long overdue that we help them, everybody has been supportive and said, 'Go ahead.’”
It’s unclear how much money is expected to be saved in local budgets or added to the state budget; the legislation does not specify, and neither the Indiana Sheriffs’ Association nor the Association of Indiana Counties were aware of those numbers.
State Rep. Jeff Thompson, the House budget writer, told State Affairs that he could not immediately recall the exact costs but did not anticipate any concerns over the amount.
The bill has a second priority clarifying language around immediate and emergency detentions, which are the processes used to detain someone against their will. For example, a law enforcement officer may use an immediate detention to bring someone threatening suicide into a medical facility.
The bill also would ensure that hospitals receive payment for detentions by noting in the law that the treatments are medically necessary. Right now, Steuerwald said, hospitals aren’t always being paid for the care.
Receiving Treatment
Even some supporters of the bill acknowledged one limitation, though.
Many Hoosiers lack adequate access to care for mental health and addiction. It’s particularly acute in rural areas, where treatment beds and providers have been scarce for years — for people both inside and outside of jail.
State Rep. Matt Pierce, D-Bloomington, voted for the bill but raised that concern.
"What I've been hearing for the last 10 years since we did criminal code reform is prosecutors and sheriffs saying, ‘I really wish I could put these people somewhere else where they could actually get their mental health or substance abuse disorders treated, but I just don't have anything around here,’” Pierce told State Affairs. “And then we complain about the jails being overcrowded.”
Pierce wants to see the General Assembly help fund an expansion of treatment for mental health and drug addiction.
Jay Chaudhary, director of the state's Division of Mental Health and Addiction, spoke to Pierce’s concerns during a House committee meeting last week.
“Do we have capacity right now to handle this? I don't think so,” Chaudhary said. “If we wait until we have capacity to tackle these issues, we'll just be waiting forever.”
What’s Next?
The bill is also supported by the Indiana Council of Community Mental Health Centers; Mental Health America of Indiana; the Coalition of Advanced Practice Nurses; and the Indiana Hospital Association.
It received unanimous support in the House on Tuesday with a 99-0 vote. It next heads to the Senate for consideration. Steuerwald said senators Freeman, Crider and Koch are sponsoring it.
Have questions or comments about the upcoming legislative session? Contact Ryan Martin on Twitter, LinkedIn, Facebook or at [email protected].)
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Header image: Indiana lawmakers hope to fix overcrowded jails and mental health treatment. (Credit: Brittney Phan)
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Eric Doden says school district consolidation is ‘death knell’ for rural Indiana
Republican gubernatorial candidate Eric Doden is calling on the Indiana Chamber of Commerce to end its support for school district consolidation in rural Indiana.
In a letter sent today, the Fort Wayne businessman labeled the business group’s position as “damaging.”
“While the stated aims of this position are laudable, the message sent to our small towns and rural communities is damaging,” Doden wrote. “Proposing to do away with small public school districts through consolidation will be seen as a death knell for the millions of Hoosiers who live in small towns and rural communities.”
For years, the Indiana Chamber has advocated for fewer school districts across Indiana. A 2017 study commissioned through Ball State University identified worse educational outcomes for students in smaller districts in several categories, including scores for state standardized testing and the SAT, as well as the pass rates for Advanced Placement classes.
The Indiana Chamber re-upped its position last month when it released its long term economic development plan. Among the listed policies was a goal to “reduce by half the number of very small school districts with enrollments below 2,000 students to provide much stronger educational opportunities for rural students and communities.”
More than half of Indiana’s school districts have fewer than 2,000 students.
In a statement to State Affairs, Indiana Chamber President and CEO Kevin Brinegar said the state is providing a “two-tiered educational system” depending on income and ZIP code.
“Hoosier students should not be limited academically solely due to where they live. And that’s the case now in some of the smaller school districts where students are not afforded the opportunity to take a full array of STEM, Advanced Placement or college preparation courses,” Brinegar said in the statement. “The Chamber’s stance on smaller school district consolidation is rooted in wanting to lift up young Hoosiers in these rural communities, so they have a better chance at prosperity by properly preparing them for the state’s current and future job opportunities.”
The statement also contained a specific response to Doden’s criticism.
“We would be happy to sit down with Mr. Doden and go through the research and show him why we have adopted this position for the betterment of the academic and economic opportunities for our young people,” Brinegar said in the statement. “The status quo that Mr. Doden is championing has and will continue to leave small communities, schools and students behind. That’s not acceptable.”
But whereas the business group sees consolidation as one way to improve life in rural Indiana, Doden sees the opposite.
“Across our state it’s easy to see the remnants of a school consolidation push that began in the 1950s,” Doden wrote in his letter. “Too many towns that lost their local school to consolidation dried up and were virtually swept from the maps while other towns kept their schools and their identities. These communities had a better opportunity to survive.”
Doden also cited one of his policy proposals, which would redirect $100 million in state money toward small towns — in an effort to address declines in populations and quality of life.
“With local leadership and local control, we can revitalize our small towns and hometowns with a fraction of the investment we give away in the form of incentives,” Doden wrote.
Doden addressed the letter to Vanessa Green Sinders, who will replace Brinegar as the Indiana Chamber’s leader. Her tenure will begin in January, so she was unavailable to provide comment to State Affairs. Either way, the Indiana Chamber’s members are the ones who suggest policy positions for the board of directors to approve before each legislative session.
In addition to Doden, the crowded Republican field for governor includes U.S. Sen. Mike Braun, former Commerce Secretary Brad Chambers, Lt. Gov. Suzanne Crouch and former Attorney General Curtis Hill.
Jennifer McCormick, the former state superintendent of public education, has emerged as the leading Democratic candidate. Instead of school district consolidation, the state should reevaluate its expansion of school choice vouchers, McCormick has previously said.
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Header image: Eric Doden, 2024 Republican candidate for governor of Indiana (Credit: Eric Doden for Indiana Governor/Facebook)
Attorney general faces misconduct allegations in handling of high-profile abortion case
The Indiana Supreme Court Disciplinary Commission today filed a formal complaint against state Attorney General Todd Rokita that alleges three violations of attorney professional conduct rules.
Rokita faces official allegations that he committed professional misconduct with his public comments about Dr. Caitlin Bernard after she provided an abortion to a 10-year-old Ohio rape victim last summer.
Rokita is defending his actions, saying that state confidentiality laws shouldn’t apply to him because Bernard was the first to talk in the news media about the girl’s treatment. It could take months before the state Supreme Court decides whether Rokita will face any punishment.
What’s Happening
The commission didn’t ask for a specific punishment against Rokita, asking simply that he be “disciplined as warranted for professional misconduct” by the state Supreme Court.
Commission Executive Director Adrienne Meiring filed the complaint that focuses on actions by Rokita and his office between early July 2022 and Nov. 30, 2022, when the attorney general’s office filed a misconduct complaint against Bernard with the state Medical Licensing Board.
Bernard drew national attention in the days after a July 1, 2022, story by The Indianapolis Star quoting her about the young girl’s abortion just days after the U.S. Supreme Court’s overturning of Roe v. Wade.
The complaint against Rokita highlights his July 13 appearance on a Fox News program, during which he said he would investigate Bernard’s actions and called her an “abortion activist acting as a doctor — with a history of failing to report.”
It also points to his office’s unusual action of publicly releasing on July 13 a letter to Gov. Eric Holcomb that named Bernard in seeking records from two state agencies and a July 14 press release from his office about the investigation.
The complaint alleges Rokita’s actions violated confidentiality requirements of pending medical licensing investigations under state law and by doing so Rokita “caused irreparable harm to Dr. Bernard’s reputational and professional image.”
Rokita responded Monday with a legal filing saying that the confidentiality requirements shouldn’t apply to him because Bernard had already gone public about the girl’s medical treatment.
Rokita also argued that “The Attorney General, an elected official who answers to the public, has a duty to keep the public informed of the Office’s actions and decisions.”
The state Medical Licensing Board voted 5-1 in May to reprimand Bernard and fine her $3,000 for violating patient privacy laws. The board, however, voted unanimously to reject allegations from the attorney general’s office that Bernard violated state law by not reporting the child abuse that led to the girl’s pregnancy to Indiana authorities and did not issue any restrictions on Bernard’s medical license.
Why It Matters
The Disciplinary Commission’s complaint carries the potential of forcing the Republican attorney general from office.
State law requires that the attorney general be “duly licensed to practice law in Indiana.” The state Supreme Court, which has the final say over attorney disciplinary matters, has wide discretion, with options all the way up to permanently stripping an attorney of his law license.
Rokita won the Republican nomination for attorney general in 2020 over then-Attorney General Curtis Hill after Hill faced allegations that he drunkenly groped four women at a party celebrating the end of the 2018 legislative session.
The Supreme Court suspended Hill’s law license for 30 days, saying that “by clear and convincing evidence that [Hill] committed the criminal act of battery.” The court rejected the hearing officer’s recommendation of a longer suspension that could have forced him from office. Hill is now seeking the Republican 2024 nomination for governor.
Rokita has sought to burnish his anti-abortion and national profile with the Bernard case. Besides challenging Bernard’s medical license, his office last week filed a lawsuit against the doctor’s employer, Indiana University Health, alleging it violated federal law by allowing Bernard to disclose information about the Ohio girl’s treatment. The girl’s mother brought her to Indiana to receive abortion drugs because an Ohio ban on abortions after six weeks had taken effect after the U.S. Supreme Court’s ruling last summer.
What’s Next?
Rokita is entitled to defend himself with a hearing before a judicial officer appointed by the Supreme Court, who would then submit a recommended punishment to the court.
In Hill’s case, it took about 14 months from the time that the disciplinary complaint was filed against him for the court’s five justices to receive the case and make their decision.
Rokita’s defense lawyers include two from the Washington, D.C., firm Schaerr-Jaffe. The firm also assisted the attorney general’s office with the case against Bernard under a contract allowing it to bill the state $550 an hour for work by the firm’s attorneys.
“This is a complaint against the official duties of the Attorney General and is an attack against his official capacity, so this is paid by the office,” Rokita’s office said.
Rokita isn’t backing down in the political battle, either, as he released a statement Monday calling himself “a passionate fighter” who “is beating back the culture of death, grievance and transanity being pushed by radicals in workplaces, schools, media and government.”
Democrats argue Rokita is using the Bernard case “to further his own personal political ambitions.”
“Todd Rokita’s actions toward Dr. Caitlin Bernard over the past year brought shame and ridicule upon our state,” Indiana Democratic Chairman Mike Schmuhl said in a statement. “Now, he is starting to see the consequences of making baseless claims regarding a medical professional on national television.”
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Tom Davies is a Statehouse reporter for State Affairs Pro Indiana. Reach him at [email protected] or on X at @TomDaviesIND.
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Header image: Indiana Attorney General Todd Rokita speaks during the America First Agenda Summit organized by America First Policy Institute. (Photo by Oliver Contreras/SIPA USA)(Sipa via AP Images)
Sen. Jon Ford confirms move to coal industry group upon resignation
Republican Sen. Jon Ford of Terre Haute confirmed Friday that he is resigning from the Legislature to become leader of an association that promotes the coal industry and other fossil fuel producers in Indiana.
Ford told State Affairs that he will join Reliable Energy this fall after his Senate resignation takes effect Oct. 16.
“I’ll be running the association, the business side of it,” said Ford, who faces a one-year prohibition on being a paid lobbyist after leaving the Legislature.
What is Reliable Energy?
Reliable Energy was incorporated as a nonprofit corporation by prominent lobbyist Matt Bell in 2020 with the same downtown Indianapolis address as his Catalyst Public Affairs Group.
In testimony to a legislative committee last year, Bell described the group’s members as “fossil fuel producers and the Hoosier businesses supporting the fossil fuel industry.”
“Reliable Energy advocates for policies that ensure an abundant supply of available, affordable and dependable energy in Indiana and across the country,” Bell’s testimony said.
The organization is an offshoot of the Indiana Coal Council.
“I think it really grew out of that group and is really a group made up of membership of people involved in energy in a lot of different ways,” Ford said. “Many of the members are vertically integrated power companies. Some produce coal, some produce energy. Most are involved in alternative energies, as well.”
Ford’s reasons for resignation?
Ford, who was first elected to the Senate in 2014, won reelection last November to a four-year term. His resignation will result in a new senator serving for three legislative sessions without appearing on a general election ballot.
Ford cited personal reasons for deciding to resign less than a year after winning his new Senate term.
“Some things in my life have changed that made me think, you know, the passing of friends and other life events made me rethink what I wanted to do in my life and what I had achieved in the district,” Ford said. “I just felt it was time to move on.”
Ford said the Reliable Energy position didn’t prompt his Senate resignation.
“The job really came after the decision that it was time to move on,” he said.
Ford hasn’t specialized in energy-related issues while in the Legislature and hasn’t been a member of the utilities or environmental committees that consider most such legislation.
Ford has been business development director for the economic and community development group Thrive West Central, based in Terre Haute.
Will Ford become a lobbyist?
State law prohibits members of the General Assembly from lobbying former colleagues for one year after leaving office.
Ford said that even after that time he was not sure he would become an advocate for Reliable Energy in the Statehouse hallways.
“This group has had a hired lobbyist for a while that’s worked with them, so I don’t know,” Ford said. “I would see it playing a similar role to many other associations that are out there, but, you know, main focus will be to grow it and to focus on where Indiana goes forward with energy.”
Involvement in selecting replacement?
Ford was noncommittal on whether he would endorse a candidate to replace him ahead of the caucus of Republican precinct committee leaders who will make that decision in the coming weeks.
“I don’t know at this time, it really depends, I guess, on who steps up,” Ford said. “I don’t foresee myself being at the vote, to be quite honest. I think it’s a decision of the precinct committeemen.”
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Tom Davies is a Statehouse reporter for State Affairs Pro Indiana. Reach him at [email protected] or on X at @TomDaviesIND.
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Header image: Republican Sen. Jon Ford speaks in the Indiana Senate chamber. (Credit: Indiana Senate Republicans)
Indiana’s 988 hotline is helping people in crisis or struggling with thoughts of suicide
The Gist
Indiana’s 988 Suicide and Crisis Lifeline is already receiving more than 3,000 calls per month a little more than a year after its launch, according to the Indiana Family and Social Services Administration, and more than 90% of the calls are being answered by trained Hoosiers.
The state agency provided an update this week in part to raise awareness for National Suicide Prevention Month.
What’s Happening
The 988 hotline is a free resource for people who are experiencing a crisis. Callers can receive a supportive ear on the call as well as resources to help.
That’s why state officials want to have as many calls as possible answered by people who live in Indiana. While the calls are being backstopped by people working nationally, the people working in Indiana’s five call centers can more easily connect callers to in-person resources to help with whatever is contributing to the crisis, such as a lack of food or housing.
Indiana’s answer rate of more than 90% since November is leading the nation, according to state officials.
A caller’s average wait time is about 10 seconds, said Kara Biro, Family and Social Services Administration state director of behavioral health crisis care, and the average call lasts 12 to 20 minutes.
The hotline, launched in Indiana last July, is just the first step in a larger vision. The state is steadily building a three-part crisis system that also includes mobile crisis teams to respond to calls for help and crisis stabilization units where people can go for up to 23 hours at a time to receive care.
“We are marching toward a time where individuals in crisis, regardless of day, time or location, have someone to call, someone who can respond, and a safe place to help,” Family and Social Services Administration Secretary Dr. Daniel Rusyniak said.
Why It Matters
Indiana has long struggled with an above average number of suicide deaths, lower life expectancy driven by excessive substance use and a rapidly increasing number of drug overdoses.
As a result, Indiana is persistently ranked as one of the worst states by the nonprofit Mental Health America when it comes to mental health treatment.
But, almost quietly, change appears to be on the horizon. And maybe even hope.
During the last legislative session, Indiana lawmakers poured $100 million in new money over two years into mental health treatment.
That amounted to less than half of what experts say is needed to fully address the crisis. At least $130.6 million per year would be needed, according to a 2022 estimate by the state.
But an additional $50 million per year was still celebrated by Gov. Eric Holcomb and mental health advocates — who all noted that the three-part crisis system will not be built overnight anyway.
And that’s on top of the more than $100 million that the federal government sent Indiana to kickstart the creation of the three-part crisis system.
What’s Next
In June, state officials awarded a combined $57 million in federal American Rescue Plan dollars to community mental health centers in 15 counties to expand the services they provide to people in crisis.
Stabilization units, in particular, were the focus of the grants.
“These are physical locations — a safe place for help — where individuals in crisis will be stabilized and connected with follow up care,” Jay Chaudhary, director of the state’s Division of Mental Health and Addiction, said at the time. “Too many Hoosiers today in behavioral health crises end up in a jail or in the emergency department.”
Meanwhile, the Family and Social Services Administration is on track to apply for what’s called a Medicaid demonstration program. If approved, mental health providers would receive greater Medicaid reimbursements, which advocates say would make it far easier to implement and expand the services they can provide to Hoosiers who need mental health treatment. The state is facing a March 2024 deadline to apply, officials confirmed this week.
And the state is still hoping for statewide coverage of the three-part crisis system by 2027.
As for the 988 hotline, state officials are hoping to increase accessibility to people who don’t speak English or who are deaf or hard of hearing.
If you or someone you know is in crisis, please call the 988 Suicide and Crisis Lifeline, which has trained listeners standing by and ready to help. Visit 988indiana.org for crisis services or for more information. Visit the Indiana Suicide Prevention website for resources.
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Header image: Indiana’s 988 Suicide and Crisis Lifeline launched last year and is already receiving more than 3,000 calls per month. (Credit: Indiana Family and Social Services Administration)