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pdfAppendix C. Attachment Table of Contents
Attachment A.
BJS authorizing legislation (42 USC 3732) …..
p. 2-6
Attachment B.
2000 Death in Custody Reporting Act (P.L. 106-297) …
p. 7-8
Attachment C.
2011 Death in Custody Reporting Act (H.R. 2189) …
p. 9-16
Attachment D. BJS confidentiality regulations …
(Title 42, USC, Sections 3789g and 3735)
p. 17-19
Attachment E. 2012 CJ9A Annual Summary on Inmates …
p. 20-37
Under Jail Jurisdiction;
2012 CJ-10A Annual Summary on Inmates in Private and Multi-Jurisdictional Jails;
2013 CJ-9A/10A Annual Summary on Inmates Under Jail Jurisdiction (See
Appendix_C_2013 CJ-9A_10A for the one-time expanded data collection form);
2012 NPS-4 Annual Summary of Inmate Deaths in State Prisons;
2013 CJ-9 Death Report on Inmates Under Jail Jurisdiction;
2013 CJ-10 Death Report on Inmates in Private and Multi-Jurisdictional Jails;
2013 NPS-4A State Prison Inmate Death Report
Attachment F. 2013 CJ-11 Arrest-Related Deaths Summary of Incidents …
p. 38-52
2013 CJ-11A Arrest-Related Deaths Incident Report;
2013 CJ-11A Arrest-Related Deaths Incident Report (CJ-11A) Question-by-Question
Guide
Attachment G. Example of arrest-related death program launch email…..
to state reporting coordinator;
p. 53-77
Attachment H. Example of arrest-related death ‘status report’ to a state …..
reporting coordinator;
p. 78-81
Attachment I.
Example of jail and prison DCRP program launch …..
mailing to jail and prison respondents;
Attachment J. Example of letters, emails and telephone scripts for …..
data quality and non-response follow-up for DCRP jail respondents
p. 82-119
p. 120-129
Attachment A. BJS authorizing legislation (42 USC
3732)
Page 5021
TITLE 42-THE PUBLIC HEALTH AND WELFARE
1976, 90 Stat. 2411, 2424, related to purposes and cat
egories of grants for law enforcement and criminal jus
tice purposes, prior to the general amendment of this
chapter by Pub. L. 96-157.
AMENDMENTS
1984-Pub. L. 98-473 struck out "(including white-col
lar crime and public corruption)" after "information
concerning crime" and "(including crimes against the
elderly, white-collar crime, and public corruption)"
after "levels of crime".
EFFECTIVE DATE OF 1984 AMENDMENT
Amendment by Pub. L. 98-473 effective Oct. 12, 1984,
see section 609AA(a) of Pub. L. 98--473, set out as an Ef
fective Date note under section 3711 of this title.
§ 3732. Bureau of Justice Statistics
(a)
Establishment
There is established within the Department of
Justice, under the general authority of the At
torney General, a Bureau of Justice Statistics
(hereinafter referred to in this subchapter as
"Bureau").
(b) Appointment of Director; experience; author·
ity; restrictions
The Bureau shall be headed by a Director ap
pointed by the President, by and with the advice
and consent of the Senate. The Director shall
have had experience in statistical programs. The
Director shall have final authority for all
grants, cooperative agreements, and contracts
awarded by the Bureau. The Director shall be re
sponsible for the integrity of data and statistics
and shall protect against improper or illegal use
or disclosure. The Director shall report to the
Attorney General through the Assistant Attor
ney General. The Director shall not engage in
any other employment than that of serving as
Director; nor shall the Director hold any office
in, or act in any capacity for, any organization,
agency, or institution with which the Bureau
makes any contract or other arrangement under
this Act.
(c) Duties and functions of Bureau
The Bureau is authorized to(1) make grants to, or enter into cooperative
agreements or contracts with public agencies,
institutions of higher education, private orga
nizations, or private individuals for purposes
related to this subchapter; grants shall be
made subject to continuing compliance with
standards for gathering justice statistics set
forth in rules and regulations promulgated by
the Director;
(2) collect and analyze information concern
ing criminal victimization, including crimes
against the elderly, and civil disputes;
(3) collect and analyze data that will serve
as a continuous and comparable national so
cial indication of the prevalence, incidence,
rates, extent, distribution, and attributes of
crime, juvenile delinquency, civil disputes,
and other statistical factors related to crime,
civil disputes, and juvenile delinquency, in
support of national, State, tribal, and local
justice policy and decisionmaking;
(4) collect and analyze statistical informa
tion, concerning the operations of the crimi
nal justice system at the Federal, State, trib
al, and local levels;
§3732
(5) collect and analyze statistical informa
tion concerning the prevalence, incidence,
rates, extent, distribution, and attributes of
crime, and juvenile delinquency, at the Fed
eral, State, tribal, and local levels;
(6) analyze the correlates of crime, civil dis
putes and juvenile delinquency, by the use of
statistical information, about criminal and
civil justice systems at the Federal, State,
tribal, and local levels, and about the extent,
distribution and attributes of crime, and juve
nile delinquency, in the Nation and at the
Federal, State, tribal, and local levels;
(7) compile, collate, analyze, publish, and
disseminate uniform national statistics con
cerning all aspects of criminal justice and re
lated aspects of civil justice, crime, including
crimes against the elderly, ])lVenile delin
quency, criminal offenders, juvenile delin
quents, and civil disputes in the various States
and in Indian country;
(8) recommend national standards for justice
statistics and for insuring the reliability and
validity of justice statistics supplied pursuant
to this chapter;
(9) maintain liaison with the judicial
branches of the Federal Government and State
and tribal governments in matters relating to
justice statistics, and cooperate with the judi
cial branch in assuring as much uniformity as
feasible in statistical systems of the executive
and judicial branches;
(10) provide information to the President,
the Congress, the judiciary, State, tribal, and
local governments, and the general public on
justice statistics;
(11) establish or assist in the establishment
of a system to provide State, tribal, and local
governments with access to Federal informa
tional resources useful in the planning, imple
mentation, and evaluation of programs under
this Act;
(12) conduct or support research relating to
methods of gathering or analyzing justice sta
tistics;
(13) provide for the development of justice
information systems programs and assistance
to the States, Indian tribes, and units of local
government relating to collection, analysis, or
dissemination of justice statistics;
(14) develop and maintain a data processing
capability to support the collection, aggrega
tion, analysis and dissemination of informa
tion on the incidence of crime and the oper
ation of the criminal justice system;
(15) collect, analyze and disseminate compre
hensive Federal justice transaction statistics
(including statistics on issues of Federal jus
tice interest such as public fraud and high
technology crime) and to provide technical as
sistance to and work jointly with other Fed
eral agencies to improve the availability and
quality of Federal justice data;
(16) provide for the collection, compilation,
analysis, publication and dissemination of in
formation and statistics about the prevalence,
incidence, rates, extent, distribution and at
tributes of drug offenses, drug related offenses
and drug dependent offenders and further pro
vide for the establishment of a national clear
inghouse to maintain and update a compre-
§3732
TITLE 42-THE PUBLIC HEALTH AND WELFARE
hensive and timely data base on all criminal
justice aspects of the drug crisis and to dis
seminate such information;
(17) provide for the collection, analysis, dis
semination and publication of statistics on the
condition and progress of drug control activi
ties at the Federal, State, tribal, and local lev
els with particular attention to programs and
intervention efforts demonstrated to be of
value in the overall national anti-drug strat
egy and to provide for the establishment of a
national clearinghouse for the gathering of
data generated by Federal, State, tribal, and
local criminal justice agencies on their drug
enforcement activities;
(18) provide for the development and en
hancement of State, tribal, and local criminal
justice information systems, and the standard
ization of data reporting relating to the col
lection, analysis or dissemination of data and
statistics about drug offenses, drug related of
fenses, or drug dependent offenders;
(19) provide for improvements in the accu
racy, quality, timeliness, immediate acces
sibility, and integration of State and tribal
criminal history and related records, support
the development and enhancement of national
systems of criminal history and related
records including the National Instant Crimi
nal Background Check System, the National
Incident-Based Reporting System, and the
records of the National Crime Information
Center, facilitate State and tribal participa
tion in national records and information sys
tems, and support statistical research for crit
ical analysis of the improvement and utiliza
tion of criminal history records;
(20) maintain liaison with State, tribal, and
local governments and governments of other
nations concerning justice statistics;
(21) cooperate in and participate with na
tional and international organizations in the
development of uniform justice statistics;
(22) ensure conformance with security and
privacy requirement of section 3789g of this
title and identify, analyze, and participate in
the development and implementation of pri
vacy, security and information policies which
impact on Federal, tribal, and State criminal
justice operations and related statistical ac
tivities; and
(23) exercise the powers and functions set
out in subchapter VIII of this chapter.
(d) Justice statistical collection, analysis, and
dissemination
(1) In general
To ensure that all justice statistical collec
tion, analysis, and dissemination is carried
out in a coordinated manner, the Director is
authorized to--(A) utilize, with their consent, the serv
ices, equipment, records, person..."'lel, informa
tion, and facilities of other Federal, State,
local, and private agencies and instrumen
talities with or without reimbursement
therefor, and to enter into agreements with
such agencies and instrumentalities for pur
poses of data collection and analysis;
(B) confer and cooperate with State, mu
nicipal, and other local agencies;
Page 5022
(C) request such information, data, and re
ports from any Federal agency as may be re
quired to carry out the purposes of this
chapter;
(D) seek the cooperation of the judicial
branch of the Federal Government in gather
ing data from criminal justice records;
(E) encourage replication, coordination
and sharing among justice agencies regard
ing information systems, information pol
icy, and data; and
(F) confer and cooperate with Federal sta
tistical agencies as needed to carry out the
purposes of this subchapter, including by en
tering into cooperative data sharing agree
ments in conformity with all laws and regu
lations applicable to the disclosure and use
of data.
(2) Consultation with Indian tribes
The Director, acting jointly with the Assist
ant Secretary for Indian Affairs (acting
through the Office of Justice Services) and the
Director of the Federal Bureau of Investiga
tion, shall work with Indian tribes and tribal
law enforcement agencies to establish and im
plement such tribal data collection systems as
the Director determines to be necessary to
achieve the purposes of this section.
(e) Furnishing of information, data, or reports by
Federal agencies
Federal agencies requested to furnish informa
tion, data, or reports pursuant to subsection
(d)(l)(C) of this section shall provide such infor
mation to the Bureau as is required to carry out
the purposes of this section.
(f) Consultation with representatives of State,
tribal, and local government and judiciary
In recommending standards for gathering jus
tice statistics under this section, the Director
shall consult with representatives of State, trib
al, and local government, including, where ap
propriate, representatives of the judiciary.
(g) Reports
Not later than 1 year after July 29, 2010, and
annually thereafter, the Director shall submit
to Congress a report describing the data col
lected and analyzed under this section relating
to crimes in Indian country.
(Pub. L. 9Q-351, title I, §302, as added Pub. L.
96--157, §2, Dec. 27-, 1979, 93 Stat. 1176; amended
Pub. L. 91H73, title II, §605(b), Oct. 12. 1984, 98
Stat. 2079; Pub, L. IOQ---690, title VI, §6092(a), Nov.
18, 1988, 102 Stat. 4339; Pub. L. 103-322, title
XXXIII, §33000l(h)(2), Sept. 13, 1994, 108 Stat.
2139; Pub. L. 109-162, title XI, §1115(a), Jan. 5,
2006, 119 Stat, 3103; Pub. L. 111-211, title II,
§25l(b), July 29, 2010, 124 Stat. 2297.)
REFERENCES IN TExT
This Act, referred to in subsecs. (b) and (c)(ll), is Pub.
L. 90--351, June 19, 1968, 82 Stat. 197, known as the Omni
bus Crime Control and Safe Streets Act of 1968. For
complete classification of this Act to the Code, see
Short Title note set out under section 3711 of this title
and Tables.
PRIOR PROVISIONS
A prior section 3732, Pub. L. 90--351, title I, § 302, June
19, 1968, 82 Stat. 200; Pub. L. 93-83, §2, Aug. 6, 1973, 87
Page 5023
TITLE 42-THE PUBLIC HEALTH AND WELFARE
Stat. 201; Pub. L. 94--503, title I, §110, Oct. 15, 1976, 90
Stat. 2412, related to establishment of State planning
agencies to develop comprehensive State plans for
grants for law enforcement and criminal justice pur
poses, prior to the general amendment of this chapter
by Pub. L. 96-157.
AMENDMENTS
2010 Subsec. (c)(3) to
(6).
Pub. L. 111-211,
§251(b)(1)(A), inserted "tribal," after "State," wherever
appearing.
Subsec. (c)(7). Pub. L. 111-211, §25l(b)(l)(B), inserted
"and in Indian country" after "States".
Subsec. (c)(9). Pub. L. 111-211, §251(b)(1)(0), sub
stituted "Federal Government and State and tribal
governments" for "Federal and State Governments".
Subsec. (c)(10), (11). Pub. L. 111-211, §251(b)(1)(D), in
serted", tribal," after "State".
Subsec. (c)(13). Pub. L. 111-211, § 25l(b)(l)(E), inserted
", Indian tribes," after "States".
Subsec. (c)(17). Pub. L. 111-211, §25l(b)(1)(F), sub
stituted "activities at the Federal, State, tribal, and
local" for "activities at the Federal, State and local"
and "generated by Federal, State, tribal, and local" for
"generated by Federal, State, and local".
Subsec. (0)(18). Pub. L. 111-211, §251(b)(1)(G), sub
stituted "State, tribal, and local" for "State and
local''.
Subsec. (c)(l9). Pub. L. 111-211, §251(b)(l)(H), inserted
"and tribal" after "State" in two places.
Subsec. (c)(20). Pub. L. 111-211, §25l(b)(1)(I), inserted
'',tribal,'' after ''State''.
Subsec. (c)(22). Pub. L. 111-211, §251(b)(l)(J), inserted
", tribal," after "Federal".
Subsec. (d). Pub. L. 111-211, §251(b)(2), designated ex
isting provisions as par. (1), inserted par. (1) heading,
substituted "To ensure" for "To insure", redesignated
former pars. (1) to (6) as subpars. (A) to {F), respec
tively, of par. (1), realigned margins, and added par. (2).
Subsec. (e). Pub. L. 111-211, §25l(b)(3), substituted
"subsection (d)(1)(C)" for "subsection (d)(3)".
Subsec. (f). Pub. L. 111-211, §25l(b){4)(B), inserted
", tribal," after "State".
Pub. L. 111-211, §251(b)(4)(A), which directed insertion
of", tribal," after "State" in heading, was executed
editorially but could not be executed in original be
cause heading had been editorially supplied.
Subsec. (g). Pub. L. 111-211, §251(b)(5), added subsec.
(g).
2006-Subsec. (b). Pub. L. 109-162, §1115(a)(1), inserted
after third sentence "The Director shall be responsible
for the integrity of data and statistics and shall protect
against improper or illegal use or disclosure."
Subsec. (c)(19). Pub. L. 109-162, §1115(a)(2), amended
par. (19) generally. Prior to amendment, par. (19) read
as follows: "provide for research and improvements in
the accuracy, completeness, and inclusiveness of crimi
nal history record information, information systems,
arrest warrant, and stolen vehicle record information
and information systems and support research concern
ing the accuracy, completeness, and inclusivenes$ of
other criminal justice record information;".
Subsec. (d)(6). Pub. L. 109-162, §1115(a)(3), added par.
(6).
1994--Subsec. (c)(19). Pub. L. 103-322 substituted a
semicolon for period at end.
1988-Subsec. (c)(16) to (23). Pub. L. 100-690 added pars.
(16) to (19) and redesignated former pars. (16) to (19) as
(20) to (23), respectively.
1984--Subsec. (b). Pub. L. 98-473, §605(b)(1), inserted
provision requiring Director to report to Attorney Gen
eral through Assistant Attorney General.
Subsec. (c)(13). Pub. L. 98-473, §605(b)(2)(A), (C), added
par. (13) and struck out former par. (13) relating to pro
vision of financial and technical assistance to States
and units of local government relating to collection,
analysis, or dissemination of justice statistics.
Subsec. (c)(14), (15). Pub. L. 98-473, § 605(b)(2)(C), added
pars. (14) and (15). Former pars. (14) and (15) redesig
nated (16) and (17), respectively.
§3732
Subsec. (c)(16). Pub. L. 98-473, §605(b)(2)(A), (B), redes
ignated par. (14) as (16) and struck out former par. (16)
relating to insuring conformance with security and pri
vacy regulations issued under section 3789g of tbis title.
Subsec. (c)(17). Pub. L. 98-473, §605(b)(2)(B), redesig
nated par. (15) as (17). Former par. (17) redesignated
(19).
Subsec. (c)(18). Pub. L. 98-473, §605(b)(2)(D), added par.
(18).
Subsec. (c)(19). Pub. L. 98-473, § 605(b)(2)(B), redesig
nated former par. (17) as (19).
Subsec. (d)(l). Pub. L. 98-473, § 605(b)(3)(A), inserted
", and to enter into agreements with such agencies and
instrumentalities for purposes of data collection and
analysis".
Subsec. (d)(5). Pub. L. 98-473, §605(b)(3)(B)-(D), added
par. (5).
EFFECTIVE DATE OF 1984 AMENDMENT
Amendment by Pub. L. 98-473 effective Oct. 12, 1984,
see section 609AA(a) of Pub. L. 98-473, set out as an Ef
fective Date note under section 3711 of this title.
CONSTRUCTION OF 2010 AMENDMENT
Pub. L. 111-211, title II, §251(c), July 29, 2010, 124 Stat.
2298, provided that: "Nothing in this section [amending
this section and provisions set out as a note under sec
tion 534 of Title 28, Judiciary and Judicial Procedure]
or any amendment made by this section"(!) allows the grant to be made to. or used by, an
entity for law enforcement activities that the entity
lacks jurisdiction to perform; or
"(2) has any effect other than to authorize, award,
or deny a grant of funds to a federally recognized In
dian tribe for the purposes described in the relevant
grant program."
[For definition of "Indian tribe" as used in section
251(o) of Pub. L. 111-211, set out above, see section 203(a)
of Pub. L. 111-211, set out as a note under section 2801
of Title 25, Indians.]
STUDY OF CRIMES AGAINST SENIORS
Pub. L. 106-534, §5, Nov. 22, 2000, 114 Stat. 2557. pro
vided that:
"(a) IN GENERAL.-The Attorney General shall con
duct a study relating to crimes against seniors, in
order to assist in developing new strategies to prevent
and otherwise reduce the incidence of those crimes.
"(b) ISSUES A.DDRESSED. The study COnducted under
this section shall include an analysis of"(1) the nature and type of crimes perpetrated
against seniors, with special focus on
"(A) the most common types of crimes that affect
seniors;
"(B) the nature and extent of telemarketing,
sweepstakes, and repair fraud against seniors; and
"(C) the nature and extent of financial and mate
rial fraud targeted at seniors;
"(2) the risk factors associated with seniors who
have been victimized;
"(3) the manner in which the Federal and State
criminal justice systems res'pond to crimes against
seniors;
"(4) the feasibility of States establishing and main
taining a centralized computer database on the inci
dence of crimes against seniors that will promote the
uniform identification and reporting of such crimes;
"(5) the effectiveness of damage awards in court ac
tions and other means by which seniors receive reim
bursement and other damages after fraud has been es
tablished; and
"(6) other effective ways to prevent or reduce the
occurrence of crimes against seniors."
INCLUSION OF SENIORS IN NATIONAL CRIME
VICTIMIZATION SURVEY
Pub. L. 106-534, §6, Nov. 22, 2000, 114 Stat. 2557, pro
vided that: "Beginning not later than 2 years after the
date of enactment of this Act [Nov. 22, 2000], as part of
§3733
TITLE 42-THE PUBLIC HEALTH AND WELFARE
each National Crime Victimization Survey, the Attor
ney General shall include statistics relating to"(1) crimes targeting or disproportionately affect
ing seniors;
"(2) crime risk factors for seniors, including the
times and locations at which crimes victimizing sen
iors are most likely to occur; and
"(3) specific characteristics of the victims of crimes
who are seniors, including age, gender, race or eth
nicity, and socioeconomic status."
CruME VICTIMS WITH DISABILITIES AWARENESS
Pub. L. 105-301, Oct. 27, 1998, 112 Stat. 2838, as amend
ed by Pub. L. 106--402, title IV, §401(b){10), Oct. 30, 2000,
114 Stat. 1739, provided that:
"SECTION 1. SHORT TITLE.
"This Act may be cited as the 'Crime Victims With
Disabilities Awareness Act'.
"SEC. 2. FlliDlliGS; PURPOSES.
"(a) FrnDINGS.-Congress finds that--"(1) although research conducted abroad dem
onstrates that individuals with developmental dis
abilities are at a 4 to lO times higher risk of becoming
crime victims than those without disabilities, there
have been no significant studies on this subject con
ducted in the United States;
"(2) in fact, the National Crime Victim's Survey,
conducted annually by the Bureau of Justice Statis
tics of the Department of Justice, does not specifi
cally collect data relating to crimes against individ
uals with developmental disabilities;
"(3) studies in Canada, Australia, and Great Britain
consistently show that Victims with developmental
disabilities suffer repeated victimization because so
few of the crimes against them are reported, and even
when they are, there is sometimes a reluctance by po
lice, prosecutors, and judges to rely on the testimony
of a disabled individual, making individuals with de
velopmental disabilities a target for criminal preda
tors;
"(4) research in the United States needs to be done
to"(A) understand the nature and extent of crimes
against individuals with developmental disabilities;
"(B) describe the manner in which the justice sys
tem responds to crimes against individuals with de
velopmental disabilities; and
"(C) identify programs, policies, or laws that hold
promises for making the justice system more re
sponsive to crimes against individuals with devel
opmental disabilities; and
"(5) the National Academy of Science Committee
on Law and Justice of the National Research Council
is a premier research institution with unique experi
ence in developing seminal, multidisciplinary studies
to establish a strong research base from which to
make public policy.
"(b) PURPOSES.-The purposes of this Act are"(1) to increase public awareness of the plight of
victims of crime who are individuals with develop
mental disabilities;
"(2) to collect data to measure the extent of the
problem of crimes against individuals with develop
mental disabilities; and
"(3) to develop a basis to find new strategies to ad
dress the safety and justice needs of victims of crime
who are individuals with developmental disabilities.
"SEC. 3. DEFINITION OF DEVELOPMENTAL DIS
ABILITY.
"In this Act, the term 'developmental disability' has
the meaning given the term in section 102 of the Devel
opmental Disabilities Assistance and Bill of Rights Act
of 2000 [42 u.s.a. 15002].
"SEC. 4. STUDY.
"(a) IN GENERAL.-The Attorney General shall con
duct a study to increase knowledge and information
about crimes against individuals with developmental
Page 5024
disabilities that will be useful in developing new strate
gies to reduce the incidence of crimes against those in
dividuals.
"(b) ISSUES ADDRESSED.-The study conducted under
this section shall address such issues as"(1) the nature and extent of crimes against indi
viduals with developmental disabilities;
"(2) the risk factors associated with victimization
of individuals with developmental disabilities;
"(3) the manner in which the justice system re
sponds to crimes against individuals with develop
mental disabilities; and
"(4) the means by which States may establish and
maintain a centralized computer database on the incidence of crimes against individuals with disabilities
within a State.
"(C) NATIONAL ACADEMY OF SCIENCES.-In carrying
out this section, the Attorney General shall consider
contracting with the Committee on Law and Justice of
the National Research Council of the National Acad
emy of Sciences to :provide research for the study con
ducted under this section.
"(d) REPORT.-Not later than 18 months after the date
of enactment of this Act [Oct. 27, 1998], the Attorney
General shall submit to the Committees on the Judici
ary of the Senate and the House of Representatives a
report describing the results cf the study conducted
under this section.
''SEC. 5. NATIONAL CRIME VICTIM'S SURVEY.
"Not later than 2 years after the date of enactment
of this Act, as part of each National Crime Victim's
Survey, the Attorney General shall include statistics
relating to"(1) the nature of crimes against individuals with
developmental disabilities; and
"(2) the specific characteristics of the victims of
those crimes."
§ 3733. Authority for 100 per entum grants
A grant authorized under this subchapter may
be up to 100 per centum of the total cost of each
project for which such grant is made. The Bu
reau shall require, whenever feasible as a condi
tion of approval of a grant under this sub
chapter, that the recipient contribute money,
facilities, or services to carry out the purposes
for which the grant is sought.
(Pub. L. 90-351, title I, §303, as added Pub. L.
96-157, §2, Dec. 27, 1979, 93 Stat. 1178.)
PRIOR PROVISIONS
A prior section 3733, Pub. L. 90-351, title I, §303, June
19, 1968, 82 Stat. 201; Pub. L. 91-644, title I, §4(5), (6),
Jan. 2, 1971, 84 Stat. 1883; Pub. L. 93-83, §2, Aug. 6, 1973,
87 Stat. 201; Pub. L. 93-415, title V, §543, Sept. 7, 1974,
88 Stat. 1142; Pub. L. 94-503, title I, § 111, Oct. 15, 1976,
90 Stat. 2413; Pub. L. 96-181, §15(b), Jan. 2, 1980, 93 Stat.
1316, set out requirements of State plans in order to
qualify for grants for law enforcement and criminal
justice purposes, prior to the general amendment of
this chapter by Pub. L. 96-157.
§ 3734. Repealed. Pub. L. 98-473, title TI, § 605(c),
Oct. 12, 1984, 98 Stat. 2080
Section, Pub. L. 90-351, title I, § 304, as added Pub. L.
96-157, §2, Dec. 27, 1979, 93 Stat. 1178, provided for a Bu
reau of Justice Statistics Advisory Board, including es
tablishment and composition of Board, rules respecting
organization and procedure, term of office, duties and
functions of Beard, and delegation of powers and duties
to Director.
A prior section 3734, Pub. L. 90-351, title I, §304, June
19, 1968, 82 Stat. 202; Pub. L. 93-83, §2, Aug. 6, 1973, 87
Stat. 203; Pub. L. 94--503, title I, §112, Oct. 15, 1976, 90
Stat. 2414, related to plans or applications for financial
assistance from local government units, prior to the
general revision of this chapter by Pub. L. 96-157.
Attachment B. 2000 Deaths in Custody Reporting Act
(P.L. 106-297)
PUBLIC LAW 106–297—OCT. 13, 2000
114 STAT. 1045
Public Law 106–297
106th Congress
An Act
To amend the Violent Crime Control and Law Enforcement Act of 1994 to ensure
that certain information regarding prisoners is reported to the Attorney General.
Oct. 13, 2000
[H.R. 1800]
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Death in Custody Reporting
Act of 2000’’.
SEC. 2. REPORTING OF INFORMATION.
Section 20104(a) of the Violent Crime Control and Law Enforcement Act of 1994 (42 U.S.C. 13704(a)) is amended—
(1) in paragraph (1)—
(A) by inserting ‘‘(A)’’ after ‘‘(1)’’; and
(B) by redesignating subparagraphs (A) and (B) as
clauses (i) and (ii), respectively;
(2) in paragraph (2), by striking ‘‘(2)’’ and inserting ‘‘(B)’’;
(3) in paragraph (3)—
(A) by striking ‘‘(3)’’ and inserting ‘‘(C)’’;
(B) by redesignating subparagraphs (A) and (B) as
clauses (i) and (ii), respectively; and
(C) by striking the period and inserting ‘‘; and’’; and
(4) by adding at the end the following new paragraph:
‘‘(2) such State has provided assurances that it will follow
guidelines established by the Attorney General in reporting,
on a quarterly basis, information regarding the death of any
person who is in the process of arrest, is en route to be incarcerated, or is incarcerated at a municipal or county jail, State
prison, or other local or State correctional facility (including
any juvenile facility) that, at a minimum, includes—
‘‘(A) the name, gender, race, ethnicity, and age of the
deceased;
‘‘(B) the date, time, and location of death; and
‘‘(C) a brief description of the circumstances surrounding the death.’’.
Approved October 13, 2000.
LEGISLATIVE HISTORY—H.R. 1800:
CONGRESSIONAL RECORD, Vol. 146 (2000):
July 24, considered and passed House.
Oct. 3, considered and passed Senate.
Æ
Death in Custody
Reporting Act of
2000.
42 USC 13701
note.
Attachment C. H.R. 2189 Death in Custody Reporting
Act of 2011
AUTHENTICAT 9
U.S. GOVERNMENT
INfORMATION
GPO
II
Calendar No. 237
112TH
CONGRESS
1ST SESSION
H R 2189
•
•
IN rrHE SENATE OF THE UNITED STATES
SEPTEMBER 21, 2011
Received; read twice and refeJTed to the Committee on the Judiciary
NOVEMBER 17, 2011
Reported by Mr. LEAHY, without amendment
AN ACT
To encourage States to report to the Attorney General cer
tain information regarding the deaths of individuals in
the custody of law enforcement agencies, and for other
purposes.
1
Be it enacted by the Senate and House of Representa-
2 tives of the United States of America in Congress assembled,
3
4
SECTION 1. SHORT TITLE.
This Act may be cited as the "Death in Custody Re-
5 porting Act of 2011".
2
1
SEC. 2. STATE INFORMATION REGARDING INDIVIDUALS
2
WHO DIE IN THE CUSTODY OF LAW ENFORCE
3
MENT.
4
(a) IN GENERAL.-For each fiscal year after the ex-
5 piration of the period specified in subsection (c)(l) in
6 which a State receives funds for a program referred to
7 in subsection (c)(2), the State shall report to the Attorney
8 General, on a quarterly basis and pursuant to guidelines
9 established by the Attorney General, information regard10 ing the death of any person who is detained, under arrest,
11 or is in the process of being arrested, is en route to be
12 incarcerated, or is incarcerated at a municipal or county
13 jail, State prison, State-run boot camp prison, boot camp
14 prison that is contracted out by the State, any State or
15 local contract facility, or other loeal or State correctional
16 facility (including any juvenile facility).
17
(b) INFORMATION REQUIRED.-'fhe report required
18 by this section shall contain information that, at a min19 imum, includes20
21
(1) the name, gender, race, ethnicity, and age
of the deceased;
22
(2) the date, time, and location of death;
23
(3) the law enforcement agency that detained,
24
arrested, or was in the process of arresting the de-
25
ceased; and
•HR 2189 RS
3
1
( 4) a brief description of the circumstances sur-
2
rounding the death.
3
(c) COMPLIANCE AND INELIGIBILITY.-
4
(1) COMPI,IANCE DATE.-Each State shall have
5
not more than 120 days from the date of enactment
6
of this Act to comply with subsection (a), except
7
that-
8
(A) the Attorney General may grant an ad-
9
ditional 120 days to a State that is making
10
good faith efforts to comply with such sub-
11
section; and
12
(B) the Attorney General shall waive the
13
requirements of subsection (a) if compliance
14
with such subsection by a State would be un-
15
constitutional under the constitution of such
16
State.
17
(2) INELIGIBILITY FOR FUNDS.-For any fiscal
18
year after the expiration of the period specified in
19
paragraph (1), a State that fails to comply with sub-
20
section (a), shall, at the discretion of the Attorney
21
General, be subject to not more than a 10 percent
22
reduction of the funds that would otherwise be allo-
23
cated for that fiscal year to the State under subpart
24
1 of part E of title I of the Omnibus Crime Control
25
and Safe Streets Act of 1968 ( 42 U.S.C. 3750 et
•HR 2189 RS
4
1
seq.), whether characterized as the Edward Byrne
2
Memorial State and Local Law Enforcement Assist-
3
ance Programs, the Local Government Law Enforce-
4
ment Block Grants Program, the Edward Byrne Me-
5
morial Justice Assistance Grant Program, or other-
6
WISe.
7
(d) REALLOCATION.-Amounts not allocated under a
8 program referred to in subsection (c)( 2) to a State for fail9 ure to fully comply with subsection (a) shall be reallocated
10 under that program to States that have not failed to com11 ply with such subsection.
12
(e) DEFINITIONS.-In this section the terms "boot
13 camp prison" and "State" have the meaning given those
14 terms, respectively, in section 901(a) of the Omnibus
15 Crime Control and Safe Streets Act of 1968 (42 U.S.C.
16 3791(a)).
17
(f) STUDY AND REPORT OF INFORMATION RELATING
18 TO DEATHS IN CUSTODY.19
(1) STUDY REQUIRED.-The Attorney General
20
shall carry out a study of the information reported
21
under subsection (b) and section 3(a) to-
22
(A) determine means by which such infor-
23
mation can be used to reduce the number of
24
such deaths; and
•HR 2189 RS
5
1
(B) examme the relationship, if any, be-
2
tween the number of such deaths and the ac-
3
tions of management of such jails, prisons, and
4
other specified facilities relating to such deaths.
5
(2) REPORT.-Not later than 2 years after the
6
date of the enactment of this Act, the Attorney Gen-
7
eral shall prepare and submit to Congress a report
8
that contains the findings of the study required by
9
paragraph (1).
10
SEC. 3. FEDERAL LAW ENFORCEMENT DEATH IN CUSTODY
11
12
REPORTING REQUIREMENT.
(a) IN GENERAL.-For each fiscal year (beginning
13 after the date that is 120 days after the date of the enact14 ment of this Act), the head of each Federal law enforce15 ment agency shall submit to the Attorney General a report
16 (in such form and manner specified by the Attorney Gen17 eral) that contains information regarding the death of any
18 person who is19
(1) detained, under arrest, or is in the process
20
of being arrested by any officer of such Federal law
21
enforcement agency (or by any State or local law en-
22
forcement officer while participating in and for pur-
23
poses of a Federal law enforcement operation, task
24
force, or any other Federal law enforcement capacity
•HR 2189 RS
6
1
carried out by such Federal law enforcement agen-
2
cy); or
3
4
(2) en route to be incarcerated or detained, or
is incarcerated or detained at-
5
(A) any facility (including any immigration
6
or juvenile facility) pursuant to a contract with
7
such Federal law enforcement agency;
8
(B) any State or local government facility
9
used by such Federal law enforcement agency;
10
or
(C) any Federal correctional
11
facility or
12
Federal pre-trial detention facility located with-
13
in the United States.
14
(b) INFORMATION REQUIRED.-Each report required
15 by this section shall include, at a minimum, the inforrna16 tion required by section 2(b).
17
(c) STUDY AND REPORT.-Information
reported
18 under subsection (a) shall be analyzed and included in the
19 study and report required by section 2(f).
•HR 2189 RS
Calendar No. 237
112TH CONGRESS
1ST SESSIOK
H R 2189
•
•
.
AN ACT
To encourage States to report to the Attorney Gen
eral certain information regarding the deaths of
individuals in the c'Ustody of law enforcement
agencies, and for other purposes.
NOYEI'vnmR 17,2011
Reported without amendment
Attachment D. BJS confidentiality regulations (Title 42,
USC, Sections 3789g and 3735).
§3789g
Page 5048
TITLE 42--THE PUBLIC HEALTH AND WELFARE
PRIOR PROVISIONS
A prior section Bll of Pub. L. 90-351 was classified to
section 3789 of this title prior to repeal by section
609B(e) of Pub. L. 98--473.
(c) Criminal intelligence systems and inform.a·
tion; prohibition against violation of privacy
and constitutional rights of individuals
All criminal intelligence systems operating
through support under this chapter shall collect,
maintain, and disseminate criminal intelligence
1994-Subsec. (e). Pub. L. 103-322 substituted "Bureau
of Justice Assistance" for "Law Enforcement Assist information in conformance with policy stand
ards which are prescribed by the Office of Jus
ance Administration".
tice Programs and which are written to assure
1984---Subsecs. (a), (b). Pub. L. 98--473, §609B(j)(l), sub
stituted "Office of Justice Programs" for "Office of that the funding and operation of these systems
Justice Assistance, Research, and Sta-tistics" wherever furthers the purpose of this chapter and to as
appearing.
sure that such systems are not utilized in viola
Subsecs. (d) to (f). Pub. L. 98--473, §609B(j)(2), (3), re
tion of the privacy and constitutional rights of
designated subsecs. (e) and (f) as (d) and (e), respec
tively, and struck out former subsea. (d) relating to individuals.
AMENDMENTS
civil rights regulations and conforming changes of the
regulations.
(d) Violations; fine as additional penalty
Amendment by section 609B(j) of Pub. L. 98--473 effec
tive Oct. 12, 1984, see section 609AA(a) of Pub. L. 98-473,
set out as an Effective Date note under section 3711 of
this title.
Any person violating the provisions of this
section, or of any rule, regulation, or order is
sued thereunder, shall be fined not to exceed
$10,000, in addition to any other penalty imposed
by law.
(Pub. L. 90-351, title I, § 812, formerly § 818, as
§ 3789g. Confidentiality of infonnation
added Pub. L. 96-157, §2, Dec. 27, 1979, 93 Stat.
(a) Research or statistical infonnation; immunity
from process; prohibition against admission
as evidence or use in any proceedings
98-473, title II, §609B(D, (k), Oct.12, 1984, 98 Stat.
2093, 2096; Pub. L. 109--162, title XI, §1115(c), Jan.
5, 2006, 119 Stat. 3104.)
EFFECTrYE DATE OF 1984 AMENDMENT
No officer or employee of the Federal Govern
ment, and no recipient of assistance under the
provisions of this chapter shall use or reveal any
research or statistical information furnished
under this chapter by any person and identifi
able to any specific private person for any pur
pose other than the purpose for which it was ob
tained in accordance with this chapter. Such in
formation and copies thereof shall be immune
from legal process, and shall not, without the
consent of the person furnishing such informa
tion, be admitted as evidence or used for any
purpose in any action, suit, or other judicial,
legislative, or administrative proceedings.
(b) Criminal history information; disposition and
arrest data; procedures for collection, · stor
age, dissemination, and current status; secu·
rity and privacy; availability for law enforce
ment, criminal justice, and other lawful pur·
poses; automated systems: review, challenge,
and correction of information
All criminal history information collected,
stored, or disseminated through support under
this chapter shall contain, to the maximum ex
tent feasible, disposition as well as arrest data
where arrest data is included therein. The col
lection, storage, and dissemination of such in
formation shall take place under procedures rea
sonably designed to insure that all such infor
mation is kept current therein; the Office of
Justice Programs shall assure that the security
and privacy of all information is adequately pro
vided for and that information shall only be
used for law enforcement and criminal justice
and other lawful purposes. In addition, an indi
vidual who believes that criminal history infor
mation concerning him contained in an auto
mated system is inaccurate, incomplete, or
maintained in violation of this chapter, shall,
upon satisfactory verification of his identity, be
entitled to review such information and to ob
tain a copy of it for the purpose of challenge or
correction.
1213; renumbered § 812 and amended Pub. L.
PRIOR PROVISIONS
A prior section 812 of Pub. L. 90--351 was classified to
section 3789a of this title prior to repeal by section
609B(e) of Pub. L. 98--473.
AMENDMENTS
2006-Subsec. (a). Pub. L. 109--162 substituted "No" for
''Except as provided by Federal law other than this
chapter, no".
1984---Subsecs. (b), (c). Pub. L. 98-473, 609B(k), sub
stituted "Office of Justice Programs" for "Office of
Justice Assistance, Research, and Statistics".
EFFECTIVE DATE OF 1984 AMENDMENT
Amendment by section 609B(k) of Pub. L. 98--473 effec
tive Oct. 12, 1984, see section 609AA(a) of Pub. L. 98-473,
set out as an Effective Date note under section 3711 of
this title,
§ 3789h. Repealed.
Pub. L. 98-473, title D,
§ 609B(e), (/), Oct, 12, 1984, 98 Stat. 2093, 2096
Section, Pub. L. 90-351, title I, § 819, as added Pub. L.
96--157, §2, Dec. 27, 1979, 93 Stat. 1213, authorized accept
ance of voluntary services. See section 3788(g) of this
title.
EFFECTIVE DATE OF REPEAL
Repeal effective Oct. 12, 1984, see section 6{)9AA(a) of
Pub. L. 98-473, set out as an Effective Date note under
section 3711 of this title.
§ 3789i. Administration
of juvenile delinquency
programs
The Director of the National Institute of Jus
tice and the Director of the Bureau of Justice
Statistics shall work closely with the Adminis
trator of the Office of Juvenile Justice and De
linquency Prevention in developing and imple
menting programs in the juvenile justice and de
linquency prevention field.
(Pub. L. 90-351, title I, §813, formerly §820, as
added Pub. L. 96-157, §2, Dec. 27, 1979, 93 Stat.
1214; renumbered § 813 and amended Pub. L.
98-473, title II, §609B(D.
Stat. 2093, 2096.)
(m),
Oct. 12, 1984, 98
Page 5025
TITLE 42--THE PUBLIC HEALTH AND WELFARE
EFFECTIVE DATE OF REPEAL
Repeal effective Oct. 12, 1984, see section 609AA(a) of
Pub. L. 98-473, set out as an Effective Date note under
section 3711 of this title.
§ 3735. Use of data
Data collected by the Bureau shall be used
only for statistical or research purposes, and
shall be gathered in a manner that precludes
their use for law enforcement or any purpose re
lating to a private person or public agency other
than statistical or research purposes.
(Pub. L. 90-351, title I, §304, formerly §305, as
added Pub. L. 96-157, §2, Dec. 27, 1979, 93 Stat.
1179; renumbered §304, Pub. L. 98-473, title II,
§605(d), Oct. 12, 1984, 98 Stat. 2080; amended Pub.
L. 109--162, title XI, §1115(b), Jan. 5, 2006, 119 Stat.
3104.)
PRIOR PROVISIONS
A prior section 304 of Pub. L. 90-351, as added by Pub.
L. 96-157, was classified to section 3734 of this title
prior to repeal by Pub. L. 98-473, title II, §605(c), Oct.
12, 1984, 98 Stat. 2080.
Prior sections 3735 to 3739 were omitted in the general
amendment of this chapter by Pub. L. 96-157.
Section 3735, Pub. L. 90-:-351, title I, §305, June 19, 1968,
82 Stat. 202; Pub. L. 91-644, title I, §4(7), Jan. 2, 1971, 84
Stat. 1883; Pub. L. 93-83, §2, Aug. 6, 1973, 87 Stat. 203, re
lated to reallocation of funds.
Section 3736, Pub. L. 90-351, title I, §306, June 19, 1968,
82 Stat. 202; Pub. L. 91-644, title I, §4(8), Jan. 2, 1971, 84
Stat. 1883; Pub. L. 93-83, §2, Aug. 6, 1973, 87 Stat. 203;
Pub. L. 94-503, title I, §113, Oct. 15, 1976, 90 Stat. 2415,
related to allocation of fnnds.
Section 3737, F'ub. L. 9D-351, title I, §307, June 19, 1968,
82 Stat. 202; Pub. L. 93-83, §2, Aug. 6, 1973, 87 Stat. 204;
Pub. L. 94-503, title I, §114, Oct. 15, 1976, 90 Stat. 2415,
related to priority programs and projects.
Section 3738, Pub. L. 90-351, title I, § 308, as added
Pub. L. 93-83, §2.. Aug. 6, 1973, 87 Stat. 204; amended Pub.
L. 94-503, title I, §115, Oct. 15, 1976, 90 Stat. 2415, related
to Administration action upon State plans within pre
scribed time after date of-submission.
Section 3739, Pub. L. 9Q-351, title I, § 309, as added
Pub. L. 94-503, title I, §116, Oct. 15, 1976, 90 Stat. 2415,
related to assistance and grants to aid State antitrust
enforcement.
AMENDMENTS
2006-Pub. L. 109-162 substituted "private person or
public agency" for "particular individual".
SUBCHAPTER IV-ESTABLISHMENT OF
BUREAU OF JUSTICE ASSISTANCE
PRIOR PROVISIONS
A prior subchapter IV, consisting of sections 3741 to
3748, related to block grants by Bureau of Justice As
sistance, prior to repeal by Pub. L. 10Q-690, title VI,
§6091(a), Nov. 18, 1988, 102 Stat. 4328. For similar provi
sions, see part A (§3750 et seq.) of subchapter V of this
chapter.
Section 3741, Pub. L. 9Q-351, title I, §401, as added
Pub. L. 98-473, title II, §606, Oct. 12, 1984, 98 Stat. 2080;
amended Pub. L. 99--570, title I, §1552(b)(1), Oct. 27, 1986,
100 Stat. 3207--46, related to establishment of Bureau of
Justice Assistance, appointment of Director, and au
thority and restrictions with regard to Director.
Section 3742, Pub. L. 9Q-351, title I, §402, as added
Pub. L. 98-473, title II, §,606, Oct. 12, 1984, 98 Stat. 2080,
related to duties and functions of Director.
Section 3743, Pub. L. 9Q-351, title I, §403, as added
Pub. L. 98-473, title II, §606, Oct. 12, 1984, 98 Stat. 2081,
described grant program.
Section 3744, Pub. L. 9Q-351, title I, §404, as added
Pub. L. 98-473, title II, §606, Oct. 12, 1984, 98 Stat. 2082,
§3735
authorized Bureau to make financial assistance under
this subchapter available to States.
Section 3745, Pub. L. 90-351, title I, §405, as added
Pub. L. 98-473, title II, §606, Oct. 12, 1984, 98 Stat. 2082,
related to applications for assistance and contents of
applications.
Section 3746, Pub. L. 90-351, title I, §406, as added
Pub. L. 98-473, title II, §606, Oct. 12, 1984, 98 Stat. 2084,
related to review of applications.
Section 3747, Pub. L. 90-351, title I, §407, as added
Pub. L. 98-473, title II, §606, Oct. 12, 1984, 98 Stat. 2084,
related to allocation and distribution of funds.
Section 3748, Pub. L. 90-351, title I, §408, as added
Pub. L. 98-473, title II, §606, Oct. 12, 1984, 98 Stat. 2085,
related to designation of a State office to prepare appli
cations and administer funds.
Another prior subchapter IV, consisting of sections
3741 to 3745, related to formula grant program, prior to
the general amendment of this subchapter by Pub. L.
98-473.
Section 3741, Pub. L. 90-351, title I, §401, as added
Pub. L. 96-157, §2, Dec. 27, 1979, 93 Stat. 1179, described
formula grant program.
Section 3742, Pub. L. 90-351, title I, §402, as added
Pub. L. 96-157, §2, Dec. 27, 1979, 93 Stat. 1181, related to
eligibility provisions for formula grants.
Section 3743, Pub. L. 9Q-351, title I, §403, as added
Pub. L. 96-157, §2, Dec. 27, 1979, 93 Stat. 1187, concerned
application requirements for formula grants.
Section 3744, Pub. L. 9Q-351, title I, §404, as added
Pub. L. 96-157, §2, Dec. 27, 1979, 93 Stat. 1188, provided
for review of applications for formula grants.
Section 3745, Pub. L. 90-351, title I, §405, as added
Pub. L. 9£--157, §2, Dec. 27, 1979, 93 Stat. 1189, provided
for allocation and distribution of funds for formula
grants.
Another prior subchapter IV, consisting of sections
3741 to 3748 and 3750 to 3750d, related to training, edu
cation, research, demonstration, and special grants
prior to the general amendment of this chapter by Pub.
L. 96-157.
Section 3741, Pub. L. 9Q-351, title I, §401, June 19, 1968,
82 Stat. 203; Pub. L. 93-83, §2, Aug. 6, 1973, 87 Stat. 205,
set out the Congressional statement of purposes in
making provision for training, education, research,
demonstration, and special grants.
Section 3742, Pub. L. 9Q-351, title I, §402, June 19, 1968,
82 Stat. 203; Pub. L. 93-83, §2, Aug. 6, 1973, 87 Stat. 205;
Pub. L. 94-503, title I, §117, Oct. 15, 1976, 90 Stat. 2416,
provided for creation of a National Institute of Law En
forcement and Criminal Justice.
Section 3743, Pub. L. 90-351, title I, §403, June 19, 1968,
82 Stat. 203; Pub. L. 93-83, §2, Aug. 6, 1973, 87 Stat. 206,
related to limitations on size of grants and contribu
tions requirements for grants.
Section 3744, Pub. L. 90-351, title I, §404, June 19, 1968,
82 Stat. 204; Pub. L. 93--83, §2, Aug. 6, 1973, 87 Stat. 207,
provided for Federal Bureau of Investigation law en
forcement training programs.
Section 3745, Pub. L. 90-351, title I, §405, June 19, 1968,
82 Stat. 204; Pub. L. 93--83, §2, Aug. 6, 1973, 87 Stat. 207,
repealed Law Enforcement Assistance Act of 1965 and
provided for funds to continue projects started there
under.
Section 3746, Pub. L. 90-351, title I, §406, June 19, 1968,
82 Stat. 204; Pub. L. 91-644, title I, §5(1). Jan. 2, 1971, 84
Stat. 1884; Pub. L. 93--83, §2. Aug. 6, 1973, 87 Stat. 207,
provided for academic educational assistance.
Section 3747, Pub. L. 9Q-351, title I, §407, formerly
§408, as added Pub. L. 91-644, title I, §5(2), Jan. 2, 1971,
84 Stat. 1885; renumbered §407, Pub. L. 93-83, §2, Aug. 6,
1973, 87 Stat. 209, related to administration of training
programs for prosecuting attorneys.
Another prior section 3747, Pub. L. 90-351, title I, §407,
as added Pub. L. 91-644, title I, §5(2), Jan. 2, 1971, 84
Stat. 1885, related to Administration law enforcement
training program for enforcement personnel, prior to
the general amendment of this chapter by section 2 of
Pub. L. 93--83.
Section 3748, Pub. L. 90-351, title I, §408, as added
Pub. L. 91-644, title I, § 5(2), Jan. 2, 1971, 84 Stat. 1885,
Attachment E. 2012 CJ-9A (Annual Summary on
Inmates Under Jail Jurisdiction); 2012 CJ-10A (Annual
Summary on Inmates in Private and MultiJurisdictional Jails); 2012 NPS-4 (Annual Summary on
Inmate Deaths in State Prisons); 2013 CJ-9 (Death
Report on Inmates Under Jail Jurisdiction); 2013 CJ-10
(Death Report on Inmates in Private and MultiJurisdictional Jails); 2013 NPS-4A (State Prison
Inmate Death Report)
OMB No. 1121-0249 Approval Expires MO/DAY/YEAR
DEATHS IN CUSTODY—2012
ANNUAL SUMMARY ON INMATES
UNDER JAIL JURISDICTION
Form CJ-9A
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
RTI INTERNATIONAL
FORM COMPLETED BY:
Name
Title
Official
Address
Telephone
City
FAX
State
Zip
E-mail
Instructions for Completion
IF YOUR JURISDICTION DID NOT HAVE A DEATH IN CALENDAR YEAR 2012:
•
Complete this form and return it to RTI International. Once you complete EVERY question, your submission will be
complete for 2012.
IF YOUR JURISDICTION DID HAVE ONE OR MORE DEATHS IN CALENDAR YEAR 2012:
•
•
Please ensure that you have completed a 2012 CJ-9 (individual death report) form for each death reported.
If you need additional CJ-9 forms, please go to the DCRP Web site (https://bjsdcrp.rti.org), call 1-800-344-1387, or
send an e-mail to [email protected].
General Information
Please submit your completed form within 30 days of receipt. You may submit your annual summary in one of these ways:
ONLINE: Complete this form online at: https://bjsdcrp.rti.org
E-MAIL: [email protected]
MAIL: RTI International, Attn: Data Capture
Project Number: 0212335.001.302.200
PO Box 12194
Research Triangle Park, NC 27709-2194
FAX (TOLL-FREE): 1-866-800-9179
If you need assistance, contact Kim Aspinwall of RTI International toll-free at 1-800-344-1387 or [email protected].
What facilities are included in this data collection?
INCLUDE…
• Confinement facilities usually administered by a local law
enforcement agency, intended for adults but sometimes holding
juveniles
EXCLUDE…
• Facilities that are exclusively used as temporary holding or
lockup facilities, where inmates are generally held for less than
72 hours and not held beyond arraignment
• All jails and city/county correctional centers that hold inmates
beyond arraignment. Report data on all inmates, including those
held in separate holding or lockup areas within your facility
• Privately operated jails and facilities operated by two or more
jurisdictions (i.e., multi-jurisdictional facilities; these jails will be
contacted directly for data on deaths in their custody)
• Special jail facilities (e.g., medical/treatment/release centers,
halfway houses, and work farms)
• Deaths of persons in the process of arrest by your agency if
they have not yet been booked into your jail facility. Arrestrelated deaths should be reported using a CJ-11A form
• Inmates held for other jurisdictions, including federal authorities,
state prison authorities and other local jail jurisdictions
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The burden of
this collection is estimated to average 5 minutes per response for jurisdictions reporting zero deaths and 30 minutes per each reported death, including revi ewing
instructions, searching existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden estimate or any
aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW , Washington, DC 20531. Do
not send your completed form to this address.
«AGENCY ID»
INMATE COUNTS AND DEATHS
1. How many males and females under the supervision of
your jail jurisdiction were confined in your jail facilities on
December 31, 2012?
When exact numeric answers are not available, provide
estimates and mark () in the box beside each figure.
INCLUDE:
Persons on transfer to treatment facilities but who
remain under your jurisdiction
Persons out to court while under your jurisdiction
Persons held for other jurisdictions
EXCLUDE:
X
X
X
Persons housed in facilities operated by two or more
jurisdictions or those held in privately operated jails
Inmates who are AWOL, escaped, or on long-term
transfer to other jurisdictions
All persons in nonresidential community-based
programs run by your jails (e.g., electronic
monitoring, house arrest, community service, day
reporting, work programs)
When exact numeric answers are not available, provide
estimates and mark () the box beside each figure.
Inmates on
December 31,
2012
Males:
Estimate
Females:
Estimate
2. How many males and females under the supervision of
your jail jurisdiction were admitted to your jail facilities
during 2012?
INCLUDE:
New admissions only (i.e., persons officially booked
into and housed in your facilities by formal legal
document and by the authority of the courts or some
other official agency)
Repeat offenders booked on new charges
EXCLUDE:
X
Returns from escape, work release, medical
appointments/treatment facilities, bail, and court
appearances
When exact numeric answers are not available, provide
estimates and mark () the box beside each figure.
New ANNUAL
admissions
during 2012
3. On December 31, 2012, how many persons were confined
in your jail facilities on behalf of any of the following:
Males:
Estimate
Females:
Estimate
a.
U.S. Immigration and
Customs Enforcement:
Estimate
b.
U.S. Marshals Service:
Estimate
c.
All other holds (state and
federal prison, Bureau of
Indian Affairs, or any holds
for other jail jurisdictions):
Estimate
4. Between January 1, 2012, and December 31, 2012, what
was the average daily population of all jail confinement
facilities operated by your jurisdiction?
To calculate the average daily population, add the number of
persons for each day during the period January 1, 2012,
through December 31, 2012, and divide the result by 365.
If daily counts are not available, estimate the average daily
population by adding the number of persons held on the same
day of each month and divide the result by 12.
If average daily population cannot be calculated as directed
above, then estimate the typical number of persons held in
your jail confinement facilities each day.
When exact numeric answers are not available, provide
estimates and mark () the box beside each figure.
Average daily
population
during 2012
Males:
Estimate
Females:
Estimate
5. Between January 1, 2012, and December 31, 2012, how
many persons died while under the supervision of your
jail jurisdiction?
INCLUDE:
Deaths of ALL persons CONFINED in your jail
facilities; or UNDER YOUR JURISDICTION but out to
court or in special facilities (e.g., hospitals, halfway
houses, work farms, and medical/treatment/ release
centers); or WHILE IN TRANSIT to or from your
facilities while under your jurisdiction.
Number of
inmate deaths
during 2012
Males:
Females:
NOTE: BEFORE COMPLETING THIS FORM, PLEASE BE
SURE THAT THERE ARE ENTRIES FOR ALL RESPONSE
BOXES. FOR EXAMPLE, IF YOU HAVE ZERO FEMALE
DEATHS IN QUESTION 5, PLEASE ENTER 0 IN THE BOX
RATHER THAN LEAVING IT BLANK.
«AGENCY ID»
OMB No. 1121-0249 Approval Expires MO/DAY/YEAR
DEATHS IN CUSTODY—2012
ANNUAL SUMMARY ON INMATES IN
PRIVATE AND MULTI-JURISDICTION JAILS
Form CJ-10A
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
RTI INTERNATIONAL
FORM COMPLETED BY:
Name
Title
Official
Address
Telephone
City
FAX
State
Zip
E-mail
Instructions for Completion
IF YOUR JURISDICTION DID NOT HAVE A DEATH IN CALENDAR YEAR 2012:
•
Complete this form and return it to RTI International. Once you complete EVERY question, your submission will be
complete for 2012.
IF YOUR JURISDICTION DID HAVE ONE OR MORE DEATHS IN CALENDAR YEAR 2012:
•
•
Please ensure that you have completed a 2012 CJ-10 (individual death report) form for each death reported.
If you need additional CJ-10 forms, please go to the DCRP W eb site (https://bjsdcrp.rti.org), call 1-800-344-1387,
or send an e-mail to [email protected].
General Information
Please submit your completed form within 30 days of receipt. You may submit your annual summary in one of these ways:
ONLINE: Complete this form online at: https://bjsdcrp.rti.org
E-MAIL: [email protected]
MAIL: RTI International, Attn: Data Capture
Project Number: 0212335.001.302.200
PO Box 12194
Research Triangle Park, NC 27709-2194
FAX (TOLL-FREE): 1-866-800-9179
If you need assistance, contact Kim Aspinwall of RTI International toll-free at 1-800-344-1387 or [email protected].
What facilities are included in this data collection?
INCLUDE…
• All confinement facilities, including detention centers, jails, and
other correctional facilities, intended for adults but sometimes
holding juveniles which are either privately owned and operated
or administered by two or more governments (or a board
composed of representatives from two or more governments)
• All jails and city/county correctional centers that hold inmates
beyond arraignment. Report data on all inmates, including
those held in separate holding or lockup areas within your
facility
• Special jail facilities (e.g., medical/treatment/release centers,
halfway houses, and work farms)
EXCLUDE…
• Facilities that are exclusively used as temporary holding or
lockup facilities, where inmates are generally held for less
than 72 hours and not held beyond arraignment. If your facility
holds inmates beyond arraignment, report data on ALL
inmates, including those held in separate holding or lockup
areas within your facility
• Deaths of persons in the process of arrest by your agency if
they have not yet been booked into your jail facility. Arrestrelated deaths should be reported using a CJ-11A form
• Inmates held for jurisdictions other than the participating
jurisdictions
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The burden of
this collection is estimated to average 5 minutes per response for jurisdictions reporting zero deaths and 30 minutes per each reported death, including reviewing
instructions, searching existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden estimate or any
aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW , Washington, DC 20531. Do
not send your completed form to this address.
«AGENCY ID»
INMATE COUNTS AND DEATHS
1. How many males and females under the supervision of
your jail facility were confined in your jail facility on
December 31, 2012?
INCLUDE:
Persons on transfer to treatment facilities but who
remain under your jurisdiction
Persons out to court while under your jurisdiction
Persons held for other jurisdictions
3. On December 31, 2012, how many persons were confined
in your jail facilities on behalf of any of the following:
When exact numeric answers are not available, provide
estimates and mark () in the box beside each figure.
a.
U.S. Immigration and
Customs Enforcement:
Estimate
b.
U.S. Marshals Service:
Estimate
c.
All other holds (state and
federal prison, Bureau of
Indian Affairs, or any holds
for other jail jurisdictions):
Estimate
EXCLUDE:
X
Inmates who are AWOL, escaped, or on long-term
transfer to other jurisdictions
When exact numeric answers are not available, provide
estimates and mark () the box beside each figure.
Inmates on
December 31,
2012
Males:
Estimate
Females:
Estimate
4. Between January 1, 2012, and December 31, 2012, what
was the average daily population of all jail confinement
facilities operated by your jail?
To calculate the average daily population, add the number of
persons for each day during the period January 1, 2012,
through December 31, 2012, and divide the result by 365.
2. How many males and females under the supervision of
your jail facility were admitted to your jail facilities during
2012?
INCLUDE:
New admissions only (i.e., persons officially booked
into and housed in your facilities by formal legal
document and by the authority of the courts or some
other official agency)
Repeat offenders booked on new charges
EXCLUDE:
X
Returns from escape, work release, medical
appointments/treatment facilities, bail, and court
appearances
When exact numeric answers are not available, provide
estimates and mark () the box beside each figure.
New ANNUAL
admissions
during 2012
Males:
Estimate
Females:
Estimate
If daily counts are not available, estimate the average daily
population by adding the number of persons held on the same
day of each month and divide the result by 12.
If average daily population cannot be calculated as directed
above, then estimate the typical number of persons held in
your jail confinement facilities each day.
When exact numeric answers are not available, provide
estimates and mark () the box beside each figure.
Average daily
population
during 2012
Males:
Estimate
Females:
Estimate
5. Between January 1, 2012, and December 31, 2012, how
many persons died while under the supervision of your
jail?
INCLUDE:
Deaths of ALL persons CONFINED in your jail
facilities; or UNDER YOUR JURISDICTION but out to
court or in special facilities (e.g., hospitals, halfway
houses, work farms, and medical/treatment/ release
centers); or WHILE IN TRANSIT to or from your
facilities while under your jurisdiction.
Number of
inmate deaths
during 2012
Males:
Females:
NOTE: BEFORE COMPLETING THIS FORM, PLEASE BE
SURE THAT THERE ARE ENTRIES FOR ALL RESPONSE
BOXES. FOR EXAMPLE, IF YOU HAVE ZERO FEMALE
DEATHS IN QUESTION 5, PLEASE ENTER 0 IN THE BOX
RATHER THAN LEAVING IT BLANK.
«AGENCY ID»
OMB No. 1121-0249 Approval Expires MO/DAY/YEAR
DEATHS IN CUSTODY—2012
ANNUAL SUMMARY OF INMATE DEATHS
IN STATE PRISONS
Form NPS-4
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
RTI INTERNATIONAL
FORM COMPLETED BY:
Name
Title
Official
Address
Telephone
City
FAX
State
Zip
E-mail
What deaths should be reported?
INCLUDE deaths of ALL persons…
•
Confined in your correctional facilities, whether housed
under your jurisdiction or that of another state
•
Under your jurisdiction but housed in private correctional
facilities, whether located in or out of state
•
Under your jurisdiction but in special facilities (e.g.,
medical/ treatment/release centers, halfway houses,
police/court lockups, and work farms)
•
EXCLUDE deaths of ALL persons…
•
Executed in your state
•
Confined in local jail facilities, whether located in or out of
state
•
Under your jurisdiction but housed in a state-operated
correctional facility in another state or in a federal facility
•
Under probation or parole supervision in your state
In transit to or from your facilities while under your
supervision
During 2012, how many persons died while in the custody of your state correctional facilities?
Number of deaths in 2012
Please fill out the number of deaths that occurred in calendar year 2012 above and submit this form and corresponding NPS -4A forms
to RTI International. You may submit these data in one of these ways:
ONLINE: Complete this form online at: https://bjsdcrp.rti.org
E-MAIL: [email protected]
MAIL:
RTI International, Attn: Data Capture
Project Number: 0212335.001.302.200
PO Box 12194
Research Triangle Park, NC 27709-2194
FAX (TOLL-FREE): 1-866-800-9179
For each inmate death, please ensure that you have submitted a STATE PRISON INMATE DEATH REPORT (NPS-4A) form.
IF NO DEATHS OCCURRED, it is still important that you complete this form and return it to RTI International.
If you need assistance, contact Kim Aspinwall of RTI International toll-free at 1-800-344-1387 or send an e-mail to [email protected]
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The
burden of this collection is estimated to average 5 minutes per response for jurisdictions reporting zero deaths and 30 minutes per each reported death, including
reviewing instructions, searching existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden
estimate or any aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW,
Washington, DC 20531. Do not send your completed form to this address.
«AGENCY ID»
OMB No. 1121-0249 Approval Expires MO/DAY/YEAR
DEATHS IN CUSTODY—2013
DEATH REPORT ON INMATES
UNDER JAIL JURISDICTION
Form CJ-9
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
RTI INTERNATIONAL
FORM COMPLETED BY:
Name
Title
Official
Address
Telephone
City
FAX
State
Zip
E-mail
Instructions for Completion
If no deaths occurred in 2013:
• You do not need to report anything at this time.
• At the beginning of 2014, you will be asked to complete a summary form whether or not you had a death occurrence in 2013.
If you had more than one death in 2013:
• Make copies of this form for each additional death.
• Complete the entire form for each inmate death.
• Once your death records are complete, there are several ways to submit a death report:
ONLINE: Complete the report online at: https://bjsdcrp.rti.org
MAIL: RTI International, Attn: Data Capture
Project Number: 0212335.001.302.200
PO Box 12194
Research Triangle Park, NC 27709-2194
E-MAIL: [email protected]
FAX (TOLL-FREE): 1-866-800-9179
If you need assistance, contact Kim Aspinwall of RTI International toll-free at 1-800-344-1387 or [email protected]
What deaths should be reported?
INCLUDE deaths of ALL persons…
EXCLUDE deaths of ALL persons…
•
Confined in your jail facilities, whether housed under
your own or another jurisdiction
•
Confined in facilities operated by two or more
jurisdictions or those held in privately operated jails
•
Under your jurisdiction but housed in special jail
facilities (e.g., medical/treatment/release centers,
halfway houses, and workfarms); or on transfer to
treatment facilities
•
Under your jurisdiction but in nonresidential communitybased programs run by your jails (e.g., electronic
monitoring, house arrest, community service, day
reporting, work programs)
•
Under your jurisdiction but out to court
•
Under your jurisdiction but AWOL, escaped, or on longterm transfer to another jurisdiction
•
In transit to or from your facilities while under your
jurisdiction
•
In the process of arrest by your agency, but not yet
booked into your jail facility
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The burden of
this collection is estimated to average 5 minutes per response for jurisdictions reporting zero deaths and 30 minutes per each reported death, including reviewing
instructions, searching existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden estimate or any
aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW , Washington, DC 20531. Do
not send your completed form to this address.
«AGENCY ID»
LOCAL JAIL INMATE DEATH REPORT
1. What was the inmate’s name?
LAST
8. On what date was the inmate admitted to a facility
under your jurisdiction?
FIRST
MI
MONTH
DAY
YEAR
2. On what date did the inmate die?
2
MONTH
DAY
0
1
9. Was the inmate being confined in your jail facility
on behalf of any of the following?
3
YEAR
PLEASE PROVIDE A RESPONSE FOR EACH ITEM (a–c)
3. What was the name and location of the correctional
facility involved?
Facility Name:
Facility City:
Facility State:
DON’T
YES NO KNOW
a. U.S. Immigration and
Customs Enforcement................................ ...........
b. U.S. Marshals Service................................ ...........
c. State or federal prison,
Bureau of Indian Affairs,
or any other jail jurisdiction......................... ...........
10. For what offense(s) was the inmate being held?
4. What was the inmate’s date of birth?
a.
b.
MONTH
DAY
YEAR
c.
5. What was the inmate’s sex?
Male
Female
6. Was the inmate of Hispanic, Latino, or Spanish
origin?
Yes
No
7. In addition, what was the inmate’s race? Please
select one or more of the following racial
categories:
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Pacific Islander
Some other race
d.
e.
11. What was the inmate’s legal status at time of
death? (For inmates with more than one status, report
the status associated with the most serious offense.)
Convicted—new court commitment
Convicted—returned probation/parole violator
Unconvicted
Other
Please Specify:
12. Since admission, did the inmate ever stay
overnight in a mental health observation unit or an
outside mental health facility?
Yes
No
Don’t Know
«AGENCY ID»
13. Where did the inmate die?
In a general housing unit within the jail facility or on jail grounds
In a segregation unit
In a special medical unit/infirmary within jail facility
In a special mental health services unit within jail facility
In a medical center outside jail facility
In a mental health center outside jail facility
While in transit
Elsewhere
Please Specify:
14. Are the results of a medical examiner’s or coroner’s evaluation (such as an autopsy, postmortem exam, or
review of medical records) available to establish an official cause of death?
YES
CONTINUE TO Q15
Evaluation complete—results are pending
SKIP REMAINING QUESTIONS AND SUBMIT THIS FORM—YOU WILL BE CONTACTED AT A LATER
TIME FOR THE CAUSE OF DEATH
No evaluation is planned
15. What was the cause of death?
CONTINUE TO Q15
*** Please SPECIFY cause of death—it is critical information ***
Illness—Exclude AIDS-related deaths [Specify]
Acquired Immune Deficiency Syndrome (AIDS)
Accidental alcohol/drug intoxication [Describe]
Accidental injury to self [Describe]
Accidental injury by other (e.g., vehicular
accidents during transport) [Describe]
Suicide (e.g., hanging, knife/cutting instrument,
intentional drug overdose) [Describe]
Homicide [Describe]
Other cause(s) [Specify]
16. Where did the incident (e.g., accident, suicide, or homicide) causing the death take place?
NOT APPLICABLE—Cause of death was illness, intoxication, or AIDS-related
In the jail facility or on the jail grounds
In the inmate’s cell/room
In a temporary holding area/lockup
In a common area within the facility (e.g., yard, library, cafeteria)
[PLEASE
In a segregation unit
SPECIFY]
In a special medical unit/infirmary
In a special mental health services unit
Elsewhere within the jail facility
Please Specify:
Outside the jail facility (e.g., while on work release or on work detail)
Elsewhere
Please Specify:
«AGENCY ID»
17. When did the incident (e.g., accident, suicide, or homicide) causing the death occur?
NOT APPLICABLE—Cause of death was illness, intoxication, or AIDS-related
Morning (6 am to Noon)
Afternoon (Noon to 6 pm)
Evening (6 pm to Midnight)
Overnight (Midnight to 6 am)
18. Excluding emergency care provided at the time of death, did the inmate receive any of the following medical
services for the medical condition that caused his/her death after admission to your correctional facilities?
NOT APPLICABLE—Cause of death was accidental injury, intoxication, suicide, or homicide
YES
NO
DON’T KNOW
a. Evaluation by physician/medical staff ......................................................
PLEASE PROVIDE A
b. Diagnostic tests (e.g., X-rays, MRI) .........................................................
RESPONSE FOR
c. Medications ...............................................................................................
EACH ITEM (a–f)
d. Treatment/care other than medications ....................................................
e. Surgery......................................................................................................
f. Confinement in special medical unit. ........................................................
19. Was the cause of death the result of a pre-existing medical condition or did the inmate develop the condition
after admission? (If multiple conditions caused the death and any of the conditions were pre-existing, mark
―Pre-existing medical condition.‖)
NOT APPLICABLE—Cause of death was accidental injury, intoxication, suicide, or homicide
Pre-existing medical condition
Deceased developed condition after admission
Could not be determined
Please add any additional notes regarding this death here:
«AGENCY ID»
OMB No. 1121-0249 Approval Expires MO/DAY/YEAR
DEATHS IN CUSTODY—2013
DEATH REPORT ON INMATES IN PRIVATE
AND MULTI-JURISDICTIONAL JAILS
Form CJ-10
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
RTI INTERNATIONAL
FORM COMPLETED BY:
Name
Title
Official
Address
Telephone
City
FAX
State
Zip
E-mail
Instructions for Completion
If no deaths occurred in 2013:
• You do not need to report anything at this time.
• At the beginning of 2014, you will be asked to complete a summary form whether or not you had a death occurrence in 2013.
If you had more than one death in 2013:
• Make copies of this form for each additional death.
• Complete the entire form for each inmate death.
• Once your death records are complete, there are several ways to submit a death report:
ONLINE: Complete the report online at: https://bjsdcrp.rti.org
MAIL: RTI International, Attn: Data Capture
Project Number: 0212335.001.302.200
PO Box 12194
Research Triangle Park, NC 27709-2194
E-MAIL: [email protected]
FAX (TOLL-FREE): 1-866-800-9179
If you need assistance, contact Kim Aspinwall of RTI International toll-free at 1-800-344-1387 or [email protected]
What deaths should be reported?
INCLUDE deaths of ALL persons…
•
Confined in your jail facilities, even if housed for
another jurisdiction
•
Under your jurisdiction but housed in special jail
facilities (e.g., medical/treatment/release centers,
halfway houses, and work farms); or on transfer to
treatment facilities
•
Under your jurisdiction but out to court
•
In transit to or from your facilities while under your
supervision
EXCLUDE deaths of ALL persons…
•
Under your jurisdiction but in nonresidential communitybased programs run by your jails (e.g., electronic
monitoring, house arrest, community service, day
reporting, work programs)
•
Under your jurisdiction but AWOL, escaped, or on longterm transfer to another jurisdiction
•
In the process of arrest by your agency, but not yet
booked into your jail facility
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The burden of
this collection is estimated to average 5 minutes per response for jurisdictions reporting zero deaths and 30 minutes per each reported death, including reviewing
instructions, searching existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden estimate or any
aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW , Washington, DC 20531. Do
not send your completed form to this address.
form to this address.
«AGENCY ID»
JAIL INMATE DEATH REPORT
1. What was the inmate’s name?
LAST
8. On what date was the inmate admitted to your jail
facility?
FIRST
MI
MONTH
DAY
YEAR
2. On what date did the inmate die?
2
2
MONTH
DAY
0
0
1
1
3
9. Was the inmate being confined in your jail facility
on behalf of any of the following?
3
YEAR
PLEASE PROVIDE A RESPONSE FOR EACH ITEM (a–c)
3. What was the name and location of the correctional
facility involved?
FacilityName:
Name:
Facility
Facility Location:
Facility City:
Facility State:
DON’T
YES NO KNOW
a. U.S. Immigration and
Customs Enforcement ................................ ..........
b. U.S. Marshals Service ................................ ..........
c. State or federal prison,
Bureau of Indian Affairs,
or any other jail jurisdiction ......................... ..........
10. For what offense(s) was the inmate being held?
4. What was the inmate’s date of birth?
a.
MONTH
DAY
YEAR
b.
c.
5. What was the inmate’s sex?
Male
Female
d.
e.
6. Was the inmate of Hispanic, Latino, or Spanish
origin?
Yes
No
7. In addition, what was the inmate’s race? Please
select one or more of the following racial
categories:
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Pacific Islander
Some other race
11. What was the inmate’s legal status at time of
death? (For inmates with more than one status, report
the status associated with the most serious offense.)
Convicted—new court commitment
Convicted—returned probation/parole violator
Unconvicted
Other
Please Specify:
12. Since admission, did the inmate ever stay
overnight in a mental health observation unit or an
outside mental health facility?
Yes
No
Don’t Know
«AGENCY ID»
13. Where did the inmate die?
In a general housing unit within the jail facility or on jail grounds
In a segregation unit
In a special medical unit/infirmary within jail facility
In a special mental health services unit within jail facility
In a medical center outside jail facility
In a mental health center outside jail facility
While in transit
Elsewhere
Please Specify:
14. Are the results of a medical examiner’s or coroner’s evaluation (such as an autopsy, postmortem exam, or
review of medical records) available to establish an official cause of death?
YES
CONTINUE TO Q15
Evaluation complete—results are pending
SKIP REMAINING QUESTIONS AND SUBMIT THIS FORM - YOU WILL BE CONTACTED AT A LATER
TIME FOR THE CAUSE OF DEATH
No evaluation is planned
CONTINUE TO Q15
15. What was the cause of death?
*** Please SPECIFY cause of death—it is critical information ***
Illness—Exclude AIDS-related deaths [Specify]
Acquired Immune Deficiency Syndrome (AIDS)
Accidental alcohol/drug intoxication [Describe]
Accidental injury to self [Describe]
Accidental injury by other (e.g., vehicular
accidents during transport) [Describe]
Suicide (e.g., hanging, knife/cutting instrument,
intentional drug overdose) [Describe]
Homicide [Describe]
Other cause(s) [Specify]
16. Where did the incident (e.g., accident, suicide, or homicide) causing the death take place?
NOT APPLICABLE—Cause of death was illness, intoxication, or AIDS-related
In the jail facility or on the jail grounds
In the inmate’s cell/room
In a temporary holding area/lockup
In a common area within the facility (e.g., yard, library, cafeteria)
[PLEASE
In a segregation unit
SPECIFY]
In a special medical unit/infirmary
In a special mental health services unit
Elsewhere within the jail facility
Please Specify:
Outside the jail facility (e.g., while on work release or on work detail)
Elsewhere
Please Specify:
«AGENCY ID»
17. When did the incident (e.g., accident, suicide, or homicide) causing the death occur?
NOT APPLICABLE—Cause of death was illness, intoxication, or AIDS-related
Morning (6 am to Noon)
Afternoon (Noon to 6 pm)
Evening (6 pm to Midnight)
Overnight (Midnight to 6 am)
18. Excluding emergency care provided at the time of death, did the inmate receive any of the following medical
services for the medical condition that caused his/her death after admission to your correctional facilities?
NOT APPLICABLE—Cause of death was accidental injury, intoxication, suicide, or homicide
YES
NO
DON’T KNOW
a. Evaluation by physician/medical staff ......................................................
PLEASE PROVIDE A
b. Diagnostic tests (e.g., X-rays, MRI) .........................................................
RESPONSE FOR EACH
c. Medications ...............................................................................................
ITEM (a–f)
d. Treatment/care other than medications ....................................................
e. Surgery......................................................................................................
f. Confinement in special medical unit. ........................................................
19. Was the cause of death the result of a pre-existing medical condition or did the inmate develop the condition
after admission? (If multiple conditions caused the death and any of the conditions were pre-existing, mark
―Pre-existing medical condition.‖)
NOT APPLICABLE—Cause of death was accidental injury, intoxication, suicide, or homicide
Pre-existing medical condition
Deceased developed condition after admission
Could not be determined
Please add any additional notes regarding this death here:
«AGENCY ID»
OMB No. 1121-0249 Approval Expires MO/DAY/YEAR
DEATHS IN CUSTODY—2013
STATE PRISON INMATE
DEATH REPORT
Form NPS-4A
(Addendum)
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
RTI INTERNATIONAL
FORM COMPLETED BY:
Name
Title
Official
Address
Telephone
City
FAX
State
Zip
E-mail
Instructions for Completion
If no deaths occurred in 2013:
• You will not need to report anything at this time.
• At the beginning of 2014, you will be asked to complete a summary form whether or not you had a death occurrence in 2013.
If you had more than one death in 2013:
• Make copies of this form for each additional death.
• Complete the entire form for each inmate death.
• Once your death records are complete, there are several ways to submit a death report:
ONLINE: Complete the report online at: https://bjsdcrp.rti.org
MAIL: RTI International, Attn: Data Capture
Project Number: 0212335.001.302.200
PO Box 12194
Research Triangle Park, NC 27709-2194
E-MAIL: [email protected]
FAX (TOLL-FREE): 1-866-800-9179
If you need assistance, call Kim Aspinwall of RTI International toll-free at 1-800-344-1387 or [email protected]
What deaths should be reported?
INCLUDE deaths of ALL persons…
•
•
•
•
Confined in your correctional facilities, whether housed
under your jurisdiction or that of another state
Under your jurisdiction but housed in private correctional
facilities, whether located in or out of state
Under your jurisdiction but in special facilities (e.g.,
medical/treatment/release centers, halfway houses,
police/court lockups, and work farms)
In transit to or from your facilities while under your
supervision
EXCLUDE deaths of ALL persons…
•
Executed in your state
•
Confined in local jail facilities, whether located in or out of
state
•
Under your jurisdiction but housed in a state-operated
correctional facility in another state or in a federal facility
•
Under probation or parole supervision in your state
•
Under your jurisdiction but on AWOL or escape-status at
the time of death
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The
burden of this collection is estimated to average 5 minutes per response for jurisdictions reporting zero deaths and 30 minutes per each reported death, including
reviewing instructions, searching existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden
estimate or any aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW,
Washington, DC 20531. Do not send your completed form to this address.
«AGENCY ID»
STATE PRISON INMATE DEATH REPORT
1.
8.
What was the inmate’s name?
LAST
FIRST
On what date was the inmate admitted to one of
your correctional facilities?
MI
MONTH
2.
DAY
YEAR
On what date did the inmate die?
2
MONTH
DAY
0
1
9.
3
For what offense(s) was the inmate being held?
a.
YEAR
b.
3.
What was the name and location of the
correctional facility involved?
c.
d.
Facility Name:
e.
Facility City:
Facility State:
10. Since admission, did the inmate ever stay
overnight in a mental health facility?
4.
What was the inmate’s date of birth?
MONTH
DAY
Yes
No
Don’t Know
YEAR
11. Where did the inmate die?
5.
What was the inmate’s sex?
Male
Female
6.
Was the inmate of Hispanic, Latino, or Spanish
origin?
Yes
No
In a general housing unit in the facility or on
prison grounds
In a segregation unit
In a special medical unit/infirmary within your
facility
In a special mental health services unit within
your facility
In a medical center outside your facility
In a mental health center outside your facility
While in transit
Elsewhere
Please Specify:
7.
In addition, what was the inmate’s race? Please
select one or more of the following racial
categories:
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Pacific Islander
Some other race
Please Specify:
«AGENCY ID»
12. Are the results of a medical examiner’s or coroner’s evaluation (such as an autopsy, postmortem exam, or
review of medical records) available to establish an official cause of death?
YES
CONTINUE TO Q13
Evaluation complete—results are pending
SKIP REMAINING QUESTIONS AND SUBMIT THIS FORM—YOU WILL BE CONTACTED AT A
LATER TIME FOR THE CAUSE OF DEATH
No evaluation is planned
13. What was the cause of death?
CONTINUE TO Q13
*** Please SPECIFY cause of death—it is critical information***
Illness—Exclude AIDS-related deaths [Specify]
Acquired Immune Deficiency Syndrome (AIDS)
Accidental alcohol/drug intoxication [Describe]
Accidental injury to self [Describe]
Accidental injury by other (e.g., vehicular accidents
during transport) [Describe]
Suicide (e.g., hanging, knife/cutting instrument,
intentional drug overdose) [Describe]
Homicide [Describe]
Other cause(s) [Specify]
0
14. Where did the incident (e.g., accident, suicide, or homicide) take place?
NOT APPLICABLE—Cause of death was illness, intoxication, or AIDS-related
In the prison facility or on the prison grounds
In the inmate’s cell/room
In a temporary holding area/lockup
In a common area within the facility (e.g., yard, library, cafeteria)
In a special medical unit/infirmary
[PLEASE
In a special mental health services unit
SPECIFY]
In a segregation unit
On death row, special unit awaiting capital punishment
Elsewhere within the prison facility
Please Specify:
Outside the prison facility (e.g., while on work release or on work detail)
Elsewhere
Please Specify:
15. When did the incident (e.g., accident, suicide, or homicide) causing the inmate’s death occur?
NOT APPLICABLE—Cause of death was illness, intoxication, or AIDS-related
Morning (6 am to Noon)
Afternoon (Noon to 6 pm)
Evening (6 pm to Midnight)
Overnight (Midnight to 6 am)
«AGENCY ID»
16. Excluding emergency care provided at the time of death, did the inmate receive any of the following medical
services for the medical condition that caused his/her death after admission to your correctional facilities?
NOT APPLICABLE—Cause of death was accidental injury, intoxication, suicide, or homicide
a.
b.
c.
d.
e.
f.
YES
NO
DON’T KNOW
Evaluated by physician/medical staff .......................... ...............................
PLEASE PROVIDE A
Diagnostic tests (e.g., X-rays, MRI) ............................ ...............................
RESPONSE FOR
EACH ITEM (a–f)
Medications ................................................................. ...............................
Treatment/care other than medications ...................... ...............................
Surgery ........................................................................ ...............................
Confinement in special medical unit ........................... ...............................
17. Was the cause of death the result of a pre-existing medical condition or did the inmate develop the condition
after admission? (If multiple conditions caused the death and any of the conditions were pre-existing, mark
―Pre-existing medical condition.‖)
NOT APPLICABLE—Cause of death was accidental injury, intoxication, suicide, or homicide
Pre-existing medical condition
Deceased developed condition after admission
Could not be determined
Please add any additional notes regarding this death here:
«AGENCY ID»
Attachment F. 2013 CJ-11 (Arrest-Related Deaths
Summary of Incidents); 2013 CJ-11A (Arrest-Related
Death Incident Report); Arrest Related Deaths Incident
Report (CJ-11A) Question by Question Guide
Form CJ-11
QMB No. ####-####Approval Expires##/##/###:#
U.S_ DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
.
ARREST-RELATED DEATHS
SUMMARY OF INCIDENTS, 2013
AND ACTING AS COLLECTION AGENT:
RT! INTERNATIONAL
DATA SUPPLIED BY
Name:
Title:
Agency:
Telephone: (
)
(
)
Fax:
.
..
.
state:
E-mail Address
...
.
.
·..
..
',
·
..
.
GENERALJNFORMATION
•
.
.
•
Arrest-Related Deaths (ARD) data may be submitted quarteriy or annually.
•
For each arrest-related death, please ensure that you have submitted an ARREST-RELATED DEATH-S INCIDENT REPORT (CJ-11A).
•
•
IF NO DEATHS OCCURRED during the report"1ng period, it is still important that you complete and return this form.
Please return your completed form (and corresponding CJ-11A forms) within 60 days of the end of the reporting period.
.";
..
.·
.
....
· •••••
J _
WHA"]'DEAJfiS SHOULD BE REPORTED? •· -_ ·_.··. , '·
.·.·_
....
.·
..
·
.•
Report all civilian deaths that occur while their freedom to leave is restricted by State or local law enforcement personnel, such as:
• All deaths attributed to any use of force by law enforcement personnel (e.g., officer-involved shootings, accidental deaths caused by
weapons or tactics)
• Any death that occurs in the presence of law enforc6ment prior to, during, or following an arrest, including deaths that occur:
0 While detained for questioning or investigation (i.e., Terry stop)
0 During the process of apprehension (i.e., pursuit of criminal suspect, standoff with law enforcement)
0 While in the custody of, or shortly after restraint by, law enforcement (even if the decedent was not formally under arrest)
0 During transport to or from law enforcement or medical facilities
0 While confined in lockups or booking centers (i.e., facilities from which arrestees are usually transferred within 72 hours and not
held beyond arraignment)
• Any death that occurs during· an interaction with law enforcement personnel during response to medical or mental health
assistance (e.g., response to suicidal persons)
.
.....· ..
.
.-. ·.·
·.•
....
Reporting Period (please specify):
..
0
D
D
D
D
...... _./
Quarter
Quarter
Quarter
Quarter
i'lUMBE OF DEATHS .
.......... .. .....
_ _
_
....._._··
.··· ...._
..
····
....
.
.
,·
.
1 (January 1- March 31)
2 (April1 -June 30)
3 (July 1 -September 30)
4 (October 1 - December 31)
Annual (January 1- December 31)
During the specified reporting period, how many arrest-related deaths occurred in your state? Number of deaths:
CJ
Please enter the number of arrest-related deaths that occurred during the specified reporting period and submit this form and
corresponding CJ-11A forms to RTI International. There are several ways to submit these data:
FAX (TOLL-FREE): 1-877-262-7654
E-MAIL: [email protected]
MAIL:
RTI International
Attn: Kevin Strom
3040 Cornwallis Road, P.O. Box 12194
Research Triangle Park, NC 27709-2194
.If you need assistance with the completion of the CJ-11 or CJ-11A, contact the ARD Help Desk at [email protected] or toll-free at
1-877-475-7039.
Burden Statement
Under the Pape!Work Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMS control number. The burden of this
collection is estimated to average 5 minutes per response, including reviewing instructions, searching existing data sources, gathering necessary data, and completing and
reviewing this form. Send comments regarding this burden estimate or any aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of
Justice Statistics, 810 Seventh Street, N.W., Washington, DC 20531.
Form CJ-11A
OMB No.####-#### Approval Expires##/##/####
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
ARREST-RELATED DEATHS
INCIDENT REPORT, 2013.
AND ACTING AS COLLECTION AGENT:
RTIINTERNATIONAL
DATA SUPPLIED BY
Title:
Name:
.
.
.
Telephone:
Agency:
.
Fax:
State:
E·mail Address:
·.
.
.·
INSTRUCTIONS FOR COMPLETION
.
.
• Complete an Incident Report [CJ-11A) for all civilian deaths that occur while the decedent's freedom to leave is restricted by state or
local law enforcement personnel- including deaths that occur prior to, during, or following an arrest.
• Complete questions 1 through 22 for each arrest-related death in your jUrisdiction. Any additional information or a short narrative of
the incident may be provided in the "Notes" section at the end of the CJ-11A
• Include the decedent's name on both pages 3 and 4 of the CJ-11A
• Send the completed CJ-11A by FAX or MAIL to your State Reporting Coordinator (SRC) within 60 days of the arrest-related death.
A national listing of SRCs is located on page 2 of this form. If needed, please contact SRCs directly for a mailingaddress.
• If
no arrest-related
deaths occurred in your jurisdiction, you will not need to corilplete a CJ-11A.
• If you need assistance completing the CJ-11A, please refer to the CJ-11A Question-by-Question Guide or contact the Arrest-Related
Deaths (ARD) Help Desk at [email protected] or toll-free at 1-877-475-7039.
'
.
WHAT DEATHS SHOULD BE REPORTED?
'.
INCLUDE
;
EXCLUDE
• All deaths resulting from any use of force by state or local law
enforcement personnel.
• Deaths attributed to federal law enforcement personnel (i.e.,
FBI, DEA).
.
• All deaths caused by injuries sustained while attempting to
elude state Or local law enforcement personnel or injuries
incurred after custody had been established.
• Any inmate death that occurred in the custody of local jails, state
prisons, state juvenile correctional facilities, or private
correctional facilities. These types of deaths should be reported to
the Jails and Prisons data colleCtion component of the Deaths in
Custody Reporting Program (visit www.bjsdcro.org).
• All deaths attributed to suicide, alcohol or other drug
intoxications, or medical conditions (i.e., cardiac arrest) that
occur during the process of arrest by or in the custody of state
or local !_aw enforcement personnel.
• All deaths occurring in the custody of state or local law
enforcement personnel responding to a medical/mental health
assistance or welfare call.
• All deaths that occur while confined in lockups or booking
centers {i.e., facilities from which arrestees are usually
transferred within 72 hours and not held beyond arraignment).
• LaW enforcement personnel killed in the line of duty or in the
course of law enforcement activities.
• Any death of a criminal suspect that occurred before the
decedent came into contact with law enforcement (e.g., a
decedent with an active arrest warrant who died before law
enforcement personnel attempted to apprehend him or her).
Burden Statement
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMS control number. The burden of this
collection is estimated to average 60 minUtes per response, including reviewing instructions, searching existing data sources, gathering necessary data, and completing and
reviewing this form. Send comments regarding this burden estimate or any aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of
Justice Statistics, 810 Seventh Street, N.W., Washington, DC 20531.
CJ-11A
National Listing of State Reporting Coordinators
Alabama: Lynn Childs
Alabama Criminal Justice Information Center
PH: (334) 517-2415 FX: (334) 517-2740
Alaska: Alan McKelvie
Alaska Statistical Analysis Center
PH: (907) 786-1809 FX: (907) 786-7777
Arizona:Phillip Stevenson
Arizona Criminal Justice Commission
PH: (602) 364-1157FX: (B02) 364-1175
Arkansas: CrystaiDaye
Arrest-Related Deaths Program Staff
PH: (919) 541-7321 FX: (877) 262-7654
California:-Amber Lozano
Criminal'JUstice Statistics Center
PH: (916) 227-3545 FX: (916) .227-0427
COlorado: Laurencelucenio Colorado
Department ofPublic Safety PH: (303)239-4663 FX:(303) 239-4491
CD:nneCticut:_Ivan KuzYk
Gonnecticut·Office_ of Policy_ & Managenient
. PH: (860)418-6238 Fk(860) 418,6496
Delaware:. Julia Cahill
Delaware StatistiCal- aly_siS .Center.
PH: (302)739-2589FX: (302) 739-4630
District of Columbia:Bgt Harry Hill
Office of the Assistant Chief of Police
PH: (202) 576,3394 FX: (202) 727,3307
Florida:Susan Burton
Florida Department of Law Enforcemenl
PH: (850) 410-7140 FX: (850) 410-7150
Georgia: EriO_.Kennedy
Arrest-Related DeathsProgramStaff
PH:(919) 485-5736 FX: (877) 262-7654
Hawaii:Daniel Kauleinamoku
Hawaii Department of Public Safety
PH: (808) 587-1211 FX: (808) 587-1244
Idaho:Natalie Warner
l.daho Departmentnf CorrectionS
PH: (208) 658-2127 FX: (208) 327-7480
Illinois:Mark-Powers
Illinois Criminal Justice Information Authority
PH (312) 793-8550 FX: (312) 793-8422
Indiana: Stephanie Rosenberg
Indiana Department of Corrections
PH: (317) 234-4417 FX: (317) 233-1474
Iowa: Paul Stageberg
Iowa Division of Criminal & JuVenile Justice
Planning
PH: (515) 242-6122 FX (515) 242-6119
Kansas: Fengfang Lu
Kansas Sentencing Commission
PH (785) 296-0923 FX: (785) 296-0927
Kentucky: MaDorie Stanek
Kentucky Justice & Public Safety Cabinet
PH: (502) 564-8295 FX: (502) 564-6686
North Dakota: Colleen Weltz
Office of Attorney General
PH: (701) 328-5527 FX: (701) 328-5510
Louisiana: Kim Eiland
Louisiana Department of Corrections
PH: (225) 342-8630 FX: (225) 342-3095
Ohio: Lisa Shoaf
Office of Criminal Justice Services
PH: (614) 466-5997 FX: (614) 466-0308
Maine: Mark Be!serene
Office of the Chief Medical Examiner
PH:(207) 624-7180 FX: (207) 624-7178
Oklahoma: Angie Baker
Office of Criminal Justice Statistics
PH: (405) 858-5271 FX: (405) 879-2301
Maryland:Jeffrey Zuback
Governor's Office of Crime Control & Prevention
PH:(410) 821-2855 FX: (410)321-3116
Oregon: Lee Anna Bennatt-Ashworth
Offioe of Public Health
PH: (971) 673-0129FX: (971) 673-0990
Massachusetts: Usa Sampson·
Executive Office of Public Safety and Secunty
PH: (617) 725-3361 FX: (617) 725 0260
Pim-nsylvania: Darlene'HUr18-y
Offi:Ce of CriminatJustfce SYsterris Improvement
· PH: (717) 265-8522 FX: (717)772-0550
Michigan: Elizabeth Arritt
Michigan State Police·
.. PH: (517)241-1907 FX: (517)241-191J4
Rhode lsland:Thomas Mongeau
Rhode ! and Department of Public Safety
PH: (401) 222-2620 FX:(401)2Z2-1294
·,- MinnesOta:'Carolyn- R6b\nso!J·_
South Carolina:RobeMcManus
South Carolina Department of Public Safety
PH: (803) 896'8717 FX: (803) 896-8393
Mifl_qesota_Bureau of CrJri11_rial Apprehension
PH:f651) 793-1054 FX:(651) 793-1001
Mi_s_sis$ipPi:'.Alan-ThoinpSO_ri
·. University.of -sou_ hem'Mississ'fpr)i
PH:.(6Q1}.26?,P172 FX:(601) 266-4391
Missouii;'Ron.ald.Beck
South D i<:Brenda Manning
Divjsion of-Criminal _l_nve tlgation
· PH; (605) 773-6312FX: (805) 7T3-6471
-
.
.
Tennessee:'Jackie:Vande-rcook
· MissburiSta!e Highway Patrol
PH: (573) 751-9000 FX: (573) 526-6274
Teii-nessee BureaU of nVeStigatidriPH: (615) 744-4014 fX: (615)744-4662
··Moiltarla:-Sara'h:Price
Moiltana Department of Justice
PH:(406) 444-3651 FX: (406)444-4722
Texas:ReneieGray
Office of ttJe Attorney General
PH: (512) 305'8882 FX:(512) 494-8283
Nebraska:Mike Overton
Nebraska Crime Commission
PH: (402)471-2194 FX: (402) 471-2837
Utah: Ben Peterson
Commission on Criminal & Juv_enile Justice
PH: (801.) 538-1047 FX: (801) 538-9609
Nevada:Timothy Hart
Center for the-Analysis of Crime Statistics
PH: (702) 895-0233 FX: (702) 895-0252
Vermont:Patricia·Rscher
Vermont Crime lnforrriation Center
PH: (802) 244-8727 F)(: (802) 241.5552
New Hampshire: Timothy Brackett
Office of the Attorney General
PH: (603) 271'8090 FX: (603) 271-6290
\(irginia:-James McDOnough Department
of Criminal Justice Services PH: (804)
786-4612 FX: (804)225-3853
New Jersey:Jean Petherbridge
Di_vision of Criminal Justice
PH: (609) 984-5693 FX: (609) 984-3381
Washington: Tanya Todd
Association of Sheriffs & Chiefs of-poJice
PH: (360) 486-2380 FX: (360) 486-2381
New MeXico: Lisa Broidy
New Mexico Statistical Analysis Center
PH: 505-277-6247 FX: (505) 277-4215
West Virginia: Monika Sterling
Division of Justice and Community Services
PH: (304) 558-8814 FX: (304) 558-0391
New York: Adam Dean
Division of Criminal Justice Services
PH: (518) 457-1149 FX: (518) 485-8039
Wisconsin: Erin Kennedy
Arrest-Related Deaths Program Staff
PH: (919) 485-5736 FX: (877) 262-7654
North Carolina: Patricia Barnes
Office of the Chief Medical Examiner
PH: (800) 672-7024 FX: (919) 962-6263
Wyoming:Burke Grandjean
Wyoming..Survey & Analysis Center
PH (307) 760-5913 FX (307) 766-2759
2
CJ-11A
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
RTIINTERNATIONAL
1.
ARREST-RELATED DEATHS
INCIDENT REPORT, 2013
10. What was the reason for the initial contact between the
decedent and law enforcement personnel? (Mark only
one)
What was the decedeht's name?
Last
2.
MI.
First
0
What was the time and date of death?
_:_QAMQPM
Month:
Day:
, 2013
Q
What law enforcement agency was involved with the
3.
Civilian request for response to criminal or suspicious
activity, specify reason for request
Civilian request for medical, mental health, or welfare
assistance, specify reason for request:
death?
0 Routine patrol/on-view (other than traffic stop), specify
Agency name: .
cD Check if multiple law enforcement agencies responded
Agency ORI:
D Agency
4.
observed behavior:
0 Traffic/vehicle stop, specify reason for stop:
----------..,.-ORI unknown
Where did the eventcausing the death occur?
Street Address: '7"'--'--:...c..;,:..
..:cc -"--:-'-'-·
City> State, Zip: _ 22 --,--22--,-'-'-:------,----'-
5.
Q
Wa"rrant service, specify Charge:
0.
Othet-:'ret:: son f6r.contact,' specify reasOn:
::0 _Unknowh.;
What location category best qescribeswheretheevent
causing the death oC,curre ly onej
11/.Atany time tiuri gthe
....· .
..
Q. ReSiden /H.otn_e-··
0 Law enforC<:lrnent fat;ility
8.
•· Business, specify \Ype
6.
8
8.
---
.
--
=b.,;..;=h··.d ;; .; ·; . d.·:. . ·· ·.·:
..
..
.....
......
o
.•.•.Q•.• Q........
· 1.2. At any time· during the incident, did the decedent display
Male
or. tJ::>e a· weapo ?"-:
Female
0 Yes, mark all that apply:
·D
What was the decedent's date of birth (DOB)?
/
!
or age at death if DOB unknown
Displayed firearm without discharge
D
Discharged firearm
D
Displayed other weapon, specify weapon displayed:
D
Used other weapon, specify weapon used:
D
Used vehicle as a weapon
What was the decedent's ethnic origin? (Mark only one)
0 Hispanic or Latino
0 Not Hispanic or Latino
0 Unknown
9.
. :No·· Y s· Unknown
d :::·:,:::0:8:::8':::::.8
Atteilipt tO 9ain-possessiqn_ ?f officer's.
weapon......•.............. ci
What was the decedent's sex? (Mark only one)
.'.
7.
-..,.
.
Attempt to escape/fleefrom custody .... ..
Attempt to grab, hit, or kick officer(s)..
..
.. . Field/Woods/Lake/Waterway/Beach
Other, specify -'Unknown
.
= = : lb ai ,;: t:
Roadway/l'lighway/StreeVSidewalk
Parking Lot/Garage
§
0
incident, did thedecedent-
0
Q
What was the decedent's race? (Mark only one)
0 American Indian or Alaska Native.
0 Asian
0 Black or African American
§
No
Unknown
13. At any time during the incident, did the decedent attempt
to injure or injure others?
0
Native Hawaiian or Other Pacific !slander
White
Two or more races
Unknown
Yes, mark all that apply:
D Fatally injured law enforcement personnel
D Non-fatally injured law enforcement personnel
D Attempted to injure law enforcement personnel
D
D
D
0No
0
3
Fatally injured civilian(s)
Non-fatally injured civilian(s)
Attempted to injure civilian(s)
Unknown
CJ-11 A
Name of decedent
18. Where did the death occur? (Mark only one)
14. At any time during the incident, did law enforcement
personnel
No
Law enforcement facility/booking center
Yes Unknown
Scene of incident
Dead on arrival at medical facility
Hoo o
Fight or struggle with decedent..
.
Physically restrain decedent
(e.g;, control hold, body compression)O....O.
Restrain decedent with equipment
Medical facility following clinical intervention
..0
Other;specify
Unknown
(e.g., handcuffs, leg shackles) ...._.._._.·_·_·8-_-_,_··.·. ·8._-._·_·_··.·. -_··8·
19. What was the manner of death? (Mark only one)
Place decedent in prone position.
Engage in motor vehicle pursuit ......._._··_·_· ·...·.··.8<·.·_·_·.._._·-.8·
Engage in foot pursuit .................
Other, specify ..... ···········
Natural
Homicide
Accident
....oH.o.......o
Suicide
15. At any time during the incident, Oid law enforcement
personnel use- any of the following Weapons?
No
Could not be determined
Unknown
Yes Unknown
20. What was the cause of death?
d - ;;;;; (T i .
Immediate Calise
Pedpr;p:_
e-r/._c
OCtes.dp:r:a: y_,:m ace dispers;ij_on;-...;..._..;..·.-- ·.-.·.·.-..··._.·.-·.·.··.·.--Baton/blunt instrumentimpact..........•..._.,.._
Other, sp cify ......................................
o...o.....
.... _ .......
Ho .
Secondary causes (if.applicable)
··1s. If the.decedentsustained fatal injuries durin_g the in¢ident,
9w .Were these .injt,iries sustained?
0
NO Yes -l..J;nknOwil
Law enforcement afscene
:;_ j
_
.._ .•HOHHO.-•-·H-0
i: ntdu".ng_lf ".sit '. b- o-ki 8:::8:
Other civilian .....;...
21'. J:iow -ljlfas_fnformati_on·proVided _fOr_ cause of d:eatl)
· (lte:m20) deiennined? (Markonl)lone)
?:8
.-•.0 _ beathcertific,te
Q....... o
-8
c., ...........;..........o ....
1-7. lf a weapon caused the death, what type.of weapon
caused the death? (Mark only one)
0
0
0
80
0
§
Unknown·(Skip ltern 21-ifcause ofdeathisunknown)
: ts : d-ica r-.,ev,-a_l,..ua'-t-io_n_'
--,-
22, Di(:Uhe·autopsy--report or-medical_ eValuation indicate the
Handgtin
Rifle/shotgun
pi-esen_ce·of alcoliOI or of drugs other than alcohol?
0 Yes, mark all that apply:
Firearm; unspeCified
D
Conducted energy device (e.g., Taser)
Knife/edgd instrument
Baton/blunt instrument
D
Alcohol.
Drug(s) otherthan alcohol, specify
0 No
Unknown, did not obtain autopsy report or medical
0 evaluation
Ot[1er w apo_n, specify
Venicle-involved death(i.e., vehicle accident)
Not applicable, weapon or vehicle did not cause death
Unknown
Notes:
4
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
ARREST-RELATED DEATHS
Incident Report (CJ-llA)
Question-by-Question Guide
Item 1: What was the decedent's name?
Please provide the decedent's legal name (last, first, and middle initial).
Item 2: What was the time and date of death?
Please indicate the "official" time and date of death. The "official" time and date of death indicate when
the decedent was pronounced dead by either medical personnel or another authorized official. The
official time and/or date of death may be different from the time and/or date of the fatal event, If the
official time and date of death are unknown, please estimate the time and date of when the fatal injury
was sustained or the fatal medical condition presented.
Example: The decedent sustained a life-threatening injury (e.g., gunshot wound, blunt force
trauma) during the process of arrest, but did not die until hours/days/weeks later. The most
appropriate response to this item would reflect the time and date life ceased rather than the time
and date the injuries were sustained.
Item 3: What law enforcement agency was involved with the death?
Please indicate the name and ORI (ORiginating Jdentifier) of the primary law enforcement ·agency
involved with the death. When personnel from a single agency are involved with the decedent during the
incident, the primary agency is the responding agency. In instances when personnel from more than one
agency interact with the decedent during the incident, the primary agency is the one most-involved with
the death. For the purposes of ARD, the "primary" agency refers to the agency that caused or contributed
to the death, or the agency detaining the decedent at the time of death. The primary agency may be
different than the agency initially involved with decedent at the start of the incident.
Example 1: Law enforcement personnel from Agency X attempt a traffic stop. The suspect flees
and initiates a high-speed chase that crosses several jurisdictions. Personnel from Agency Y and
Agency Z join Agency X in the pursuit. An officer from Agency Z deploys a spike strip (tire
deflation device), which punctures the suspect's tires. The punctured tires cause the suspect to
lose control of the vehicle and crash into a utility pole at a high rate of speed. The impact from the
crash causes fatal injuries. In this instance, Agency Z should be listed as the primary agency
because that agency affected the death.
Example 2: A small local police department receives a mental health assistance call for a suicidal
person. Officers from this agency are dispatched to the scene. The local agency requests backup
from the larger county sheriffs' department and the assistance of their Crisis Intervention Team
(CIT). The CIT is given operational responsibility for the suicidal person, who is apprehended and
placed under their custody. The suspect dies from complications attributed to a fatal drug
overdose during transport to the medical facility. In this instance, the sheriffs' department should
be listed as the primary agency because the decedent was in their custody at the time of death.
1
If personnel from multiple law enforcement agencies are involved with an arrest-related death, please
mark the box labeled, "Check if multiple law enforcement agencies responded." In this case, only the
primary law enforcement agency should be reported; additional agencies do not need to be listed.
The ORI number is an alpha-numeric identification code used by law enforcement agencies to report and
access data. Alllaw enforcement agencies are issued an ORI number by the FBI. ORinumbers are not
derived from the incident or case number generated by the reporting law enforcement agency. If you are
unsure of the reporting agencies' ORI number, please mark the box labeled, "Agency ORI unknown."
Item 4: Where did the event resulting in the death occur?
Please indicate the address or the approximate location (i.e., street intersection, neighborhood) of where
the decedent was injured or developed the condition that resulted in death. The purpose of this item is to
identifY the location of where the death-causing event occurred, which may be different from the location
where the incident began or where the decedent died or was pronounced dead (e.g., medical center).
If the incident occurred at multiple locations, specifY the location where the decedent was injured or
developed the condition that resulted in death.
Example 1: Law enforcement personnel are dispatched to a residence for disturbance. While at
the residence, the decedent sustains a gunshot wound and later died at a medical facility. The
most appropriate response to this item would be the street address of the decedent's residence.
Example 2: Law enforcement personnel respond to a bank robbery" in progress. The suspect flees
the bank and engages law enforcement personnel in a pursuit. The suspect fires gunshots at law
enforcement personnel during the pursuit, who return fire and cause fatal injury. The most
appropriate response to this item would be the address of where the gun fire occurred, not the
bank where the incident originated.
Item 5: What location category best describes where the event causing the death occurred?
Please categorize the address or the approximate location provided as response to Item 4 into one of the
listed location types. The purpose of this item is to specifY the type oflocation where the decedent was
injured or develop the condition that resulted in death. If none of the listed location categories describe
where the event that resulted in death "Occurred, please mark "Other" and specifY the most appropriate
location type. If the location type is unknown, mark "Unknown."
If the incident occurred at multiple locations, specifY the location type of where the decedent was injured
or developed the condition that resulted in death.
Residence/Home: Permanent residences, including apartments, condominiums,
townhouses, nursing homes, residential driveways, and/or residential yards. Incidents
occurring on public sidewalks or in public streets near residences should be categorized as
"Roadway/Highway/Street/Sidewalk"
Law Enforcement Facility: Places where law enforcement activities are carried out. Including
local police departments, sheriffs' offices, sub-stations, lockups, or booking centers, where
arrestees are detained or confined prior to arraignment. Incidents occurring in local jails, state
prisons, state juvenile correctional facilities, or private correctional facilities should be excluded
from the ARD collection and reported to Jails or Prisons data collection components of the
Deaths in Custody Reporting Program (DCRP).
2
Business, specify type: Places where an organization is engaged in the trade of goods, services,
or both to consumers. Includes the interior space occupied by the business, as well as the related
parking lot, and/or walkway. Please specify theof business where the event resulting in
death occurred (e.g., bank, convenience store, liquor store, bar/night club, restaurant, grocery
store/supermarket).
Highway/Road/Alley/Street/Sidewalk: Includes open public ways for the passage of vehicles,
people, and animals, except where a business is associated with a walkway (mark "Business").
Parking Lot/Garage: Includes areas that are primarily used for parking motorized vehicles,
except when a business is associated with a parking lot (mark "Business").
Field/Woods/Lake/Waterway/Beach: Includes areas that are primarily open fields or wooded
areas, shorelines, lakes, streams, canals, or bodies of water other than swimming pools. This
category does not include parks.
Other, specify: This category encompasses any location that is not applicable above. Please
specify the location type in the space provided (e.g. hotel/motel, school/college,
church/syuagogue/temple/mosque).
Item 6: What was the decedent's sex?
If the decedent's sex is not known, leave blank.
Item 7: What was the decedent's date of birth (DOB)?
Please indicate the decedents' date of birth (DOB) in a MM-DD-YYYY format If the DOBis unknown,
please indicate the decedent's age at time of death. If both DOB and age at death are unknown, leave
blank.
Item 8: What was the decedent's ethnic origin?
Race and ethnicity are considered separate and distinct identities. There are two categories for data on
ethnicity: "Hispanic or Latino" and "Not Hispanic or Latino." In addition to the decedent's race, please
indicate whether the decedent was of Hispanic or Latino descent or origin. If ethnic origin is unknown,
mark '"Unknown."
Hispanic or Latino. A person of Cuban, Mexican, Puerto Rican, South or Central America, or
other Spanish culture or origin, regardless of race. The term, "Spanish origin," can be used in
addition to "Hispanic or Latino."
Item 9: What was the decedent's race?
In addition to ethnicity, please specify the decedent's race. There are five categories for data on race:
"American Indian or Alaska Native," "Asian," "Black or African American," "Native Hawaiian or Other
Pacific Islander, and "White." The categories in this classification are social-political constructs and
should not be interpreted as being scientific or anthropological in nature. If race is unknown, mark
''Unknown."
3
American Indian or Alaska Native: A person having origins in any of the original peoples of
North and South America (including Central America), and who maintains tribal affiliation or
community attachment..
Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or
the Indian subcontinent including, for yxample, Cambodia, China, India, Japan, Korea, Malaysia,
Pakistan, the Philippine Islands, Thailand, and Vietnam.
Black or African American: A person having origins in any of the black racial groups of Afi-ica.
Terms such as "Haitian" or "Negro" can be used in addition to "Black or African American."
Native Hawaiian or Other Pacific Islander: A person having origins in any of the original
peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White: A person having origins in any of the original peoples of Europe, the Middle East, or
North Africa.
Item 10: What was the reason for the initial contact between the decedent and law enforcement
personnel?
Please indicate how the decedent came into contact with law enforcement personnel and specifY why the
contact occurred. Contact between the decedent and law enforcement can be initiated by civilians,
including the·decedent, or by law enforcement personnel. Civilian initiated contacts include "civilian
request for response to criminal or suspicious activity" and "civilian request for medical, mental health, or
welfare assistance." Law enforcement initiated contacts include "routine patrol/on-view,"
"Traffic/vehicle stop," and "wartant service." If the reason for. contact between the decedent and law
enforcement isnot listed, please mark "Other" and specifY why the interaction occurred. If the reason for
contact between the decedent and law enforcement is unknown, mark "Unknown."
Civilian request for response to criminal or suspicious activity: Involves situations in which a
civilian requests the assistance of law enforcement in response to actual, perceived, or suspected
criminal activity. This includes 9-1-1 calls for law enforcement assistance as well as instances in
which law enforcement personnel are flagged down by civilians.
Example 1: A woman calls 9-1-1 to report a domestic assault in progress. Law
enforcement personnel are dispatched to her residence. Upon their arrival, law
enforcement personnel are confronted by a man with a gun. The man engages in a shoot
out with officers and is fatally wounded. The most appropriate response to this item would
be "civilian request for response to criminal or suspicious activity" specified as "domestic
violence/assault."
Civilian request for medical, mental health, or welfare assistance: Involves situations where a
civilian requests the assistance of law enforcement for reasons that are not criminally related,
such as requests related to medical or mental health assistance (i.e., suicidal person) and welfare
checks. This includes 9-1-1 calls for law enforcement assistance as well as instances in which
law enforcement personnel are flagged down by civilians.
Example 2: A 9-1-1 call is made requesting law enforcement personnel perform a well
being check at a residence. Officers anive and make contact with the subject. Following
the initial contact, the subject threatens to commit suicide and then banicades himself in
the residence. Officers hear a gunshot from inside the residence during the standoff.
4
They later enter the residence and find the subject dead from what appears to be a self
inflicted gunshot. The most appropriate response would be "civilian request for medical,
mental health, or welfare assistance."
Routine patrol/on-view {other than traffic stop): Involves situations in which law enforcement
personnel witness an actual or perceived criminal act during the course of performing law
enforcement duties. This category excludes contacts initiated by a traffic stop, even if the traffic
stop was made during routine patrol activities. This category also excludes dispatched responses
to 9-1-1 calls, which should be recorded as either "civilian request for response to criminal or
suspicious activity" or "civilian request for medical, mental health, or welfare assistance."
Example 3: An officer is on routine patrol of his beat when he sees a man attempting to
break into the back door of closed retail store. Upon seeing the officer, the subject flees
the scene on foot and engages the officer in a pursuit The subject runs into traffic during
the pursuit and is fatally struck by a civilian motorist The. most appropriate response
would be "routine patrol/on-view (other than traffic stop)" specified as "burglary" or
"breaking and entering."
TrafficNehicle Stop: Involves situations in which law enforcement personnel initiate contact
with the decedent through a traffic or vehicle stop during the course of performing law
enforcement duties.
Example 4: An officer observes a vehicle driving erratically and initiates a traffic stop.
The officer suspects the subject is intoxicated and begins conducting field sobriety tests.
The subject becomes belligerent during the tests and attempts to punch the officer. The
officer uses his conductive energy device on the subject The subject falls and strikes his
head on the ground, causing fatal injury. The most appropriate response would be
"traffic/vehicle stop."
Warrant service: Involves situations in which law enforcement initiate contact with the decedent
through an attempt to serve an active warrant for their arrest This category excludes situations
where the decedent had an active arrest warrant, but came into with law enforcement personnel for
other reasons, such as a traffic stop.
Example 5: Law enforcement personnel obtain an arrest warrant for a murder suspect
and attempt to apprehend the suspect at his residence. The suspect flees the house with a
firearm and a pursuit ensues. The suspect fires several shots at officers as he attempts to
escape. Officers return fire and fatally wound the decedent. The most appropriate
response would be "warrant service" specified as "murder" or "homicide."
. Item 11: At any time during the incident, did the decedent Please indicate whether the decedent engaged in any of the actions listed, during the incident that resulted
in death, by marking either "Yes" or "No" for each item. For the purposes of the ARD program, the
"incident" refers to the period of time from the decedent's initial contact with law enforcement personnel
up to the time of death. Please limit responses to actions taken by the decedent during the incident and
disregard any similar behaviors or actions that occurred prior to contact with law enforcement personnel.
!fit is unknown whether the decedent engaged in one or more of the actions listed, mark "Unknown" for
each relevant action.
5
Make suicidal statements: Includes all instances in which the decedent states he or she plans to
commit suicide, expresses a desire to end his or her life, or directs law enforcement personnel to
use lethal force against him or her. Please mark "Yes" to this response if the contact between the
decedent and law enforcement personnel was initiated because the decedent indicated he/she was
suicidal (i.e., 9-1-1 call for mental health or welfare assistance).
Barricade self or initiate standoff: Includes all instances in which the decedent attempts to
elude apprehension by refusing to surrender to law enforcement or by taking action aimed at
preventing capture, such as nsing a structure to conceal him or herself.
Verbally threaten other(s): Includes all instances in which the decedent makes statements
indicating a desire to inflict harm or to engage in violence against either law enforcement
personnel or civilians.
Resist being handcuffed or arrested: Includes all instances in which the decedent physically
struggles with law enforcement personnel in an attempt to get out from being restrained (e.g.,
handcuffed or put into a police vehicle). This category is representative of evasive actions taken
by the decedent in order to avoid restraint, rather than direct physical assaults on law enforcement
persmmel.
Attempt to escape/flee from custody: Includes all instances in which the decedent attempts or
actually absconds from law enforcement personnel in order to avoid apprehension or detention.
Attempt to grab, hit, kick, or fight with officer(s): Includes all instances in which the decedent
attempts or actually physically attacks law enforcement personnel.
Attempt to gain possession of officer's weapon: Includesall instances in which the decedent
attempts or actually disarms law enforcement personnel of his or her service fireann or other
weapon (i.e., conducted energy device, baton).
Item 12: At any time during the incident, did the decedent display or use a weapon?
Please indicate whether the decedent displayed or used a weapon against law enforcement personnel or
civilians, during the incident that resulted in death, by marking "Yes" or "No." For the purposes of the
ARD program, the "incident" refers to the period of time from the decedent's initial contact with law
enforcement personnel up to the time of death. Please limit responses to actions taken by the decedent
during the incident and disregard any similar behaviors or actions that occurred prior to contact with law
enforcement personnel. If weapon display or use by the decedent is unknown, mark "Unknown."
If"Yes," please mark all that apply to indicate if a weapon was displayed, used, or both and the type of
weapon the decedent possessed. For the purposes of this item, hands, fists, or feet are not considered
weapons.
Displayed firearm without discharge: Includes instances in which the decedent openly
brandishes or points a fireann at another person without bullets being fired from it.
Discharged fireann: Includes instances in which the decedent expels bullets from a firearm,
regardless of whether the b11llets struck another person.
Displayed other weapon: Includes instances in which the decedent made an instrument or
device other than a firearm (e.g., knife, sword, pipe, baseball bat) visible to others under
6
threatening circumstances, without using the instrument in a physical attack. Please specify the
weapon the decedent displayed in the space provided.
Used other weapon: Includes instances in which the decedent uses an instrument or device other
than firearm (e.g., knife, sword, pipe, baseball bat) to attack, cut, strike, beat, etc. another person.
Please specif'y the weapon the decedent used in the space provided.
Used vehicle as weapon: Includes instances in which the decedent uses a motor vehicle to
attempt or actually hit another person with a motor vehicle.
Item 13: At any time during the incident, did the decedent attempt to injure or injure others?
Please indicate whether the decedent attempted to injure or injured law enforcement personnel or another
civilian, during the incident that resulted in death, by marking "Yes" or "No." For the purposes of the
ARD program, the "incident" refers to the period oftime from the decedent's initial contact.with law
enforcement personnel up to the time of death. Please limit responses to actions taken by the decedent
during the incident and disregard any similar behaviors or actions that occurred prior to contact with law
enforcement personnel. If injuries inflicted by the decedent are unknown, mark "Unknown."
If "Yes," please mark all that applies to indicate whether law enforcement personnel or civilian(s) were
injured during the incident.
Fatally inJured law enforcement personnel or civilians(s): Includes instances in which the
decedent caused the death of another person during the incident, regardless of whether the death
was intentional or accident.
Non-fatally injured law enforcement personnel or civilian(s): Includes instances in which the
decedent caused physical harm to another person during the incident, regardless of whether the
harm was intentional or accidental.
Attempted to injure law enforcement personnel or civilian(s): Includes instances in which the
decedent intended to cause another person physical h arm, but did not inflict physical injuries. This
category includes instances in which the decedent discharged a firearm, in the direction of
another, without striking the intended target with the bullets.
Item 14: At any time during the incident, did law enforcement personnelPlease indicate whether law enforcement personnel engaged in any of the actions listed, during the
incident that resulted in death, by marking "Yes" or "No." For the purposes of the ARD program, the
"incident" refers to the period oftime from the decedent's initial contact with law enforcement personnel
up to the time of death. If it is unknown whether law enforcement engaged in one or more of the actions
listed, mark "Unknown" for each relevant action. If law enforcement personnel engaged in an action that
is not listed, please mark "other" and specif'y the action in the space provided.
Fight or struggle with decedent: Includes instances of physical contact between the decedent
and law enforcement personnel (e.g. punching, grabbing, kicking, wrestling).
Physically restrain decedent: Includes instances in which law enforcement personnel use bodily
contact to control, subdue, and/or restrain the decedent (e.g., control holds, body compression,
headlocks).
7
Restrain decedent with equipment: Includes instances in which law enforcement personnel
place the decedent in restraints, such as handcuffs, leg shackles, or other confining and/or
restraining device.
Place decedent in prone position: Includes instances in which law enforcement personnel
restrain the decedent by laying him or her face-down on the ground.
Engage in motor vehicle pursuit: Includes instances in which law enforcement personnel chase
or follow a decedent fleeing in a motor vehicle.
Engage in foot pursuit: Includes instances in which law enforcement personnel chase or follow
a decedent fleeing on foot.
Item IS: At any time during the incident, did law enforcement personnel use any of the following
weapons?
Please mark "Yes," "No," or '"Unknown'' for every response category. fu this question, "use" is defmed·as
any use of weapons, even if they were not a cause of or contributing factor in the death should be
reported. If law enforcement personnel used a weapon that is not listed, please indicate the response,
"Other" and fill in the specific weapon used.
Item I6: If the decedent sustained fatal injuries during the incident, how were these injuries sustained?
Please mark Yes," "No," or "Unknown" for every response category. Self-inflicted injuries would include
any accidental injwies to the decedent's self, as well as suicide.
Item 17: If a weapon caused the death, what type of weapon caused the death?
This item should be completed for all deaths, regardless of the manner of death. The purpose of this item
is to identifY specific weapon(s) that caused the death, instead of weapons that were used during the
incident. All weapons used by law enforcement during the incident should be listed under Item 15. Please
limit response to Item 17 to the one weapon to which the death was attributed, if any.
If a firearm was used, but the type of firearm is not known, please mark "Firearm, unspecified." If the
weapon that caused the death is not listed in Item 17, mark "Other weapon" and specifY the type of weapon
causing the death. Deaths due to an individual struck by a vehicle or deaths attributed to a vehicle accident
should be marked as, "Vehicle-involved crash." ·rfthe weapon that caused the death is not known, mark
"Unknown." If a weapon did not cause the death, mark "Not applicable, weapon or vehicle did not cause
death."
Item 18: Where did the death occur?
Please choose the best response for this question. The response option should reflect where the decedent
actually expired not necessarily where the incident originated.
8
Item 19: What was the manner of death?
The manner of death is "how" the person died, typically illustrated by a one-word description of
intentions and circumstances that led to the stated medical cause of death. Essentially, the manner of
death is the way in which death was caused (e.g., homicide, suicide).
Note the difference between "Could not be determined" and "Unknown." "Undetennined" is an official
cause of death, while "Unknown" indicates the information is missing, unavailable, or unknown at the
time. If a medical examiner or coroner classified the death as "Undetermined," mark "Could not be
determined."
Intentional alcohol or drug overdoses should be marked as "Suicide." Unintentional over use of alcohol
or drugs for recreational purposes should be marked as "Accident."
Item 20:.What was the cause of death?
Unlike the manner of death, which describes the circumstances leading to one's death, cause of death is a
description of the specific medical factors leading to the termination of the biological functions that
sustain life. In cases where cause of death is attributed to multiple factors, please list the primarv (e.g.,
immediate) cause of death first.
Example 1: During the incident, the decease sustained a gunshot wound and subsequently died as
a result of massive blood loss. A response of "gunshot wound" would suffice as a cause of death
regardlessof the manner of death.
Example 2:During the incident, the decedent swallows a packet of cocaine in order to conceal
the narcotics from law enforcement personnel. The packets rupture, causing the decedent to
overdose. A response of "cocaine toxicity" would suffice as a cause of death.
If any secondary causes are known, please list those. For example, during the incident, the
decedent suffered a heart attack. "Cardiovascular event" would suffice for the primary cause of
death. The coroner indicated that diabetes was also a contributing factor in the death of the
decedent. In this case, "Diabetes" would be an applicable secondary cause of death. If causes are
not known or indicated, please leave this section blank.
Item 21: How was information provided for cause of death (item 20) determined?
Please indicate whether the cause of death was determined from an official death certificate, autopsy
report or medical evaluation. If the cause of death was determined from a different source (e.g., press
release), mark "Other source" and specify the source.
item 22: Did the autopsy report or medical evaluation indicate the presence of alcohol or of drugs
other than alcohol?
The purpose of this item is to identitY the presence of drugs ruJd/or alcohol in the decedent's system. This
information should be obtained from an official document such as a death certificate, autopsy report, or
other type of medical evaluation. If the presence of drugs were reported to be present in the decedent's
system based on one of these sources, mark the checkbox "Drug(s) other than alcohol" and specify the
type of drug reported (e.g., cocaine).
If the autopsy report, death certificate, or medical evaluation was obtained, but no alcohol or drugs were
reported to be in the decedent's system, mark "No." If this information is not known, or an autopsy report
or medical evaluation was not obtained, mark "Unknown, did not obtain autopsy report or medical
evaluation."
9
Attachment G. Example of arrest-related death program
launch email to state reporting coordinator
Burch, Andrea
From:
Sent:
To:
Cc: Subject:
Attachments:
Burch, Andrea
Wednesday, January 18, 2012 9:47AM
'[email protected]'
'Strom, Kevin J.'; '[email protected]'
BJS -Arrest-Related Deaths, 2012 Forms
2012 CJ-llA (fillable).pdf; 2012 CJ-11 (fillable).pdf; ARD 2012 Data Provider FAQs.pdf;
ARD 2012 Question-by-Question Guide.pdf; ARD Program Information, 2012.pdf
Alan,
Happy New Year!
Thank you again for your continued participation in the Arrest-Related Deaths (ARD) program. As you know,the purpose
of the program is to account for all deaths occurring during the process of arrest by, or while in the custody of, state or
local law enforcement personnel. With almost 18,000 law enforcement agencies operating nationwide, it would be
nearly impossible for BJS to maintain the ARD program without assistance from you and other State Reporting
Coordinators (SRCs). The ARD program continues to improve in coverage and data quality each year, and we attribute
this success to effective partnerships with our data providers. BJS appreciates your participation and we look forward to
working with you in 2012.
The 2012 CJ-11and CJ-11A forms are available on the Arrest-Related Deaths section of the BJS website:
http://bjs.ojp.usdoj.gov/index.cfm?ty=dcdetail&iid=428. I've attached the 2012 program materials and forms for your
convenience. The 2012 versions of the CJ-11 and CJ-11A forms are identical to those used in 2010 and 2011. While data
may be submitted to the ARD program at any time, we ask that all 2012 forms are received by March 1, 2013.
In addition to launching the 2012 program, ARD staff are currently processing the 2010 and 2011data. If you haven't
already done so, we ask that you submit any identified cases and/or follow-up information as soon as possible. We
hope to have all 2010 and 2011data submitted by March 1,2012 in order to disseminate findings during the first
quarter of 2013. Data can be submitted by mail, email, or fax- please see the contact information below.
As I mentioned in my last email,BJS is committed to improving the ARD program and has solicited the assistance of the
Research Triangle Institute (RTI). Staff from BJS and RTI will work together to maintain day-to-day operations and assess
the strengths and weaknesses of several aspects of the program. The first aspect of the program we would like to assess
is the efficiency of the current design and data collection method.
You will receive an email from Kevin Strom, the ARD Program Director, and Crystal Daye, your ARD staff liaison to set up
a time to discuss your experiences with the ARD program. The purpose ofthis discussion is to introduce you to new ARD
program staff and to learn more about your data collection process and needs. Ultimately, we hope this discussion will
translate into an improved program with reduced reporting burden.
Please feel free to contact me or any other ARD staff member with questions, concerns, or comments. We welcome
your feedback and are relying on your insights to continue to develop the ARD program. You can reach Kevin Strom
([email protected]; 919-485-5729) or Crystal Daye ([email protected]; 919-541-7321) directly,or contact the ARD Help Desk
([email protected]; 1-877-475-7039).
Please submit CJ-11and CJ-11A forms to:
2011- 2012 Forms
2010 Forms
1
Email
[email protected]
[email protected]
Fax
202-616-1351, attention Andrea Burch
1-877-262-7654,attention Crystal Daye
Mail
Bureau of Justice Statistics
c/o Andrea Burch
810 7'" Street, NW
Washington, DC 20531
RTI International
Attn: Crystal Daye
3040 Cornwallis Rd.,P.O. Box 12194
Research Triangle Park, NC 27709
Thanks again,
Andrea
Andrea M. Burch
Program Manager,Arrest-Related Deaths
Bureau of Justice Statistics
U.S. Department of Justice
810 7th St. NW
Washington, DC 20531
202-307-1138
2
ARREST-RELATED DEATHS, 2012
Program Information
The Arrest-Related Deaths (ARD) program is a national accounting of persons who die during the process
of arrest (or attempted arrest) or while in the custody of, or shortly after restraint by, state or local law
enforcement personnel.
For the purposes of the ARD program, an "arrest-related" death is one that occurs anytime a person's
freedom to leave is restricted by state or local law enforcement personnel. This includes deaths occurring
while law enforcement personnel actively pursue or attempt to apprehend persons of interest or criminal
suspects, regardless of whether physical custody is established. In addition, "arrest-related" deaths
include situations in which a formal arrest process was neither initiated nor intended, such as deaths that
involve assistance in the restraint or transport of individuals in need of medical or mental health care.
Deaths reportable to the ARD program include those caused by any use of force by state or local law
enforcement personnel, as well as those not directly related to the actions of law enforcement, such as
deaths attributed to suicide, intoxication, accidental injury, and natural causes. With the exception of
innocent bystanders, hostages, and law enforcement personnel, all persons who die in the presence of
state or local law enforcement, regardless of manner of death, are subject for inclusion in the ARD
program.
Arrest-Related Deaths Summary and Incident Forms
There are two forms (CJ-11 and CJ-11A) association with the Arrest-Related Death (ARD) program.
•
The CJ-11 Form is a quarterly summary of the number of arrest-related deaths occurring within the
state. Each identified State Reporting Coordinator (SRC) is responsible for entering the total number
of reportable arrest-related deaths occurring in each quarter of the calendar year.
If no arrest-related deaths were identified during the quarter, the SRC should enter a count of "zero."
In order to distinguish between states without an arrest-related death and those with missing data, it is
essential for ARD program staff to receive a CJ-11 form for each quarter.
Contact information for each SRC is available on the CJ-11 form.
•
The CJ-UA Form is an incident report completed for each arrest-related death. Official sources of
information should be obtained to complete a CJ-llA form for each identified arrest-related death.
Items 1-19 should be completed for all arrest-related deaths. Additionally, items 20-23 should be
completed only if the death occurred at a police lockup or booking facility.
LINK TO CJ-11 FORM: http://www.bjs.gov/content/pub/pdf/cj ll
12.pdf
LINK TO CJ-llA FORM: http://www.bjs.gov/content/pub/pdf/cj lla
12.pdf
1
Data Collection Process & Schedule
The Arrest-Related Deaths (ARD) program operates on a continuous basis throughout the calendar year.
The ARD program also accepts reports of arrest-related deaths occurring prior to the current calendar
year. In addition, the ARD program accepts updated information for previously reported arrest-related
deaths.
Data are reported to the ARD program through a 3-step process:
1. Identification: Arrest-related deaths are identified by a reporting agency.
2. Data Collection: Information about the incident is collected and recorded on a CJ-IIA form.
3. Submission: CJ-IIA forms are submitted to the State Reporting Coordinator (SRC) and then to
ARD program staff.
PLEASE NOTE:
• Personnel from law enforcement agencies, medical examiner/coroner's offices, and other
reporting agencies should submit CJ-11A forms to their SRC as soon as data are available or on
a quarterly basis. See the CJ-11 form for a listing of SRCs.
•
SRCs can submit data to ARD program staff either quarterly or annually. Regardless of the
submission schedule, the SRC should submit a CJ-11 form for each quarter of the calendar
year. A CJ-11 form and any associated CJ-11A forms should be submitted to ARD program
staff within 60 days of the end of each quarter or all annual data should be submitted within 60
days of the end of the calendar year.
•
SRCs should attempt to identify all arrest-related deaths occurring within their state. The
identification of all arrest-related deaths may require SRCs to develop methods other than
relying on reports from state and local law enforcement agencies, medical examiner offices,
coroner offices, and other reporting agents/agencies.
2
State Reporting Coordinator (SRC) Data Submission Schedule
Quarterly Reporting Schedule:
Quarter
I
2
3
4
Reporting period
January I -March 31
April I -June 30
July I - September 30
October I -December 31
Data due
May 31,2012
August 31,2012
November 30, 2012
March l, 2013
Annual Reporting Schedule:
Quarter
All
Reporting period
January I -December 31
Data due
March l, 2013
CJ-11 & CJ-llA Forms may be submitted by email, fax, or postal mail
Email: [email protected]
Fax:
1-877-475-7039
Mail:
RTI International
Attn: Kevin Strom, ARD Program
3040 Cornwallis Rd. P.O. Box 12194
Research Triangle Park, NC 27709-2194
Please contact Arrest-Related Deaths program staff for any questions or comments
ARD Help Desk
Phone: 1-877-475-7039
Email: [email protected]
Crystal Daye, Program Liaison
Phone: 919-541-7321
Email: [email protected]
Erin Kennedy, Program Liaison
Phone:919-541-7321
Email: [email protected]
Kevin Strom, Program Director
Phone: 919-485-5729
Email: [email protected]
Andrea Burch, Program Manager
Phone:202-307-1138
Email: [email protected]
3
ARREST-RELATED DEATHS, 2012
Frequently Asked Questions- State Reporting Coordinators
1. What does an "arrest-related" death mean?
An "arrest-related" death is one where an arrest subject either died in the presence of
a State or local law enforcement officer or died as a result of actions taken by a State
or local law enforcement officer.
Deaths reportable to the ARD program include all persons in the custody, or under
the restraint oflaw enforcement officers, even if the person was not formally under
arrest at the time of death.
This definition includes those killed by any use of force by law enforcement officers
as well as those whose deaths are not directly related to either police action or
negligence, such as deaths attributed to intoxication, suicide, accidental injury, and
illness or natural causes.
2. Under what circumstances are deaths reportable to the ARD program?
With the exception of innocent bystanders, hostages, and law enforcement personnel,
all persons who die while their freedom to leave is restricted by state .or local law
enforcement personnel are subject for inclusion in the ARD program.
As a guiding principle, please do not exclude a case on the basis that physical custody
had not been established. This point is highlighted through ARD cases involving
officer-involved shootings. Virtually none of these cases involve subjects who were
already in the physical custody of law enforcement personnel.
Alternatively, there are instances where a person dies in the physical custody of law
enforcement although an arrest process had not been initiated. Typically these cases
involve the transport of individuals in need of medical or mental health care. Officers
may restrain a person for their own safety, or for the safety of medical personnel on
the scene. Even though these persons do not .face any criminal charges, they are still
under the restraint oflaw enforcement officers and should be reported to the ARD
program.
Please note that if such persons die at medical/mental health facilities following police
transport, they are reportable to the ARD program only if the final determination of
cause of death is directly linked to the period of law enforcement custody.
I
3. Are instances where the deceased commits suicide included in the ARD program?
Yes.
Suicide is a common type of arrest-related death. Arrest-related suicides can occur
before or after law enforcement personnel establish physical custody of the deceased.
Suicides occurring during the process of apprehension are reportable to the ARD
program if law enforcement personnel are present during the incident and attempted to
detain the deceased.
All suicides occurring in the custody of law enforcement personnel are reportable to
the ARD program. This includes arrest-related suicides occurring at booking centers
and lockup facilities.
Suicides of persons with warrants for their arrest should be reported to the ARD
program if law enforcement personal were present during the event that caused the
death. If law enforcement personnel were not present when a person with active
arrest warrants committed suicide, the death should not be reported to the ARD
program.
If you are unsure whether a death is reportable to the ARD program, please contact
the ARD Help Desk (1-877-475-7039; [email protected]) or submit a CJ-l!A
form.
4. Are vehicular accidental deaths included in the ARD program?
Deaths resulting from vehicular accidents are included in the ARD program iflaw
enforcement personnel engage in direct action against the deceased or the deceased's
vehicle during the process of apprehension. Examples of "direct action" include,
shooting at, ramming, or otherwise forcing the deceased's vehicle off the road (i.e.,
roadblocks, spike strips to blow out tires).
Deaths resulting from vehicular accidents are excluded from the ARD program iflaw
enforcement personnel did not take direct action against the deceased or the deceased's
vehicle. For the purposes of the ARD program, a police pursuit, no matter the speed,
does not meet the "direct action" criteria. Fatal vehicular accidents
occurring during a pursuit by law enforcement personnel should be excluded from the
ARD program ifthat was the only action taken against the deceased.
2
5. Are deaths caused by civilians, during an arrest process, included in the ARD
program?
Yes.
Arrest subjects who die from injuries sustained by non-law enforcement personnel are
included in the ARD program if the injuries were sustained during an arrest process.
Arrest-related deaths caused by civilians may be accidental or intentional.
Example 1: Accidental civilian homicide:
Law enforcement personnel are attempting to arrest a fleeing suspect when the
suspect collides with a civilian operated vehicle and sustains fatal injuries as a
result. This death is considered "arrest-related" because law enforcement
personnel were attempting to apprehend the suspect at the time the fatal injuries
were sustained. In this instance, the manner of death should be recorded as,
"Accidental injuries caused by others" on the CJ-IIA form.
Example 2: Intentional civilian homicide:
Law enforcement personnel are dispatched to robbery in progress at a
convenience store. Upon arrival at the scene, law enforcement personnel discover
a struggle between the arrest suspect and store clerk. The store clerk fatally
wounds the arrest suspect in the presence of law enforcement personnel. In this
instance, the manner of death should be recorded as, "Other homicide" on the CJ
IIA form.
6. Should all deaths resulting from any use of force by state or local law enforcement
personnel be included in the ARD program?
Yes.
Deaths attributed to ANY use of force by law enforcement personnel are reportable to
the ARD program.
Officers are trained to only use lethal force when their own safety or that of other
persons is gravely threatened. The presence of such a threat is a crime. Therefore,
subjects killed by police use of lethal force would more than likely have faced
criminal charges had they survived.
Deaths attributed to "less-than-lethal" tactics (i.e., positional asphyxia due to
restraint) and weapons (i.e., conducted energy devices, chemical agents) are also
included in the ARD program.
3
7. Are deaths that occur while the arrest subject was in the custody of Federal law
enforcement officers included in the ARD program?
Deaths occurring in the presence of officers from Federal law enforcement agencies
(i.e., FBI, DEA, Marshals Service) are only reportable to the ARD program if
personnel from a State or local law enforcement agency was also present during the
event causing the death.
The ARD program was developed to measure the number of deaths occurring in the
process of arrest by state and local law enforcement personnel. Therefore, arrest
related deaths occurring outside the presence of state or local law enforcement
personnel are excluded from the ARD program.
If you are unsure whether a death is reportable to the ARD program, please contact
the ARD Help Desk (1-877-475-7039; [email protected]) or submit a CJ-llA
form.
8. Why are some cases submitted to the ARD program transferred to other BJS
collections?
BJS' Deaths in Custody Reporting Program (DCRP) is currently comprised of three
components, deaths occurring in (1) prisons, (2) jails, and (3) during the process of
arrest.
The deaths of any persons held in police stations (i.e., for interrogation) or in a short
term booking facility are included in records of "arrest-related" deaths. Once an
arrestee is booked into a jail, (i.e., a facility that typically holds offenders after
arraignment, during adjudication and for sentences of less than a year) their death is
excluded from the ARD collection and captured in BJS' Jails collection.
If you are unsure whether the death occurred in a police booking center, police
lockup, or a local jail please either contact the ARD Help Desk (1-877-475-7039;
[email protected]) or submit a CJ-llA form.
ARD program staff reconciles all submitted cases to ensure each record is recorded in
the appropriate collection and that cases are not duplicated in the ARD and Jails
programs. If cases submitted to the ARD program are transferred to either the Jails
or Prisons collections, the ARD program staff will indicate it on a status report sent to
you.
4
9. Where can I obtain 2012 CJ-11 and CJ-11Aforms?
The 2012 CJ-11 and CJ-11A forms are available through the BJS website:
http://bjs.ojp.usdoj.gov/index.cfm?ty=dcdetail&iid=428
Forms can also be obtained by contacting the ARD Help Desk:
Phone: 1-877-475-7039
Email: [email protected])
10. How do I submit CJ-11 and CJ-11Aforms to ARD program staff?
Please submit CJ-11 and CJ-11A forms to ARD program staff within 60 days of the
end of each quarter or submit all annual data within 60 days of the end of the
calendar year. Forms can be submitted through email, fax, or postal mail.
Email:
[email protected]
Fax:
1-877-262-7654
Mail:
RTI International
Attn: Kevin Strom, ARD Program
3040 Cornwallis Rd. P.O. Box 12194
Research Triangle Park, NC 27709-2194
5
ARREST-RELATED DEATHS, 2012
CJ-llA Question-by-Question Guide
Item 1: What was the name of the deceased?
Please provide the deceased's legal name (last, first, and middle initial). All information
identifying individual decedents will be kept confidential in accordance with the provision of
section 812 of the Omnibus Crime Control and Safe Street Act of 1968 as amended (42 U.S.
C. 3789g). Names are solely used by ARD program staff to identifY records and to ensure
there is no duplication in reporting within the ARD program or across other BJS Deaths in
Custody Reporting Programs (DCRP), such as the "Jails" or "Prisons" collections.
Item 2: What was the time and date of the death?
In an effort to standardize responses across reporting agents, please indicate the "official"
time and date of death, if known.
The official time and date of death indicate when the deceased was pronounced dead by
either medical personnel or another authorized official. The official time and/or date of death
may be different from the time and/or date of the fatal event. If the official time and date of
death are unknown, please estimate the time and date ofwhen the fatal injury was sustained.
Please indicate when estimating the time and date of the fatal event.
Example 1: During the process of arrest, the deceased sustained a fatal injury (e.g.,
gunshot wound, blunt force trauma) and died at the scene ofthe event. The most
appropriate response to this item would reflect the time and date the deceased was
pronounced dead by an authorized official, regardless of whether the pronouncement
occurred at the scene or medical center. If the official time and date of death are
unknown, please estimate the time and date of when the fatal injury was sustained.
Example 2: During the process of arrest, the deceased sustained a life-threatening
injury (e.g., gunshot wound, blunt force trauma) but did not die until
hours/days/weeks later. The most appropriate response to this item would reflect the
time and date life ceased rather than the time and date the injuries were sustained.
I
Item 3: Where did the event causing the death occur?
The purpose of this item is to identify the location of the event causing the death, not the
location of where the deceased was pronounced dead (e.g., medical center). Please provide
the address or the approximate location (i.e., street intersection, neighborhood) of where the
deceased was injured or developed the condition causing the death.
Example 1: During the process of arrest, the deceased sustained a life-threatening
injury (e.g., gunshot wound, blunt force trauma) at his home but died later at a
medical facility. The most appropriate response to this item would be the street
address of the deceased's residence. If the exact location of the event is unavailable,
please give the best approximate location (intersection, part of town, neighborhood).
Item 4: What law enforcement agency was involved?
Please list the name and Originating Agency Identifier (ORI) number of the law enforcement
agency involved in the arrest-related death. If officers from multiple law enforcement
agencies are directly involved, please list all relevant agency names and ORI numbers.
When multiple agencies are involved, please list the primary agency first.
The ORI number is a 9-character alpha-numeric identification code used by law enforcement
agencies to report and access data. All law enforcement agencies are issued ORI numbers by
the FBI. ORI numbers are not derived from the incident or case number generated by the
reporting law enforcement agency. If you are unsure of the ORI number for the relevant law
enforcement agency, leave the item blank and enter only the agency name.
Please note, for a death to be reportable to the ARD program there must be one or more
officers/deputies from either state or local law enforcement agencies present during the
incident that led to the death. Deaths involving only officers from Federal law enforcement
agencies (e.g., FBI, Marshalls, DEA) are excluded from the ARD program.
Item 5: What was the deceased's date of birth?
Please indicate the specific data of birth when known. Note: This item was amended from
previous versions of the CJ-IIA to include the option of providing the deceased's age at
death when the month, day, and year of birth are unknown.
Item 6: What was the deceased's sex?
If the deceased sex is not known, please leave blank.
2
Item 7: What was the deceased's race/ethnic origin?
Any Hispanic persons should be recorded as "3-Hispanic or Latino" regardless of whether
their race is white, African-American, Asian, American Indian, or Native Hawaiian.
If the deceased's ethnic origin had any combination of non-Hispanic categories, please
record them as "7-Two or more races (not of Hispanic origin)."
These categories comply with guidance set forth by the White House Office of Management
and Budget (OMB).
Item 8: What was the manner of death?
The "manner" of death is "how" the person died, typically illustrated by a one word
description of intentions and circumstances which led to the stated medical cause of death.
Essentially, the manner of death is the way in which death was caused; homicide, suicide,
accidental, natural, or undetermined.
If a medical examiner or coroner classified the death as "undetermined," please mark "80ther" and specify "results of the evaluation were undetermined."
With respect to deaths due to alcohol/drug intoxications, please specifY the substance
causing the death and code responses as:
• Intentional alcohol or drug overdoses as, "3- Suicide"
•
Unintentional over use of alcohol or drugs for recreational purposes as, "6 Accidental alcohol/drng intoxication"
•
Unintentional over use of alcohol or drugs for concealment purposes (i.e., arrest
suspect swallows packets of drugs in an attempt to hide them from police and the
packets rupture and thereby cause the death) as, "4- Accidental injury to selr'
Item 9: What was the cause of death?
Unlike the "manner" of death, which describes the circumstances leading to one's death,
"cause" of death is a description of the specific medical factors leading to the termination of
the biological functions that sustain life. In cases where cause of death is attributed to
multiple factors, please list the primary cause of death first.
Example 1: During the process of arrest, the decease sustained a gunshot wound and
subsequently died as a result of massive blood loss. A response of "gunshot wound"
3
would suffice as a cause of death regardless of the manner of death (i.e., homicide by
law enforcement, other homicide, suicide, accidental injury to self, or accidental
injury caused by others).
Example 2: During the process of arrest, the decease swallows a packet of cocaine in
order to conceal the narcotics from arresting officers. The packets subsequently
rupture, causing the deceased to overdose. A response of "cocaine toxicity" would
suffice as a cause of death.
Item 10: Was the cause of death listed about determined from information in a death
certificate,
This item was added to 2010 CJ-1 lAin 2010 in an effort to identify the source of
information pertaining to the cause of death.
If information regarding the cause of death was derived through a death certificate (whether
the death certificate was physically obtained or information from the death certificate was
provided indirectly through another source) please mark the response as, "1 -Yes,''
If a death certificate was not consulted to obtain information regarding the cause of death,
please mark "2- No-Other" and specify the source of the information (i.e., police report,
media report).
Item 11: Did the deceased commit or allegedly commit any criminal offenses in the events
leading up to the death?
This item was amended from previous versions of the CJ-l!A. The item was modified to
make its intent more clear and to address concerns regarding the use of the word "charges."
The purpose of this item is to identify whether the deceased allegedly engaged in criminal
behavior, instead of whether "charges" would have been filed by a prosecutor had the
deceased survived the incident.
Please code responses as:
• "01- Yes" indicates the officer(s) engaged in an arrest process because the
deceased committed or allegedly committed a criminal offense.
Example 1: Law enforcement officers discover a bank robbery in progress. A
gun battle between the suspect and officers ensues. The suspect dies as a
result of gunshot wounds. The appropriate response to this item is "01 Yes." Furthermore, responses to Item 12 are likely to include, "attempted
murder" and "robbery."
4
Example 2: Law enforcement officers are dispatched to a residence of a
person threatening to commit suicide. When the officers arrive on scene they
find a distraught person holding a gun. The officers instruct the person to put
down the weapon, instead the person points the gun at an officer. The officers
fatally shoot the person they were initially trying to assist.
The appropriate response to this item is "01 -Yes" despite the fact the initial
reason for contact was a mental health assistance call. In this instance, a code
of"02- No- medical/mental health assistance call" would not be accurate
because the deceased engaged in criminal behavior when he pointed a gun at
the responding officers. Furthermore, a response to Item 12 could be "assault
(on a police officer or with a deadly weapon)."
• "02- No- medical/mental health assistance call" indicates the officer(s)
involved were not actively engaged in an arrest process. Law enforcement
officers are sometimes tasked with transporting persons to medical or mental
health facilities because these persons present a danger to themselves or others.
If these individuals die in the custody of an officer, or due to officer use of force
or restraint, the death is reportable. This response indicates that the deceased did
not engage in any criminal behavior (i.e., assault), regardless of how the contact
with law enforcement officers originated.
Example 3: Law enforcement officers are dispatched to a residence of a
person threatening to commit suicide. When the officers arrive on scene they
find a distraught person holding a gun. The officers instruct the person to put
down the weapon. The person runs into the house and then commits suicide.
In this instance, the deceased did not threaten anyone or engage in other
criminal behavior prior to committing suicide. Therefore, the appropriate
response to this item is "02- No medical/mental health assistance call."
Furthermore, a response a response to Item 12 should be "Not applicable"
because although the death occurred in the presence of police, the deceased
did not commit offenses prior to death.
• "03- No- other- Specify" indicates all deaths that occur in the presence of law
enforcement officers in which the deceased did not engage in criminal behavior or
require medical/mental health assistance. Please briefly specify the circumstances
that led to the encounter between law enforcement officers and the deceased.
5
Example 4: Law enforcement officers are dispatched to a residence in
response to a 911 call indicating a burglary in progress. Officers enter the
home and find a man hiding in a closet. When the officer opens the closet
door, the man stands up with a baseball bat in his hand. In the heat ofthe
moment, the officer believes he has encountered the burglar who is planning
to assault him with the baseball bat. The officer fatally shoots the man in the
closet, who turned out to be the home owner hiding from burglars.
In this instance, the deceased did not engage in criminal behavior, instead the
death was the result of mistaken identity. Therefore, the appropriate response
to this item is "03- No- other." Furthermore, a response to Item 12 should
be "Not applicable" because had the deceased survived the incident, he would
not have been arrested for a criminal offense.
Item 12: What were the most serious reported offenses committed by the deceased?
This item was amended from previous versions of the CJ-llA. This item was modified to
address concerns regarding the use of the word "charges." The purpose of this item is to
identify the alleged criminal offenses committed by the decedent that either (I) led to the
initial contact with police, and/or (2) occurred during the contact with the police. Please rank
order offenses in terms of the degree of severity.
If the deceased committed no alleged offenses, please write, "Not applicable."
Example 1: An armed suspect robs a store clerk and flees from police. The suspect
then leads law enforcement officers on a high-speed car chase before crashing. The
suspect fatally shoots one of the officers when they approach his vehicle. The
officers return fire and kill the suspect. In this instance, the appropriate response to
this item is:
a.
Homicide of law enforcement officer
b.
Armed robbery
c.
Fleeing and Eluding
Item 13: Did the deceased die from a medical condition, injuries sustained during the arrest
process, or alcohol/drug intoxication?
This item was amended from previous versions of the CJ-llA. The item was modified to
include the response category, "03- Alcohol/drug intoxication." The response category was
added in order to consistently categorize deaths attributed to alcohol and drug intoxications.
Respondents should no longer use categories, "01- Medical condition" or "02- Injuries" to
describe deaths due to alcohol/drug intoxication.
6
This item allows for multiple response categories to be mark. If "0 I - Medical condition" or
"02 - Injuries" are marked in addition to "03 -Alcohol/drug intoxication" the decease should
have an additional medical condition or sustained additional injuries that caused the death.
Item 14:
If the deceased died from arrest-related injuries, how were these injuries sustained?
Please note that multiple responses can be marked to allow for responses where the deceased
was injured by multiple parties. The response to this item should account for injuries that
occurred at the initial scene, as well as injuries sustained at any secondary locations.
Example 1: Law enforcement personnel respond to a mental health assistance call.
When officers arrive on scene, the deceased is holding a gun and threatening law
enforcement personnel. The deceased shoots at law enforcement before shooting
himself in the head. Officers return fire striking the deceased in the head and torso.
An autopsy ruled that both the deceased's bullet and the officer's bullet were fatal.
Therefore, an ,appropriate response is, "0 I -Inflicted by law enforcement officers at
the crime/arrest scene" AND "05 -Self-inflicted- Suicide."
Example 2: Law enforcement personnel respond to a robbery in progress at
shopping center and begin pursuing a fleeing subject. In an attempt to elude law
enforcement, the deceased jumps through a store Window and cuts his femoral artery
in the process. The deceased continues into oncoming traffic and is struck by a
vehicle. In this instance, the appropriate response is "02 - Inflicted by others at the
crime/arrest scene" AND "04- Self-inflicted- Accidental."
If the deceased suffered no injuries, and died solely from medical problems or alcohol/drug
intoxication, mark "99- Not applicable"
Item 15: Were any of the following used by law enforcement officers during the arrest
process?
This item was amended from previous versions of the CJ-IIA to include the response
category, "05- Firearm discharge."
The "05- Firearm discharge" category was added in order to capture events where law
enforcement officers discharge their service weapons during the arrest process. Please note
the purpose of this item is to indicate incidents in which law eriforcement officers fired their
service weapons at any point during the incident, even if the deceased did not sustain a
gunshot injury. The purpose of this item is not to capture incidents in which the deceased
fired a weapon (see Item 17).
7
Any use of restraint devices or weapons, even if they were not a cause or contributing factor
in the death, should be reported here.
If multiple types of restraints or weapons were used on the deceased, please mark all that
apply.
If law enforcement personnel used a restraint device or weapon that is not listed, please
indicate the response, "06- Other device- specify" and write in device or weapon used
during the arrest process.
Item 16: At any time during the arrest/incident, did the deceased....appear intoxicated?
...exhibit any mental health problems? ...verbally threaten the ojjicer(s) involved? ...resist
being handcuffed or arrested? ...attempt to escape/flee from custody? ...grab, hit or fight with
the ojjicer(s) involved?
The purpose of this item is to describe the full range of behaviors exhibited by the deceased
during the events that led to an arrest-related death.
Please note that multiple responses can be provided to this item.
Item 17: During the arrest process, did the deceased ....carry or possess a weapon? ...use a
weapon to threaten officer(s)? ...use a weapon to threaten other persons? ...use a weapon to
assault the officer(s)? ...use a weapon to assault other persons?
This purpose of this item is to measure weapon possession or use by the deceased, against
law enforcement personnel or other persons on the scene (e.g., hostages, victims). The
response categories have been defined to distinguish between those arrest subjects who only
possessed weapon(s) and those who actively used weapon(s) to threaten or assault others.
Please note that any weapon (e.g., knife, firearm) or object used as a weapon (e.g., vehicle,
chair, pipe, table) should be reported. Please mark all categories that apply.
Please code responses as:
• 01 -Carry or possess a weapon- to indicate the deceased was in possession of a
weapon, regardless of whether the deceased used the weapon in a threatening or
assaultive way against either law enforcement officers or other persons.
Example 1: Suspect is fleeing from police on foot when fatally struck by a
vehicle. Fallowing the accident, law enforcement officers search the suspect and
discover a handgun in the deceased's waistband. The deceased did not reveal or
use the handgun at any point during the arrest process.
8
• 02- Use a weapon to threaten the officer(s)/03- Use a weapon to threaten other
persons - indicates the deceased possessed a weapon and used it in a manner to
intentionally cause negative outcome(s) such as fear, injury, or damage.
Example 2: Suspect is fleeing from police on foot while visibly carry a handgun
when fatally struck by a vehicle. Before suspect is hit by the vehicle, the
deceased points the weapon at police and driver, but does not fire. Response
categories "01 -Carry or possess a weapon," "02- Use a weapon to threaten the
officer(s)", and "03- Use a weapon to threaten other persons" should all be
marked in this instance.
• 04- Use a weapon to assault the officer(s)/05- Use a weapon to assault other
persons - indicates the deceased possessed a weapon and used it in a manner to
intentionally cause imminent harmful or offensive contact.
Example 3: Suspect is fleeing from police on foot while shooting at pursuing
officers when fatally struck by a vehicle. Before the suspect is hit by the vehicle,
the deceased fires 4 bullets at pursuing law enforcement officers. Response
categories "01 -Carry or possess a weapon," "02- Use a weapon to threaten the
officer(s)," and "04- Use a weapon to assault the officer(s)" should all be marked
in this instance.
Item 18: /fa weapon caused the death, what types of weapons were used?
This item should be completed for all deaths, regardless of the manner of death.
The purpose of this item is to identify specific weapon(s) that caused the death, instead of
weapons that were used during the arrest process. All weapons used by law enforcement
during the arrest should be listed under Item 15. Please limit response to Item 18 to
weapon(s) in which death was attributed.
If a weapon involved in causing the death is not listed in Item 18 (e.g., vehicle), please mark
"06 - Other weapon".and specify the type of weapon causing the death.
This item was amended from previous versions of the CJ-11A. The item was modified to
include the response category, "98- Don't know." In addition, the response category "07None" was modified to "99- Not applicable" in order to account for deaths not due to the
use of a weapon.
9
Item 19: Where did the deceased die?
This item was amended from previous versions of the CJ-IIA to include the response
category, "04- Dead on arrival at medical facility."
The response category was added in order to more clearly determine where the cessation of
life occurred. An analysis of ARD cases indicated that although deaths were occurring at the
crime/arrest scene, they were coded as occurring at a medical facility. These deaths were
coded this way because the death was officially "pronounced" at the medical facility even
though life ended at the crime/arrest scene.
The item" 04 -Dead on arrival at medical facility" is meant to distinguish between persons
pronounced dead at medical facilities who did not receive medical intervention before death
from persons who were pronounced dead after receiving medical intervention.
SURVEY COMPLETE FOR DEATHS OCCURING PRIOR TO ARRIVAL AT A
BOOKING CENTER OR LOCKUP FACILITY.
Item 20: What was the time and date of the deceased's entry into the law enforcement facility
where the death occurred?
If an exact time of entry is not available, please provide the nearest hour estimate.
Item 21: At the time of entry into the facility, did the deceased ...appear intoxicated? ...exhibit
any mental health problems? ...exhibit any medical problems?
Similar to Item 16, the purpose of this item is to describe the arrestee's behavior and health
status within the context of the fatal events. Please note that multiple responses can be
provided to this item.
Item 22: If the death was an accident or homicide, who caused the death?
If death was attributed to suicide, intoxication, or illness/natural causes please mark, "99 Not applicable."
Item 23: If the death was an accident, homicide or suicide, what was the means of death?
This item is not related to the manner (item 9) or medical cause of death (item I 0), but rather
to the physical means by which the death was caused.
10
CJ-11
OMS No. 1121 0249 Approval Expires 12/31/2012
Si.tte teportillg COC)rdin.-t9t
(See back of this form
a nationallisting.)
SUMMARY OF
ARREST-RELATED DEATHS, 2012
.
.
NAME
·.·
..
TITLE
I
FAX
IArea CodeiNumber
NUMBER!
I
TELEPHONE Area Code Number
E-MAIL
ADDRESS
smre
Reporting Period (Mark only one.)
INCLUDE deaths of ALL persons in. the process of arrest or
i.n the presence of state or local law enfo.rcement qfficers.
0 Quarter 1 (January 1 March 31)
0 Quarter 2 (April 1 -June 30)
0Quarter 3 (July 1 -September 30)
0 Quarter 4 (October 1-December 31)
During the reporting quarter marked above, how many
persoris died while in the process of arrest or in the custody
of law enforcement agencies in your Stare?
fe!l}a,le
-_Killed by any use of force by lc:iw enforcement officers;
_...,.- ·the physica-l,custody, or under the physiccil restraint of law
- enfOrcement officers, even if the person was not formally under ·
arrest at the time;
At crime/arrest scene or medical facility prioto bOoking;
-Killed in vehicular pursuit accidents during which law enforcement officers took direct actk>n against the driver or vehicle ·
(e.g., shooting at the suspect, forcing the vehicle off the road
Wlth an obstruction, spike strip, or the officer's own vehicle);
-V\fhil_e in transit to or from la:W enforcement facilities;
-:- _Vyhile confined in lockups ol- bo_ok!ng centers (facilities from
·Which arrestees are ususally transferfed witi1in 72 hours and not
_held beyond a'.rrai_gnment).
-
· •· ''"·Cc•rifi,,ed iri local jails, State prisons, st teij enile .,;,[reclioh'll
(acijities, or private correctional facilitie"i ' , • . .
'
'- "- - ilted
by Feger -:la enfo cemenJ' ge_ntsi- n:Bh.:peith.e. _sta!e, .
: c:nor>l()caii?W enforcement_officers Were_:Piese:t" :t;:_,:}. - :<" - - c_ ·),
_:;<,,.·Knt:e:d;inthe.coursetoflav;;._ nfOrce erlt-'c:l,_c,ti\lit!eS:;':i ainst !lorri:_-,:_:
l<; wenforcemeht pers nnel) · •
•, :
Instructions:
• If no deaths ,occurred, please fax the completed
\::J-11 form to your sffitjl reporting coordinator
(see back of this'sheet).
For each death reported, complete at) ('.rrest-Related
Death Report (CJ-11A). Please complete items 1
through 1,9 foreach death, plus thremaining items
for all deaths at a tlooking cenrer or police lockup
• facilfty.
· ·
E ter the na :;dfte decea ed in the Spy:s_f.:lrt _e_rs;:-0p i g- SJ' _-
·..• .·
Number of deaths
> •; : , · U ; .:.
,.· · ·
< :_.,,-:
, , · --
· ··
-
-
-
1.·--;- ou n.- d···.a.:-.-ss..·.·i· ·i.;fa.':._;H .;-- - nia f'yo. r-stai ': ePo.·.·.· }h_- ;.:
, - -- C9ordi11atof:; ;Qf-t ,A ff t-Rel ted _Qeaths Hel_p oe ·-
.•., .· ...... ,,aiH774 5:Jll3$ r A'RDH.elpDesl\@rti.grg:·
..;.•.i;:;
,._,:;:_ 1:-;:
lhis-q r:t tiy U rW :dt a d kth' Qt::i t -Ji-i?o:-
: ;: )0Jiio:die befpe coming:into·contaCt With-F :riYd _w_:- !1f r9:etn ntt;_,}: :;,c=::,-<-/-'-'"-: :-::officers (e.g;., subjects o- :arre t- a rantr:;,WhP:.dJ di:be,fOt -:anY,:;--:_:.:- :.:'::.:
Ret6f
arrestprocess began). .
·, · • . ·•
·.
, •>
'
·
·<
.7""-K_med in vehicular accjdents_dUrinfl;:which laWeljforcer;nent offP:_>-;._
cerdid NOT take any direct action a·gai st t e-,(:li:iver,or'yehicfe':-.>
(see last item under "INCLUDE" for exal"ffples·of such- actions).
• :· :•cJ-11Aforrri t)lour statiHeporting coordinato[
- ;;;< -
- -_within 60 f!YS o(ihe end a;f eacl\ quarter.
BUrdeil' Statement
:; nder the Pa-perwork Reduction Act, we cannot ask You to respond to a colleCtion of information unless it displ_ays a cUrrently valid OMB cOntrol number. The burden of
. :this collection is estimated to average 5 minutes per·response, including reviewing instructions, searching existing_ da$ sources, gathering _necessary data, and,_,
_ :completing and. reviewing this forin. Sens:l comments regardif1g this btJrden estimate or a y_ aspect of this survey, ihJ:IiJding sv_g_g_estions for,redu_sinQ this ,b.urden, to, the
DJrector, Bureau of Justice Statistics, 81-0 Seventh V t, N.: · _Washington, DC 20531.
- ·"
-
National listing of state reporting coordinators
Alabama:
:Alabama "·'·'"'""' Justice Info. Center
PH: (334) 517-2415 FX: (334) 517-2740
Kentucky: Tanya Dickinson
Kentucky Justice & Public Safety Cabinet
PH: (502) 564-7554 FX: (502) 564-6686
North Dakota: Colleen Weltz
Office of Attorney General
PH: (701) 328-5527 FX: (701)328-5510
Alaska: Alan McKelvie
Alaska Statistical Analysis Center
PH: (907) 786-1809 FX: (907) 786-7777
.Louisiana: Kim Eiland
Louisiana Department of Corrections
PH: (225) 342-6630 FX: (225) 342-3095
Ohio: Lisa Shoaf
Office of Criminal Justice Services
PH: (614) 466-5997 FX: (614) 466-0308
Arizona: Phillip stevenson
Arizona Criminal Justice Commission
PH: (602) 364-1157FX: (602) 364-,1175
Maine: David King
Office of the Chief Medi.cal Examiner
PH: (207) 624-7180FX: (207) 624-7178
Oklahoma: Angie Baker
Office of Criminal Justice Statistics
PH: (405) 858-5271 FX: (405) 879-2301
' Maryland: Jeffrey Zuback
· Arkansas: Crystal Daye
..
Arrest-Related Deatfls Program Staff
PH: (919) 54F\J21 FX: (877) 262-7654
..
Ofegon: Lee Anna Behnett-Ashworth
..
Office of Public Health ..
PH: (971) 673-0129 FX: (971) 673-0990
Goveinor's Office of Crime Control & Prevention
PH: (410)821-28,55 FX: (410) 321-3116
fVIassachusetts: Lisa Sampson
Pennsylvania: Darlene Hurley
Executive Office of Public Safety anp Security Office of Criminal Justice Systems Improvement_
PH: (617) 725:3361. F: (617)J25-026q
. PH: (71(.) 265'8522 FX: (717}772-0550
alifornia: Amber Lozano·
i •Criminal Justice Stati.stics Center
.PH: (9.16) 227-3545 FX: (916) 22Hl427
Michigan: Ebb.ethPizz
.•·,·, ,. •'
;Rhode lslansJ: Thomas Mongeau
'
Michigan State Police .
•.·i:, :..: : ;:·'· .,:ghode lslandDepartmet of PublicSa'fet ··
PH.: (517) 241-1907 FX: 5J7)24;1-1'9,04
PH: (401) 222-2620 FX: (401) 222-1294 . •:;
· olorad&: Kiln English .
. ..•
Colorado Department of Public Safety·,
;PH: (303) 239-4453 FX:. (303) 239'449.1.
f? :
Connecticut:Ivan K4Zyk
Connecticut Office of Policy & Management
PH: (860) 418-6238 FX: (860) 418-6496
'Delaware: Julia Cahill
beiaware Statistical Analysis Center .
PH: (302)739-2589 FX: (302).739-4630
District of Columpia: Sgt. Harry Hill
Office of the Assistant Chief of Police
·PH: (202) 576-3394 FX: (202) 727-3307
f!orida: Susan Burton
Florida Department of Law Enforcement
PH: (850) 410C7140 FX: (850) 410-7150
teorgia: Erin Kennedy
;Arrest-Related Deaths Program Staff
PH: (919) 485-5736 f;X:(87) 262-7654.. :
!VIlnnesqta: Carolyn Robinson
fvlinnesota Bureau of Criminai Apprehension
PH: (651) 793-1054 FX: (651) 793-1001
South Carolina: Robert McManus
South Carolina Departmerlt of Public Safel)i>:
PH: (803) 896-8717 FX: (803) 89.6-8393 .
!Vfississippi: Alan. Thompson
Universi!Y of Soythem Mississippi
PH: (601) 266-6172 FX: (601) 266-4391
South Da!'• ;:
! :{ ·.. ..•.•. •. :..
L'
<;
:HaWaii: DajniJI Ka'ulein
-- --
-
:,IUihois: r\;\ark Pqwe[s .':..........
•..
;:.,·• .'t :NeW Jer.ieY:, Jn Petherbridgec:
•••·••· ji
·,llli,nois Criminal Justice Information Au!hority
Division of CriminaJ,Juslice
: :·· ' : • , '
PI;\: (312) 793-8550 FX: (312) 793-8422, :
PH: (609) 984'-5693 FX; (609)984-3381 :
-
.
.
.
.
:
.
.
:;,:: ::;/·
:' >:-,_ /':
_;
:washingtort: Tanya Todd ·
·· Association of Sheriffs.& Chiefs ofROiice
PH: (360)486,2380 FX: (360) 486.'2381
::
Indiana: Stephahie Trueing
.
fnqiamDepartment of Corrections
PH: (317) 234-4417. FX:. (317) 23.3-1474
Iowa: Paul Slageberg
l.owa Div. of Criminal & Juvenile Justice Plan
PH: (515) 242-6122 FX: (515) 242-6119
.
New fll!exico: l_isJ Brody
New Mexico Statistical Analysis Center
PH: (505)277-4257FX: (505) 277-4215
, W,est Virg,inia: Monika sterling
pivision of Justice and CofllmUnity Servite,s
PH: (304) 55 -8.814 FX (304) !\5 -0391.
New York,'Adam' Dean
Division of CriminaJustice SerVices
PH: (518) 457-1149 FX: (518) 485-8039
• Vvisconsih: Erin Kennedy
·Arrest-Related Deaths Program Staff
PH: (919) 485-5736 FX: (877) 262-7654
:
CJ-11 A ADDENDUM
OMB No.1121-0249 Approval Expires 12/31/2012
RETURN TO:State reporting coordillator
font) CJ11A ·•.· . •
ARREST-RELATED.DEATH.REPORT
{See form Q-1.1 foro nationollisting,or<;olltheBureduol
JusticeStatistics at 202.307.0765.)
State
_
Reporting period (Mark only one)
0
2012
Quarter 1 (January 1-March 31)
0 Quarter 2 (Aprill-June 30) 0 Quarter 3 (July 1-September 30) 0
Quarter4 (October 1-December 31)
t. Wltatwas the !lame <;>f the ci C:easetH
fi!Sl
98 () .Don't know
13;. Did.the ceaseddie frofT) ?melliG1l conditi<;>n, injuries
suslainedduring tlie arrest pr<;>cess,or alcohol/drug ·
intoxication?.,.,-Matk (ic) allthat apply
01[]Medical conclition {e.g., heart artac )
02
0 Injuries
03 QAicoliol!drug intoxication ·
98
0 Don't know
Burden Statement
Under the Paperwork Reduction Act, we-cannot ask you to respond to a colleCtion of information unless_ it displayS a''curri:mtl_Yvalid OM Conti-01 number.
bu-rden of this cotlection is estimated to average 60 minutes per response,-including reviewing instructions, seaoching existing data sources, gatl:lerlng necesSary
data, and completing and reviewing this form. Send comments_ regarding this burden estimate or any a5p_ect ohhis survey, including suggestfonsf,or reducing this
burden, to the Director, Bureau of Justice Statistics, 810 Seventh St!:eet, N.W., Washington, DC 0531.
,
,
Name of deceased
_
14:..1{the deceased died from arrest-relatedinjuries, h.ow
were .the. s..e. injuries sustaine.d?--,M.ark(x) all that apply
l9..Where did the death.occur?
0 :At_.booldng· c_enter/poljce'JoCkuP-.coriw_leteltemsio-23
02 :o:At:ti-jtne/arre.st sq fle
03_ 0·· At medica facility.foJiowif19 dlnical intervention Form
04 :0· Dead OJ1 arrival at medical facility
complete,
o·l
Jriflicted. b dciW enfo_rceinent dffi,ers at crime/arres.t _Si: ne.
os··o·tri·':r0ute·to·b0oldn9 <: nter(police iockup
015. 0 Elsewhere
stophere
·SpedfyJO_CqtiOn· -- ------c.<>fl1pl.,tetlle rest .of this fornjol'\ly iftlie death occurred at a
bookii)gcenter.
·
·
Specify-,-"',---,.-----,---------
97
99 D Not appttcabie;·caus:e of death was intoxication or illness
0 None ofthe above
Notes
18. If a INeapon caused.the death, whattypes. of weapons
were used? Mark(x)all that l1ppfy
01 0Handgun
02
Rifle/shotgun
0
03. [J Fkearm,unspedfied
04 Q Nightstick or baton
05
Conducted energy device
06''0 Other _weapon
0
Speci(y:
98 Cl Don'i.know
99 0 Not applicable
-
-
-
Attachment H. Example of arrest-related death ‘status
report’ to state reporting coordinator
Andrea Burch
March 14, 2012
Colorado: Laurence Lucero
Colorado Department of Public Safety
ARREST-RELATED DEATHS, 2010
STATUS REPORT
TOTAL: 16 Deaths
14 Deaths recorded (one case pending transfer),
2 Death unrecorded and need CJ-llAs
3 Deaths excluded from ARD and transferred to the Jails
Quarter 1:
1.
e, Patrick
(January 9th)
• File incomplete:
o Item 9 - What was the cause of death
2.
1, Mathew
•
3.
•
File complete.
Roberto
(February 15th)
File pending transfer to the Deaths in Custody Reporting Program (DCRP)-Jails
collection. If this record was reported to the Jails collection by the Arapahoe Co
Detention Center, it will be removed from the ARD collection.
(February 26th)
•
, Jose C.
File complete.
(February 26th)
•
Juan L.
·ne complete.
4. I
5.
6.
(January 27th)
, Joyce
(March lOth)
• File complete.
o Manner of death (Item 8) was changed from response "02 - Other homicide" to
"04- Accidental injury to self." This change was based on (I) the notes provided
on the CJ-IIA form indicating the deceased lost control of her vehicle and struck
a fixed object and (2) the response to Item 9, indicating the cause of death as
"multiple blunt force injuries to the head due to automobile.
!, Nicholas A.
•
•
(March 1 rJh)
File transferred to DCRP- Jails collection.
o Reports indicate the deceased was arrest on February 241 h and being held at the
Boulder County Jail at the time of death. The Boulder County Jail is responsible
for reporting this death to the DCRP -Jails collection.
Roger R.
(March 13'h)
File transferred to DCRP -Jails collection.
1
Andrea Burch
March 14, 2012
o Reports indicate the deceased was arrest on February 15'" and being held at the
Larimer County Detention Center at the time of death. The Larimer County
Detention Center is responsible for reporting this death to the DCRP- Jails
collection.
Quarter 1:
7.
•
8.
•
9.
, Zak
(April 14th)
File complete.
o Manner of death (Item 8) was changed from response "02 - Other homicide" to "0
I -Homicide by law enforcement officers." This change was based on (1) the
response to Item 9, indicating the cause of death as a "penetrating gunshot wound
of chest due to police involvement," (2) the response to Item 14, indicating the
arrest-related injuries were inflicted by law enforcement officers at the
crime/arrest scene, and (3) the notes on the CJ-IIA form indicating the deceased
was "shot by an officer."
Kenneth Sr.
File complete.
(May 16th)
. Arturo
• File complete.
o Manner of death (Item 8) was changed from response "02 -Other homicide" to
"01 -Homicide by law enforcement officers." This change was based on (I) the
response to Item 14, indicating the arrest-related injuries were inflicted by law
enforcement officers at the crime/arrest scene and (2) media accounts of the
event indicating law enforcement personnel fatally shot the deceased.
Quarter 3:
10.
•
Marvin L.
File complete.
o Manner of death (Item 8) was changed from response "02 - Other homicide" to
"01- Homicide by law enforcement officers." This change was based on (1) the
response to Item 14, indicating the arrest-related injuries were inflicted by law
enforcement officers at the crime/arrest scene and (2) the coroner's report
indicating the deputies actions (applying body weight to restrain, the use of a
"sleeper hold" and taser shocks) caused the death.
o Item 15 was changed from response "98- Don't know" to "01- Yes, with the
additional responses of "0 I - Handcuffs, "04 -Conducted energy device, and
"06 - Other, specified as cartiod compression" marked.
o Item 16 was changed from response "98 -Don't know" to "04 - Resisted being
handcuffed or arrested" and "06 -Attempt to grab, hit or fight with the officers
involved.
o Item 18 was changed from response "05 ...Z:onducted energy device" to "98Don't know.' This change was based on the coroner's report, which did not
indicate the Taser as the cause of death. The use of a Taser is capture in Item 15.
2
Andrea Burch
March 14,2012
11.
. , Jason A
• File complete.
12.
•
•
Quarter 4:
13.
•
14.
•
15.
(July 20th)
Alfred R.
(August 1")
File complete.
o Manner of death (Item 8) was changed from response "02 - Other homicide" to
"01- Homicide by law enforcement officers." This change was based on (1) the
response to Item 14, indicating the arrest-related injuries were inflicted by law
enforcement officers at the crime/arrest scene and (2) media accounts of the event
indicating law enforcement personnel fatally shot the deceased.
Jeffery W.
(August 28")
File transferred to DCRP- Jails collection.
o Reports indicate the deceased was in the custody of the Arapahoe County
Detention Center at the time of death The Arapahoe County Detention Center is
responsible for reporting this death to the DCRP- Jails collection.
., Christopher D.
(October 1Oth)
File complete.
o Marmer of death (Item 8) was changed from response "02 - Other homicide" to
"03- Suicide." This change was based on (1) the response to Item 14, indicating
the arrest-related injuries were self-inflicted, suicide, and (2) the notes on the CJ
llA form indicating the deceased "shot himself in the head with a handgun."
.;, Daniel
File complete.
\Ruben
• File complete.
(November 191h)
(November 23'd)
Arrest-Related Deaths in need of CJ-UA
16.
•
***
1
•
, Brent
(February 28tl')
Grand Junction Police Department.
, -unclear if death occurred.
Reports indicate the subject was not expected to live, but I could not confirm whether the subject
survived. The incident occurred late September and involved the Black Hawk/Gilpin Co SWAT
team.
3
Attachment I. Example of jail and prison DCRP
program launch mailing to jail and prison respondents
ll.S. Department of Justice
Office o l Justice Programs
Bureau f (Ju.wice Statistin
January 23, 2012
Chief Robert Thompson
Aberleen Police Department
3 I 0 East Ch urch Street
Aberleen, WA 98620
Dear Chief Robert Thompson:
Thanks to the efforts of jail administrators nationwide. the Bureau of Justice Statistics' (BJS) Deaths in
Custody Reporting Program (DCRP) has been a great success since its inception in 2000. We appreciate
your continued support ofthis important program. wh ich enjoys a 97% response rate across all jail
ju risdict ions in the country.
You may complete all applicable 2011 and 2012 forms on line by logging onto the DCRP Web site
(https bJstkrp rll Qig) and using the following login credentials:
USERNAM E: I 095863 l W A
PASSWORD: 775$orangell79
Alternatively, enclosed in this packet you will find en velopes with materials related to both 2011
a nd 2012 collection efforts. Specifically. you will find an Annual Summary on Inmate Deaths under Jail
Jurisdiction fonn (CJ-9A) for 20II.a Death Repor1 on Inmates under .Jail Jurisdiction fonn (CJ-9) for
2011.and a Dea1h Report on Inmares under Jail Jurisdiction form (CJ-9) for 2012 if you prefer to submit
your data via mail or fa.'<.
We request that you subm it all remai n i ng 20 I I data, incl uding the CJ-9A, by March I ,2012. If you have
questions abou t DCRP, please contact Tim Flanigan. t he RTT Data Collection Task Leader. at 800-3441387 or bjsdcrp.£!_.!1!:Q[g. Or. you may contact BJS directly using the contact information below. We
thank you in advance for your participation and look forward to our continued work together.
Sincerely,
- fu_
Margaret E. Noonan. Program Manager
Deaths in Custod} Reporting Program
202-353-2060
margarct.nonnan1a usdoj.go\
w I.Chief
Corrections Statistics Program
202-514-1 062
"" illiam.sabni1J;usdl)j .go\
Enclosures:
- DCRJ> Update
- 2011 envelope containing a 201 I Annual Summary em Inmate Deaths under Jml Jurisdiction fonn (CJ-9/\) and a 201I
Death Report 011 Inmates u11der Jail Jurisdiction fonn (CJ-9)
- 20 I 2 envelope containing a 2012 Death Report on lnmate1· 1111der Jai/.lurisdtction form (CJ-9)
D(R
Poeaths in Custody
Reporting Program
Conducted by the U.S. Department of Justice - Bureau of Justice Statistics (BJS) and RTI International (RTI)
Over the past decade, BJS has collaborated with local jails and state departments of corrections to
collect and disseminate statistics on mortality data.
How are the Deaths in Custody Reporting
Program (DCRP) data used?
• Over the years BJS has published several reports on
corrections-related mortality, providing the corrections
community with important statistics that help policymakers and jail administrators address key public health
issues facing jails and prisons. Some examples include—
a. Prison and Jail Deaths in Custody, 2000-2009 - Statistical Tables,
NCJ 236219
Want to test your knowledge about DCRP?
Take the following quiz!
(Answers are available further below.)
1. What is the leading natural cause of death
among jail inmates?
a. Cancer
b. Heart disease
c. AIDS/HIV
b. Mortality in Local Jails, 2000-2007 (Revised), NCJ 222988
2. Between 2000 and 2009, has the rate of
inmate jail deaths from HIV/AIDS increased or
decreased?
c. Medical Causes of Death in State Prisons, 2001-2004, NCJ
216340
3. Approximately what percentage of jail deaths
occur within the first 7 days of admission?
d. Suicide and Homicide in State Prisons and Local Jails, NCJ
210036
Please visit the BJS website at http://www.bjs.gov to
access these and other statistical reports.
• BJS occasionally fields questions from local jail
administrators who need to know how the death
rates in their jails compare with jails of a similar size or
within their state.
• BJS provides information to state departments of
corrections that need death information from previous
years for special or routine reports.
For more
information on
BJS or the DCRP,
please contact—
For more
information about
the DCRP or data
collection, please
contact—
Margaret Noonan
Program Manager
U.S. Department of Justice
Bureau of Justice Statistics
810 7th Street, NW
Washington, DC 20531
(202) 353-2060
[email protected]
Kim Aspinwall
DCRP Data Collection Task Leader
RTI International
3040 Cornwallis Road
Research Triangle Park, NC 27709
(800) 344-1387
[email protected]
a. 18%
b. 28%
c. 38%
4. True or False: Between 2001 and 2009, illnessrelated deaths accounted for 9 out of 10 prison
deaths.
5. Between 2000 and 2009, were mortality rates
among whites higher or lower than those for
other race or ethnic groups?
6. About what percentage of the nation’s
approximately 2,800 jail jurisdictions
participated in the Deaths in Custody
Reporting Program in 2010?
a. 90%
b. 95%
c. 97%
Source: Prison and Jail Deaths in Custody, 2000-2009-Statistical
Tables, BJS Web, December 2011, NCJ 236219.
(1) Heart disease. Heart disease represented approximately
22% of all jail deaths from 2000 to 2009. (2) Decreased. AIDSrelated deaths in jails declined by 54% between 2000 and 2009.
(3) About 38%. Between 2000 and 2009, the percentage of jail
deaths that took place within a week of admission ranged from
36.2% (2006) to 40.3% (2003). (4) True. Only 10% of reported
deaths are due to suicide, accidental injury, or homicide. (5) Higher.
The rate of mortality among whites is higher than that of other
races or ethnic groups. In prisons, white mortality rates were
between 1.4 and 1.8 times higher in comparison to other ethnic or
racial groups. In jails, whites had a mortality rate between 1.6 and
4.7 times higher than other ethnic or racial groups. (6) 97%. If your
jail hasn’t previously participated in DCRP, please contact RTI.
3040 Cornwallis Road n PO Box 12194
Research Triangle Park, NC 27709-2194
ATTN: Tim Flanigan 0212335.001.302.100
2011
ACTION REQUESTED
Completion of reporting for the
2011 DCRP
This packet includes:
Cover letter
Instructions for reporting data
2011 Annual Summary Form
2011 Death Report Form
Postage-paid Return Envelope
U.S. Department of Justice
Office of Justtc: Progra ms
Bureau of lmttt'C' StatistiC ,\'
\\i11hm-.:ton. D.C.11511
January 23. 2012
Chief Robert Thompson
Abcrleen Police Department
3 I 0 East Church Street
Aberleen. WA 98620
Dear Chief Robert Thompson:
Now that20 II is behind us. we ask that you complete an Annual Summary on Inmates under .fail Jurisdiction
form (CJ-9A) for 20 II. Jn addi tion. please complete a Death Reporl 011 Inmates under Jail .Jurisdiction form
(CJ-9) for each inmate death you reported on the CJ-9./\. excluding ones already submitted. If you did not have
a death in custody in 2011 then you only need to complete an Annual Summary form.
You may submit these forms onl ine by loggi ng onto the Deaths and Custody Reporting Program (DCRP) Web
site (htt p ://bisd c rp.rti .org) and using the following login creden tials:
USERNAME: I0958631WA
PASSWORD: 775$ora nge1 179
We request that you su bmit your data by March 1, 2012. We have enclosed paper forms if you prefer to submit
by mail or fax. Please disregard the paper forms if you plan to submit data online. lfyou have questions about
DCRP, please contact Tim Flanigan, the RTJ Data Collection Task Leader, at 800-344-1387 or bjsdcrp a rt1 org.
You may also contact BJS directly using the contact information below. We thank you in advance for your
participation and look forward to our continued work together.
Sincerely,
Margaret E. Noonan, Program Manager
Deaths in Custody Repo1ting Program
202-353-2060
marg cl noo n un·a usdoj.gO\
William J. Sabol, Chief
Corrections Statistics Program
202-514-l 062
''llliam sabot tiusdoj.gn\
Enclosures:
201 I Annual Summary on Inmates under Jail Jurisdiction form (CJ-9A)
2011 Death Report on Inmates under Jail Jurisdiction fonn (CJ-9)
Postage-paid return envelope
OCR
Deaths in Custody
Reporting Program
2011Reporting Instructions
All agencies should submit a 2011 Annual Summary
form, even if no deaths occurred in your custody
during 2011. It only takes about 5 minutes to complete
the summary form.
Please be sure that the total number of deaths you report
on the Annual Summary form matches the number of
individual death reports you submit for 2011.
You may submit your data online by logging onto the
Deaths and Custody Reporting Program (DCRP) Web
site (https://bjsdcrp.rti.org) using the login credentials in
your cover letter.
We have enclosed a paper version of the 2011 Annual
Summary and Death Report forms if you prefer to
submit by mail or fax. Please disregard the paper forms
if you plan to submit data online.
If you had more than one inmate death, and are unable to
use the Web option, additional Death Report forms are
available for download by logging onto the DCRP Web
site as described above.
OMB No. 1121-0249 Approval Expires 12/31/2012
DEATHS IN CUSTODY—2011
ANNUAL SUMMARY ON INMATES
UNDER JAIL JURISDICTION
Form CJ-9A
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
RTI INTERNATIONAL
DATA SUPPLIED BY:
Name
Title
Official
Address
Telephone
City
FAX
State
Zip
E-mail
Please correct any error in name or mailing address
General Information
•
There are several ways to submit a death report:
ONLINE: Complete this form online at: https://bjsdcrp.rti.org
MAIL: RTI International, Attn: Kim Aspinwall
E-MAIL: [email protected]
Project Number: 0212335.001.302.200
FAX (TOLL-FREE): 1-866-800-9179
3040 Cornwallis Road, PO Box 12194
Research Triangle Park, NC 27709-2194
•
Please return your completed form within 30 days of receipt. You may complete this form ONLINE or complete the
hardcopy form and return by FAX or MAIL.
•
If you need assistance, call Kim Aspinwall of RTI International toll-free at 1-800-344-1387 or [email protected].
What facilities are included in this data collection?
INCLUDE:
• Confinement facilities usually administered by a local law
enforcement agency, intended for adults but sometimes holding
juveniles;
EXCLUDE:
• Facilities that are exclusively used as temporary holding or
lockup facilities from which inmates are usually transferred
within 72 hours and not held beyond arraignment;
• All jails and city/county correctional centers that hold inmates
beyond arraignment. Report data on all inmates, including those
held in separate holding or lockup areas within your facility;
• Privately operated jails and facilities operated by two or more
jurisdictions (i.e., multi-jurisdictional facilities; these jails will
be contacted directly for data on deaths in their custody);
• Special jail facilities (e.g., medical/treatment/release centers,
halfway houses, and work farms);
• Deaths of persons in the process of arrest by your agency if
they have not yet been booked into your jail facility. Arrestrelated deaths should be reported using a CJ-11A form.
• Inmates held for other jurisdictions, including federal authorities,
state prison authorities and other local jail jurisdictions.
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The burden of
this collection is estimated to average 5 minutes per response for jurisdictions reporting zero deaths and 30 minutes per each reported death, including reviewing
instructions, searching existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden estimate or any
aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW , Washington, DC 20531. Do
not send your completed form to this address.
INMATE COUNTS AND DEATHS
INSTRUCTIONS FOR COMPLETION
IF YOUR JURISDICTION DID NOT HAVE A DEATH IN CALENDAR YEAR 2011:
•
Simply complete this form and return it to RTI International. The address is located on the front page of this
document. Once you complete EVERY question below, your submission will be complete for 2011.
IF YOUR JURISDICTION DID HAVE ONE OR MORE DEATHS IN CALENDAR YEAR 2011:
•
•
Please ensure that you have completed a CJ-9 (individual death report) form for each death reported below.
If you need additional CJ-9 forms, please go to the DCRP Web site (https://bjsdcrp.rti.org), call 1-800-3441387, or send an e-mail to [email protected].
1. How many persons under the supervision of your jail
jurisdiction were…
2. Between January 1, 2011, and December 31, 2011, what
was the average daily population of all jail confinement
facilities operated by your jurisdiction?
1a. CONFINED in your jail facilities on December 31, 2011?
2010?
To calculate the average daily population, add the number of
persons for each day during the period January 1, 2011,
through December 31, 2011, and divide the result by 365.
INCLUDE:
persons on transfer to treatment facilities but who remain
under your jurisdiction
persons out to court while under your jurisdiction
persons held for other jurisdictions
EXCLUDE
X
X
X
persons housed in facilities operated by two or more
jurisdictions or those held in privately operated jails
inmates who are AWOL, escaped, or on long-term
transfer to other jurisdictions
all persons in nonresidential community-based programs
run by your jails (e.g., electronic monitoring, house
arrest, community service, day reporting, work programs)
If daily counts are not available, estimate the average daily
population by adding the number of persons held on the same
day of each month and divide the result by 12.
If average daily population cannot be calculated as directed
above, then estimate the typical number of persons held in your
jail confinement facilities each day.
When exact numeric answers are not available, provide
estimates and mark (⌧) the box beside each figure.
Average daily
population
When exact numeric answers are not available, provide estimates
and mark (⌧) the box beside each figure.
Inmates on
December 31, 2011
2010
Male
Estimate
Female
Estimate
1b. ADMITTED to your jail facilities during 2011?
2010?
new admissions only (i.e., persons officially booked into
and housed in your facilities by formal legal document
and by the authority of the courts or some other official
agency)
repeat offenders booked on new charges
X
returns from escape, work release, medical
appointments/treatment facilities, bail, and court
appearances
New ANNUAL
admissions during
2011
Male
Estimate
Female
Estimate
Estimate
Female
Estimate
INCLUDE:
deaths of ALL persons CONFINED in your jail
facilities; or UNDER YOUR JURISDICTION but out
to court or in special facilities (e.g., hospitals,
halfway houses, work farms, and medical/treatment/
release centers); or WHILE IN TRANSIT to or from
your facilities while under your jurisdiction.
Number of
inmate deaths
EXCLUDE
Estimate
3. Between January 1, 2011, and December 31, 2011, how
many persons died while under the supervision of your
jail jurisdiction?
INCLUDE
Male
Male
Estimate
Female
Estimate
NOTE: BEFORE COMPLETING THIS FORM, PLEASE
BE SURE THAT THERE ARE ENTRIES FOR ALL
RESPONSE BOXES. FOR EXAMPLE, IF YOU HAVE
ZERO FEMALE DEATHS IN QUESTION 3, PLEASE
ENTER 0 IN THE BOX RATHER THAN LEAVING IT
EMPTY.
OMB No. 1121-0249 Approval Expires 12/31/2012
DEATHS IN CUSTODY—2011
DEATH REPORT ON INMATES
UNDER JAIL JURISDICTION
Form CJ-9
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
RTI INTERNATIONAL
DATA SUPPLIED BY:
Name
Title
Official
Address
Telephone
City
FAX
State
Zip
E-mail
Please correct any error in name or mailing address
Instructions for Completion
•
If no deaths occurred, you will not need to report anything at this time. At the beginning of the next calendar year, you will
be asked to complete a summary form whether you had a death occurrence or not.
•
If you had more than 1 death, make copies of pages 2 and 3 for each additional death.
•
Complete questions 1 through 16 for each inmate death.
•
Once your death records are complete, there are several ways to submit a death report:
ONLINE: Complete the report online at: https://bjsdcrp.rti.org
MAIL: RTI International, Attn: Kim Aspinwall
E-MAIL: [email protected]
Project Number: 0212335.001.302.200
FAX (TOLL-FREE): 1-866-800-9179
3040 Cornwallis Road, PO Box 12194
Research Triangle Park, NC 27709-2194
•
If you need assistance, call Kim Aspinwall of RTI International toll-free at 1-800-344-1387 or [email protected]
What deaths should be reported?
INCLUDE deaths of ALL Persons
EXCLUDE deaths of ALL Persons
Confined in your jail facilities, whether housed under your own or
another jurisdiction;
Confined in facilities operated by two or more jurisdictions or those
held in privately operated jails;
Under your jurisdiction but housed in special jail facilities
(e.g., medical/treatment/release centers, halfway houses, and work
farms); or on transfer to treatment facilities;
Under your jurisdiction but in non-residential community-based
programs run by your jails (e.g., electronic monitoring, house
arrest, community service, day reporting, work programs);
Under your jurisdiction but out to court;
Under your jurisdiction but on AWOL, escape, or long-term transfer to
other jurisdiction;
In transit to or from your facilities while under your jurisdiction.
In the process of arrest by your agency, but not yet booked into your jail
facility.
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The burden of
this collection is estimated to average 5 minutes per response for jurisdictions reporting zero deaths and 30 minutes per each reported death, including reviewing
instructions, searching existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden estimate or any
aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW , Washington, DC 20531. Do
not send your completed form to this address.
LOCAL JAIL INMATE DEATH REPORT
8. What was the inmate’s legal status at time of death?
(For persons with more than one status, report the
status associated with the most serious offense.)
1. What was the inmate’s name?
LAST
FIRST
MI
2. On what date did the inmate die?
2011
MONTH
DAY
DAY
Please Specify:
YEAR
3. What was the inmate’s date of birth?
MONTH
Convicted—new court commitment
Convicted—returned probation / parole violator
Unconvicted
Other
YEAR
4. What was the inmate’s sex?
Male
Female
9. Since admission, did the inmate ever stay overnight in
a mental health observation unit or an outside mental
health facility?
Yes
No
Don’t Know
10. Where did the inmate die?
5. What was the inmate’s race/ethnic origin?
White (not of Hispanic origin)
Black or African American (not of Hispanic origin)
Hispanic or Latino
American Indian/Alaska Native (not of Hispanic
origin)
Asian (not of Hispanic origin)
Native Hawaiian or Other Pacific Islander (not of
Hispanic origin)
Two or more races
Additional categories in your information system
In a general housing within the jail facility or on jail
grounds
In a segregation unit
In a special medical unit/infirmary within jail facility
In a special mental health services unit within jail
facility
In a medical center outside jail facility
In a mental health center outside jail facility
While in transit
Elsewhere
Please Specify:
Please Specify:
Race/Ethnicity Not Known
6. On what date had the inmate been admitted to a
facility under your jurisdiction?
MONTH
DAY
YEAR
7. For what offense(s) was the inmate being held?
a.
11. Where did the incident (e.g., accident, suicide, or
homicide) causing the death take place?
NOT APPLICABLE—Cause of death was illness,
intoxication, or AIDS-related
In the jail facility or on the jail grounds
In the inmate’s cell/room
In a temporary holding area/lockup
[SPECIFY]
In a common area within the facility (e.g.,
yard, library, cafeteria, etc.)
In a segregation unit
In a special medical unit/infirmary
In a special mental health services unit
Elsewhere within the jail facility
Please Specify:
b.
c.
Outside the jail facility (e.g., while on work release or
on work detail, etc.)
d.
Elsewhere
e.
Please Specify:
12. Had the deceased been receiving treatment for the medical condition after admission to your correctional facilities?
Exclude emergency care provided at time of death.
NOT APPLICABLE—Cause of death was accidental injury, intoxication, suicide, or homicide
a.
b.
c.
d.
e.
f.
YES
NO
DON’T KNOW
Evaluated by physician/medical staff ...................................................................
Had diagnostic tests (e.g., X-rays, MRI) ..............................................................
PLEASE PROVIDE A
Received medications ...........................................................................................
RESPONSE FOR EACH
Received treatment/care other than medications .................................................
ITEM (a – f).
Had surgery ..........................................................................................................
Confined in special medical unit. ..........................................................................
13. When did the incident (e.g., accident, suicide, or
homicide) causing the death occur?
NOT APPLICABLE—Cause of death was illness,
intoxication, or AIDS-related
14. Are the results of a medical examiner’s or coroner’s
evaluation (such as an autopsy, post-mortem exam, or
review of medical records) available in order to establish
an official cause of death?
YES
Morning (6 am to Noon)
Afternoon (Noon to 6 pm)
Evening (6 pm to Midnight)
Overnight (Midnight to 6 am)
CONTINUE TO Q15
Evaluation complete—results are pending
SKIP REMAINING QUESTIONS—YOU WILL
BE CONTACTED AT A LATER TIME FOR THE
CAUSE OF DEATH
No evaluation is planned
15. What was the cause of death?
CONTINUE TO Q15
*** Please SPECIFY cause of death as it is critical information ***
Illness—Exclude AIDS-related deaths [Specify]
Acquired Immune Deficiency Syndrome (AIDS)
Accidental alcohol/drug intoxication [Specify]
Accidental injury to self [Describe]
Accidental injury by other (e.g., vehicular
accidents during transport) [Describe]
Suicide (e.g., hanging, knife/cutting instrument,
intentional drug overdose) [Describe]
Homicide [Please provide description]
Other cause(s) [Specify]
16. Was the cause of death the result of a pre-existing
medical condition or did the inmate develop the
condition after admission? If multiple conditions
caused the death, select “Pre-existing medical
condition.”
NOT APPLICABLE—Cause of death was
accidental injury, intoxication, suicide, or
homicide
Pre-existing medical condition
Deceased developed condition after admission
Could not be determined
Please add any additional notes here:
IMPORTANT: DO NOT ENLARGE, REDUCE OR MOVE the FIM and POSTNET barcodes. They are only valid as printed!
Special care must be taken to ensure FIM and POSTNET barcode are actual size AND placed properly on the mail piece
to meet both USPS regulations and automation compatibility standards.
3040 Cornwallis Road ■ PO Box 12194
Research Triangle Park, NC 27709-2194
■
NO POSTAGE
NECESSARY
IF MAILED
IN THE UNITED
STATES
USA
BUSINESS REPLY MAIL
FIRST-CLASS MAIL
PERMIT NO. 593
DURHAM, NC
POSTAGE WILL BE PAID BY ADDRESSEE
RTI INTERNATIONAL
ATTN: TIM FLANIGAN 0212335.001.302.100
PO BOX 12194
RESEARCH TRIANGLE PARK NC 27709-9935
Artwork for Envelope, Business, #10, 4 1/8 x 9 1/2 in (4.125" x 9.5")
Layout: sample BRM Env with IMB.lyt
February 23, 2011
Produced by DAZzle Designer, Version 9.0.05
(c) 1993-2009, Endicia, www.Endicia.com
U.S. Postal Service, Serial #
3040 Cornwallis Road n PO Box 12194
Research Triangle Park, NC 27709-2194
ATTN: Tim Flanigan 0212335.001.302.100
2012
FOR FUTURE REFERENCE
Announcing the start of reporting for the
2012 Deaths in Custody Reporting Program.
** No action is requested at this time. **
This packet includes:
Instructions for reporting data
2012 Death Report Form
Postage-paid Return Envelope
2012 Reporting Instructions
We have enclosed a 2012 death report form for your
convenience. If no deaths have occurred within your jail
jurisdiction to date in 2012, you have nothing to report at
this time.
Please submit a report for any deaths that occur within your
jail jurisdiction in 2012 as soon as the autopsy or other
official death investigation results are available.
Please complete ALL form questions, including “Specify”
fields, if applicable.
You may submit your data online by logging onto the
Deaths and Custody Reporting Program (DCRP) Web site
(https://bjsdcrp.rti.org) using the login credentials in your
cover letter.
We have enclosed a paper version of the 2012 Death
Report form if you prefer to submit by mail or fax. Please
disregard the paper form if you plan to submit data online.
If you have more than one inmate death, and are unable to
use the Web option, additional Death Report forms are
available for download by logging onto the DCRP Web site
as described above.
OMB No. 1121-0249 Approval Expires 12/31/2012
DEATHS IN CUSTODY—2012
DEATH REPORT ON INMATES
UNDER JAIL JURISDICTION
Form CJ-9
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
RTI INTERNATIONAL
DATA SUPPLIED BY:
Name
Title
Official
Address
Telephone
City
FAX
State
Zip
E-mail
Please correct any error in name or mailing address
Instructions for Completion
•
If no deaths occurred, you will not need to report anything at this time. At the beginning of the next calendar year, you will
be asked to complete a summary form whether you had a death occurrence or not.
•
If you had more than 1 death, make copies of pages 2 and 3 for each additional death.
•
Complete questions 1 through 16 for each inmate death.
•
Once your death records are complete, there are several ways to submit a death report:
ONLINE: Complete the report online at: https://bjsdcrp.rti.org
MAIL: RTI International, Attn: Kim Aspinwall
E-MAIL: [email protected]
Project Number: 0213149.001.102
FAX (TOLL-FREE): 1-866-800-9179
3040 Cornwallis Road, PO Box 12194
Research Triangle Park, NC 27709-2194
•
If you need assistance, call Kim Aspinwall of RTI International toll-free at 1-800-344-1387 or [email protected]
What deaths should be reported?
INCLUDE deaths of ALL Persons
EXCLUDE deaths of ALL Persons
• Confined in your jail facilities, whether housed under your own or
another jurisdiction;
• Confined in facilities operated by two or more jurisdictions or those
held in privately operated jails;
• Under your jurisdiction but housed in special jail facilities (e.g.,
medical/treatment/release centers, halfway houses, and work farms);
or on transfer to treatment facilities;
• Under your jurisdiction but in non-residential community-based
programs run by your jails (e.g., electronic monitoring, house
arrest, community service, day reporting, work programs);
• Under your jurisdiction but out to court;
• Under your jurisdiction but on AWOL, escape, or long-term transfer to
other jurisdiction;
•
In transit to or from your facilities while under your jurisdiction.
• In the process of arrest by your agency, but not yet booked into your
jail facility.
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The burden of
this collection is estimated to average 5 minutes per response for jurisdictions reporting zero deaths and 30 minutes per each reported death, including reviewing
instructions, searching existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden estimate or any
aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW , Washington, DC 20531. Do
not send your completed form to this address.
LOCAL JAIL INMATE DEATH REPORT
8. What was the inmate’s legal status at time of death?
(For persons with more than one status, report the
status associated with the most serious offense.)
1. What was the inmate’s name?
LAST
FIRST
MI
2. On what date did the inmate die?
2012
MONTH
DAY
DAY
Please Specify:
YEAR
3. What was the inmate’s date of birth?
MONTH
Convicted—new court commitment
Convicted—returned probation / parole violator
Unconvicted
Other
YEAR
4. What was the inmate’s sex?
Male
Female
9. Since admission, did the inmate ever stay overnight in
a mental health observation unit or an outside mental
health facility?
Yes
No
Don’t Know
10. Where did the inmate die?
5. What was the inmate’s race/ethnic origin?
White (not of Hispanic origin)
Black or African American (not of Hispanic origin)
Hispanic or Latino
American Indian/Alaska Native (not of Hispanic
origin)
Asian (not of Hispanic origin)
Native Hawaiian or Other Pacific Islander (not of
Hispanic origin)
Two or more races
Additional categories in your information system
In a general housing within the jail facility or on jail
grounds
In a segregation unit
In a special medical unit/infirmary within jail facility
In a special mental health services unit within jail
facility
In a medical center outside jail facility
In a mental health center outside jail facility
While in transit
Elsewhere
Please Specify:
Please Specify:
Race/Ethnicity Not Known
6. On what date had the inmate been admitted to a
facility under your jurisdiction?
MONTH
DAY
YEAR
7. For what offense(s) was the inmate being held?
a.
11. Where did the incident (e.g., accident, suicide, or
homicide) causing the death take place?
NOT APPLICABLE—Cause of death was illness,
intoxication, or AIDS-related
In the jail facility or on the jail grounds
In the inmate’s cell/room
In a temporary holding area/lockup
[SPECIFY]
In a common area within the facility (e.g.,
yard, library, cafeteria, etc.)
In a segregation unit
In a special medical unit/infirmary
In a special mental health services unit
Elsewhere within the jail facility
Please Specify:
b.
c.
Outside the jail facility (e.g., while on work release or
on work detail, etc.)
d.
Elsewhere
e.
Please Specify:
<< AGENCY ID >>
12. Had the deceased been receiving treatment for the medical condition after admission to your correctional facilities?
Exclude emergency care provided at time of death.
NOT APPLICABLE—Cause of death was accidental injury, intoxication, suicide, or homicide
a.
b.
c.
d.
e.
f.
YES
NO
DON’T KNOW
Evaluated by physician/medical staff ...................................................................
Had diagnostic tests (e.g., X-rays, MRI) ..............................................................
PLEASE PROVIDE A
Received medications ...........................................................................................
RESPONSE FOR EACH
Received treatment/care other than medications .................................................
ITEM (a – f).
Had surgery ..........................................................................................................
Confined in special medical unit. ..........................................................................
13. When did the incident (e.g., accident, suicide, or
homicide) causing the death occur?
NOT APPLICABLE—Cause of death was illness,
intoxication, or AIDS-related
14. Are the results of a medical examiner’s or coroner’s
evaluation (such as an autopsy, post-mortem exam, or
review of medical records) available in order to establish
an official cause of death?
YES
Morning (6 am to Noon)
Afternoon (Noon to 6 pm)
Evening (6 pm to Midnight)
Overnight (Midnight to 6 am)
CONTINUE TO Q15
Evaluation complete—results are pending
SKIP REMAINING QUESTIONS—YOU WILL
BE CONTACTED AT A LATER TIME FOR THE
CAUSE OF DEATH
No evaluation is planned
15. What was the cause of death?
CONTINUE TO Q15
*** Please SPECIFY cause of death as it is critical information ***
Illness—Exclude AIDS-related deaths [Specify]
Acquired Immune Deficiency Syndrome (AIDS)
Accidental alcohol/drug intoxication [Specify]
Accidental injury to self [Describe]
Accidental injury by other (e.g., vehicular
accidents during transport) [Describe]
Suicide (e.g., hanging, knife/cutting instrument,
intentional drug overdose) [Describe]
Homicide [Please provide description]
Other cause(s) [Specify]
16. Was the cause of death the result of a pre-existing
medical condition or did the inmate develop the
condition after admission? If multiple conditions
caused the death, select “Pre-existing medical
condition.”
Please add any additional notes here:
NOT APPLICABLE—Cause of death was
accidental injury, intoxication, suicide, or
homicide
Pre-existing medical condition
Deceased developed condition after admission
Could not be determined
<>
IMPORTANT: DO NOT ENLARGE, REDUCE OR MOVE the FIM and POSTNET barcodes. They are only valid as printed!
Special care must be taken to ensure FIM and POSTNET barcode are actual size AND placed properly on the mail piece
to meet both USPS regulations and automation compatibility standards.
3040 Cornwallis Road ■ PO Box 12194
Research Triangle Park, NC 27709-2194
■
NO POSTAGE
NECESSARY
IF MAILED
IN THE UNITED
STATES
USA
BUSINESS REPLY MAIL
FIRST-CLASS MAIL
PERMIT NO. 593
DURHAM, NC
POSTAGE WILL BE PAID BY ADDRESSEE
RTI INTERNATIONAL
ATTN: TIM FLANIGAN 0213149.001.102
PO BOX 12194
RESEARCH TRIANGLE PARK NC 27709-9935
Artwork for Envelope, Business, #10, 4 1/8 x 9 1/2 in (4.125" x 9.5")
Layout: sample BRM Env with IMB.lyt
February 23, 2011
Produced by DAZzle Designer, Version 9.0.05
(c) 1993-2009, Endicia, www.Endicia.com
U.S. Postal Service, Serial #
U.S. Department of Justin·
Of1i:c of 1 ust1ce Programs
Bureau l j".lu.\lice Stclli\lic·,
\ a. lttn t''"· n.c 0531
January 23, 2012
Ms. Stephanie Robbins
North Carolina Department of Correction
506 Salisbury Street
Raleigh, NC 27609
Dear Ms. Stephanie Robbins:
Thanks to the efforts of state prison officials nationwide, the Bureau of Justice Statistics' (BJS) Deaths in
Custody Reporting Program (DCRP) has been a great success since its inception in 2000. We appreciate your
contin ued support of this important program, which enjoys a I00% response rate across all state departments
of correction in the country.
You may complete all applicable 2011 and 2012 forms online by logging onto the DCRP Web site
(hnps lw>dLrp rtt ,,rg) and using the following login credentials:
USERNA M E: 10958632NC
PASSWORD: 776$bl ueskyl83
Alternatively, enclosed in this packet you will find envelopes with materials related to both 2011 and
20U data collection efforts. Specifically. you will find an Annual Summary of Inmate Deaths in State
Prisons form (NPS-4) for 20 II,a State Prison Inmate Death Report form (NPS-4A) for 2011, and a State
Prison bunale Death Report form (NPS-4A) for 2012 if you prefer to submit your data via mail or fa.x.
We request that you submi t al l remaining 2011 data, including the N PS-4, by Mar-ch 1 , 2012. If you have
questions about DCRP, please contact Tim Flan igan, the RTI Data Collect ion Task Leader, at 800-344-1387
or bj!)d<:.rp o rtt.org. Or. you may contact BJ S directly using the contact information below. We thank you in
advance for your participation and look forward to our continued work together.
Sincerely.
- Ph_
Margaret E. Noonan, Program Manager
Deaths in Custody Reporting Program
202-353-2060
Enclosures:
OCRP Update
d'A{_
William J. Sabol. Chief
Corrections Statistics Program
202-5 I 4-l 062
"tlliam.sabol__g_usdJ!.i..gov
2011 envelope containing a !011 tlnnual Sumnwry of Inmate Demhs 111 Swte !'mons fom1 (l\PS-4) and a 2011 State Prtson
Inmate Death Report form (NPS-4/\ )
2012 envel ope contammg a 2012 State Prison Inmate Death Report fonn (NP. -tA )
0(R Poeaths in
Custody
Reporting Program
Conducted by the U.S. Department of Justice - Bureau of Justice Statistics (BJS) and RTI International (RTI)
Over the past decade, BJS has collaborated with local jails and state departments of corrections to
collect and disseminate statistics on mortality data.
How are the Deaths in Custody Reporting
Program (DCRP) data used?
• Over the years BJS has published several reports on
corrections-related mortality, providing the corrections
community with important statistics that help policymakers and jail administrators address key public health
issues facing jails and prisons. Some examples include—
a. Prison and Jail Deaths in Custody, 2000-2009 - Statistical Tables,
NCJ 236219
Want to test your knowledge about DCRP?
Take the following quiz!
(Answers are available further below.)
1. What is the leading natural cause of death
among jail inmates?
a. Cancer
b. Heart disease
c. AIDS/HIV
b. Mortality in Local Jails, 2000-2007 (Revised), NCJ 222988
2. Between 2000 and 2009, has the rate of
inmate jail deaths from HIV/AIDS increased or
decreased?
c. Medical Causes of Death in State Prisons, 2001-2004, NCJ
216340
3. Approximately what percentage of jail deaths
occur within the first 7 days of admission?
d. Suicide and Homicide in State Prisons and Local Jails, NCJ
210036
Please visit the BJS website at http://www.bjs.gov to
access these and other statistical reports.
• BJS occasionally fields questions from local jail
administrators who need to know how the death
rates in their jails compare with jails of a similar size or
within their state.
• BJS provides information to state departments of
corrections that need death information from previous
years for special or routine reports.
For more
information on
BJS or the DCRP,
please contact—
For more
information about
the DCRP or data
collection, please
contact—
Margaret Noonan
Program Manager
U.S. Department of Justice
Bureau of Justice Statistics
810 7th Street, NW
Washington, DC 20531
(202) 353-2060
[email protected]
Kim Aspinwall
DCRP Data Collection Task Leader
RTI International
3040 Cornwallis Road
Research Triangle Park, NC 27709
(800) 344-1387
[email protected]
a. 18%
b. 28%
c. 38%
4. True or False: Between 2001 and 2009, illnessrelated deaths accounted for 9 out of 10 prison
deaths.
5. Between 2000 and 2009, were mortality rates
among whites higher or lower than those for
other race or ethnic groups?
6. About what percentage of the nation’s
approximately 2,800 jail jurisdictions
participated in the Deaths in Custody
Reporting Program in 2010?
a. 90%
b. 95%
c. 97%
Source: Prison and Jail Deaths in Custody, 2000-2009-Statistical
Tables, BJS Web, December 2011, NCJ 236219.
(1) Heart disease. Heart disease represented approximately
22% of all jail deaths from 2000 to 2009. (2) Decreased. AIDSrelated deaths in jails declined by 54% between 2000 and 2009.
(3) About 38%. Between 2000 and 2009, the percentage of jail
deaths that took place within a week of admission ranged from
36.2% (2006) to 40.3% (2003). (4) True. Only 10% of reported
deaths are due to suicide, accidental injury, or homicide. (5) Higher.
The rate of mortality among whites is higher than that of other
races or ethnic groups. In prisons, white mortality rates were
between 1.4 and 1.8 times higher in comparison to other ethnic or
racial groups. In jails, whites had a mortality rate between 1.6 and
4.7 times higher than other ethnic or racial groups. (6) 97%. If your
jail hasn’t previously participated in DCRP, please contact RTI.
3040 Cornwallis Road n PO Box 12194
Research Triangle Park, NC 27709-2194
ATTN: Tim Flanigan 0212335.001.302.100
2011
ACTION REQUESTED
Completion of reporting for the
2011 DCRP
This packet includes:
Cover letter
Instructions for reporting data
2011 Annual Summary Form
2011 Death Report Form
Postage-paid Return Envelope
U.S. Department of Justice
Office
o r J ustice Programs
Bureau oflusth e Stati.\lic.,
llcl.lhlllgto/1.
January23, 2012
t> c. :!o531
Ms. Stephanie Robbins
North Carolina Department of Correction
506 Salisbury Street
Raleigh, NC 27609
Dear Ms. Stephanie Robbins:
Now that 20II is behind us. we ask that you complete an Annual SummaJ}' of Inmate Deaths in State Prisons
form (NPS-4) for 20 II. ln addition, please complete a State Prison Inmate Death Report form (NPS-4A),
excluding ones already subrnined. If you did not have a death in custody in 2011 then you only need to
complete a n A nnual Su m mary form.
You may submit these forms online by logging onto the Deaths and Custody Reporting Program (DCRP) Web
site (https 'bjsd IJU1i or!.l.) and using the followi ng login credentials:
USERNAME: I0958632NC
PASSWORD: 776$bluesky183
We request that you submit your data by March 1, 2012. We have enclosed paper forms if you prefer to submit
by mail or fax. Please disregard the paper forms if you plan to submit data online. lf you have questions about
DCRP. please contact Tim Flanigan, the RTf Data Collection Task Leader, at 800-344-1387 or btsdcrp a n1o ·g.
You may also contact BJS directly using the contact information below. We thank you in advance for your
participation and look forward to our continued work together.
Sincerely,
Margaret E. Noonan. Program Manager
Deaths in Custody Reporting Program
202-353-2060
margaret.notman a.usdoj.gm
William J. Sabol.Chief
Conections Statistics Program
202-5 14-1062
\\ llliam.sabol.!{ usdoj.I!O\
Enclosures:
2011 Annual Summary' of Inmate Deaths in State Prisons fonn (NP -4)
2011 State Prison Inmate Death Report form (NPS-4A)
Postage-paid return envelope
DCR
Poeaths in Custody
Reporting Program
2011 Data Collection Forms and
Reporting Instructions
All agencies should submit a 2011 Annual Summary
form. The form has one question asking the number of
deaths that occurred in 2011.
Please be sure that the total number of deaths you report
on the Annual Summary form matches the number of
individual death reports you submit for 2011.
You may submit your data online by logging onto the
Deaths and Custody Reporting Program (DCRP) Web
site (https://bjsdcrp.rti.org) using the login credentials on
your cover letter.
We have enclosed a paper version of the 2011 Annual
Summary and Death Report forms if you prefer to
submit by mail or fax. Please disregard the paper forms
if you plan to submit data online.
If you had more than one inmate death, and are unable to
use the Web option, additional Death Report forms are
available for download by logging onto the DCRP Web
site as described above.
OMB No. 1121-0249 Approval Expires 12/31/2012
DEATHS IN CUSTODY—2011
ANNUAL SUMMARY OF INMATE DEATHS
IN STATE PRISONS
Form NPS-4
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
RTI INTERNATIONAL
DATA SUPPLIED BY:
Name
Title
Official
Address
Telephone
City
FAX
State
Zip
E-mail
Please correct any error in name or mailing address
What deaths should be reported?
INCLUDE Deaths of ALL Persons
• Confined in your correctional facilities, whether housed under
your jurisdiction or that of another state;
• Under your jurisdiction but housed in private correctional
facilities, whether located in or out of state;
• Under your jurisdiction but in special facilities (e.g., medical/
treatment/release centers, halfway houses, police/court
lockups, and work farms);
EXCLUDE Deaths of ALL Persons
• Deaths by execution that were carried out in your state;
• Confined in local jail facilities, whether located in or out of state;
• Under your jurisdiction but housed in a state-operated
correctional facility in another state or in a federal facility;
• Under probation or parole supervision in your state.
• In transit to or from your facilities while under your supervision.
During 2011, how many persons died while in the custody of your state correctional facilities?
Number of deaths in 2011
•
Please fill out the number of deaths that occurred in calendar year 2011 above and submit this form and corresponding NPS-4A
forms to RTI International. There are several ways to submit these data:
ONLINE: Complete this form online at: https://bjsdcrp.rti.org
MAIL: RTI International, Attn: Kim Aspinwall
E-MAIL: [email protected]
Project Number: 0212335.001.302.200
FAX (TOLL-FREE): 1-866-800-9179
3040 Cornwallis Road, PO Box 12194
Research Triangle Park, NC 27709-2194
•
•
•
For each inmate death, please ensure that you have submitted a STATE PRISON INMATE DEATH REPORT (NPS-4A) form.
IF NO DEATHS OCCURRED, it is still important that you complete this form and return it to RTI International.
If you need assistance, call Kim Aspinwall of RTI International toll-free at 1-800-344-1387 or send an e-mail to [email protected].
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The burden of
this collection is estimated to average 5 minutes per response for jurisdictions reporting zero deaths and 30 minutes per each reported death, including reviewing
instructions, searching existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden estimate or any
aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW , Washington, DC 20531. Do
not send your completed form to this address.
OMB No. 1121-0249 Approval Expires 12/31/2012
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
DEATHS IN CUSTODY— 2011
STATE PRISON INMATE
DEATH REPORT
Form NPS-4A
(Addendum)
RTI INTERNATIONAL
DATA SUPPLIED BY:
Name
Title
Official
Address
Telephone
City
FAX
State
Zip
E-mail
Please correct any error in name or mailing address
Instructions for Completion
•
If no deaths occurred, you will not need to report anything at this time. At the beginning of the next calendar year, you will
be asked to complete a summary form whether you had a death occurrence or not.
•
If you had more than 1 death, make copies of pages 2 and 3 for each additional death.
•
Complete questions 1 through 16 for each inmate death.
•
Once your death records are complete, there are several ways to submit a death report:
ONLINE: Complete the report online at: https://bjsdcrp.rti.org
MAIL: RTI International, Attn: Kim Aspinwall
E-MAIL: [email protected]
Project Number: 0212335.001.302.200
FAX (TOLL-FREE): 1-866-800-9179
3040 Cornwallis Road, PO Box 12194
Research Triangle Park, NC 27709-2194
•
If you need assistance, call Kim Aspinwall of RTI International toll-free at 1-800-344-1387 or [email protected]
What deaths should be reported?
INCLUDE deaths of ALL Persons
Confined in your correctional facilities, whether housed under
your jurisdiction or that of another state;
EXCLUDE deaths of ALL Persons Deaths by
execution that were carried out in your state; Confined in local
jail facilities, whether located in or out of state;
Under your jurisdiction but housed in private correctional
facilities, whether located in or out of state;
Under your jurisdiction but in special facilities (e.g., medical/
treatment/release centers, halfway houses, police/court lockups,
and work farms);
Under your jurisdiction but housed in a state-operated
correctional facility in another state or in a federal facility;
Under probation or parole supervision in your state.
In transit to or from your facilities while under your supervision.
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The burden of
this collection is estimated to average 5 minutes per response for jurisdictions reporting zero deaths and 30 minutes per each reported death, including reviewing
instructions, searching existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden estimate or any
aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW , Washington, DC 20531. Do
not send your completed form to this address.
STATE PRISON INMATE DEATH REPORT
8. For what offense(s) was the inmate being held?
1. What was the inmate’s name?
a.
LAST
FIRST
MI
b.
2. On what date did the inmate die?
2011
MONTH
DAY
c.
d.
YEAR
e.
3. What was the name and location of the correctional
facility involved?
9. Since admission, did the inmate ever stay overnight in
a mental health facility?
Please Specify:
Yes
No
Don’t Know
4. What was the inmate’s date of birth?
MONTH
DAY
YEAR
5. What was the inmate’s sex?
Male
Female
6. What was the inmate’s race/ethnic origin?
White (not of Hispanic origin)
Black or African American (not of Hispanic origin)
Hispanic or Latino
American Indian/Alaska Native (not of Hispanic
origin)
Asian (not of Hispanic origin)
Native Hawaiian or Other Pacific Islander (not of
Hispanic origin)
Two or more races
Additional categories in your information system
Please Specify:
Race/Ethnicity Not Known
7. On what date had the inmate been admitted to one of
your correctional facilities?
YEAR
10. Where did the inmate die?
In a general housing in the facility or on prison
grounds
In a segregation unit
In a special medical unit/infirmary within your
facility
In a special mental health services unit within your
facility
In a medical center outside your facility
In a mental health center outside your facility
While in transit
Please Specify:
Elsewhere
11. Where did the incident (e.g., accident, suicide, or
homicide) take place?
NOT APPLICABLE—Cause of death was illness,
intoxication, or AIDS-related
In the prison facility or on the prison grounds
In the inmate’s cell/room
In a temporary holding area/lockup
[SPECIFY]
In a common area within the facility (e.g.,
yard, library, cafeteria, etc.)
In a special medical unit/infirmary
In a special mental health services unit
In a segregation unit
On death row, special unit awaiting capital
punishment
Elsewhere within the prison facility
Please Specify:
Outside the prison facility (e.g., while on work release
or on work detail, etc.)
Elsewhere
Please Specify:
12. Had the inmate been receiving treatment for the medical condition after admission to your correctional facilities?
Exclude emergency care provided at time of death.
NOT APPLICABLE—Cause of death was accidental injury, intoxication, suicide, or homicide
a.
b.
c.
d.
e.
f.
YES
NO
DON’T KNOW
Evaluated by physician/medical staff ....................................................................
Had diagnostic tests (e.g., X-rays, MRI) ...............................................................
PLEASE PROVIDE A
Received medications ...........................................................................................
RESPONSE FOR EACH
Received treatment/care other than medications .................................................
ITEM (a – f).
Had surgery ..........................................................................................................
Confined in special medical unit ..........................................................................
13. When did the incident (e.g., accident, suicide, or
homicide) causing the inmate’s death occur?
NOT APPLICABLE—Cause of death was illness,
intoxication, or AIDS-related
14. Are the results of a medical examiner’s or coroner’s
evaluation (such as an autopsy, post-mortem exam, or
review of medical records) available in order to establish
an official cause of death?
YES
Morning (6 am to Noon)
Afternoon (Noon to 6 pm)
Evening (6 pm to Midnight)
Overnight (Midnight to 6 am)
CONTINUE TO Q15
Evaluation complete—results are pending
SKIP REMAINING QUESTIONS—YOU WILL
BE CONTACTED AT A LATER TIME FOR THE
CAUSE OF DEATH
No evaluation is planned
15. What was the cause of death?
CONTINUE TO Q15
*** Please SPECIFY cause of death as it is critical information ***
Illness—Exclude AIDS-related deaths [Specify]
Acquired Immune Deficiency Syndrome (AIDS)
Accidental alcohol/drug intoxication [Specify]
Accidental injury to self [Describe]
Accidental injury by other (e.g., vehicular
accidents during transport) [Describe]
Suicide (e.g., hanging, knife/cutting instrument,
intentional drug overdose) [Describe]
Homicide [Please provide description]
Other cause(s) [Specify]
16. Was the cause of death the result of a pre-existing
medical condition or did the inmate develop the
condition after admission? If multiple conditions
caused the death, select “Pre-existing medical
condition.”
NOT APPLICABLE—Cause of death was
accidental injury, intoxication, suicide, or
homicide
Pre-existing medical condition
Deceased developed condition after admission
Could not be determined
Please add any additional notes here:
IMPORTANT: DO NOT ENLARGE, REDUCE OR MOVE the FIM and POSTNET barcodes. They are only valid as printed!
Special care must be taken to ensure FIM and POSTNET barcode are actual size AND placed properly on the mail piece
to meet both USPS regulations and automation compatibility standards.
3040 Cornwallis Road ■ PO Box 12194
Research Triangle Park, NC 27709-2194
■
NO POSTAGE
NECESSARY
IF MAILED
IN THE UNITED
STATES
USA
BUSINESS REPLY MAIL
FIRST-CLASS MAIL
PERMIT NO. 593
DURHAM, NC
POSTAGE WILL BE PAID BY ADDRESSEE
RTI INTERNATIONAL
ATTN: TIM FLANIGAN 0212335.001.302.100
PO BOX 12194
RESEARCH TRIANGLE PARK NC 27709-9935
Artwork for Envelope, Business, #10, 4 1/8 x 9 1/2 in (4.125" x 9.5")
Layout: sample BRM Env with IMB.lyt
February 23, 2011
Produced by DAZzle Designer, Version 9.0.05
(c) 1993-2009, Endicia, www.Endicia.com
U.S. Postal Service, Serial #
3040 Cornwallis Road n PO Box 12194
Research Triangle Park, NC 27709-2194
ATTN: Tim Flanigan 0212335.001.302.100
2012
FOR FUTURE REFERENCE
Announcing the start of reporting for the
2012 Deaths in Custody Reporting Program.
** No action is requested at this time. **
This packet includes:
Instructions for reporting data
2012 Death Report Form
Postage-paid Return Envelope
2012 Reporting Instructions
We have enclosed a 2012 Death Report form for your
convenience. If no deaths have occurred within your
prisons to date in 2012, you have nothing to report at this
time.
Please submit a report for any deaths that occur within your
prisons in 2012 as soon as the autopsy or other official
death investigation results are available.
Please complete ALL form questions, including “Specify”
fields, if applicable.
You may submit your data online by logging onto the
Deaths and Custody Reporting Program (DCRP) website
(https://bjsdcrp.rti.org) using the login credentials in your
cover letter.
We have enclosed a paper version of the 2012 Death
Report form if you prefer to submit by mail or fax. Please
disregard the paper form if you plan to submit data online.
If you have more than one inmate death, and are unable to
use the Web option, additional Death Report forms are
available for download by logging onto the DCRP Web site
as described above.
OMB No. 1121-0249 Approval Expires 12/31/2012
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
DEATHS IN CUSTODY— 2012
STATE PRISON INMATE
DEATH REPORT
Form NPS-4A
(Addendum)
RTI INTERNATIONAL
DATA SUPPLIED BY:
Name
Title
Official
Address
Telephone
City
FAX
State
Zip
E-mail
Please correct any error in name or mailing address
Instructions for Completion
•
If no deaths occurred, you will not need to report anything at this time. At the beginning of the next calendar year, you will
be asked to complete a summary form whether you had a death occurrence or not.
•
If you had more than 1 death, make copies of pages 2 and 3 for each additional death.
•
Complete questions 1 through 16 for each inmate death.
•
Once your death records are complete, there are several ways to submit a death report:
ONLINE: Complete the report online at: https://bjsdcrp.rti.org
MAIL: RTI International, Attn: Kim Aspinwall
E-MAIL: [email protected]
Project Number: 0213149.001.102
FAX (TOLL-FREE): 1-866-800-9179
3040 Cornwallis Road, PO Box 12194
Research Triangle Park, NC 27709-2194
•
If you need assistance, call Kim Aspinwall of RTI International toll-free at 1-800-344-1387 or [email protected]
What deaths should be reported?
EXCLUDE deaths of ALL Persons
INCLUDE deaths of ALL Persons
•
Confined in your correctional facilities, whether housed
under your jurisdiction or that of another state;
•
Under your jurisdiction but housed in private correctional
facilities, whether located in or out of state;
•
Under your jurisdiction but in special facilities (e.g., medical/
treatment/release centers, halfway houses, police/court
lockups, and work farms);
•
In transit to or from your facilities while under your
supervision.
•
Deaths by execution that were carried out in your state;
•
Confined in local jail facilities, whether located in or out of
state;
•
Under your jurisdiction but housed in a state-operated
correctional facility in another state or in a federal facility;
•
Under probation or parole supervision in your state.
BURDEN STATEMENT
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB control number. The burden of
this collection is estimated to average 5 minutes per response for jurisdictions reporting zero deaths and 30 minutes per each reported death, including reviewing
instructions, searching existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden estimate or any
aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW , Washington, DC 20531. Do
not send your completed form to this address.
STATE PRISON INMATE DEATH REPORT
8. For what offense(s) was the inmate being held?
1. What was the inmate’s name?
a.
LAST
FIRST
MI
b.
2. On what date did the inmate die?
2012
MONTH
DAY
c.
d.
YEAR
e.
3. What was the name and location of the correctional
facility involved?
9. Since admission, did the inmate ever stay overnight in
a mental health facility?
Please Specify:
Yes
No
Don’t Know
4. What was the inmate’s date of birth?
MONTH
DAY
YEAR
5. What was the inmate’s sex?
Male
Female
6. What was the inmate’s race/ethnic origin?
White (not of Hispanic origin)
Black or African American (not of Hispanic origin)
Hispanic or Latino
American Indian/Alaska Native (not of Hispanic
origin)
Asian (not of Hispanic origin)
Native Hawaiian or Other Pacific Islander (not of
Hispanic origin)
Two or more races
Additional categories in your information system
Please Specify:
Race/Ethnicity Not Known
7. On what date had the inmate been admitted to one of
your correctional facilities?
MONTH
DAY
YEAR
10. Where did the inmate die?
In a general housing in the facility or on prison
grounds
In a segregation unit
In a special medical unit/infirmary within your
facility
In a special mental health services unit within your
facility
In a medical center outside your facility
In a mental health center outside your facility
While in transit
Please Specify:
Elsewhere
11. Where did the incident (e.g., accident, suicide, or
homicide) take place?
NOT APPLICABLE—Cause of death was illness,
intoxication, or AIDS-related
In the prison facility or on the prison grounds
In the inmate’s cell/room
In a temporary holding area/lockup
[SPECIFY]
In a common area within the facility (e.g.,
yard, library, cafeteria, etc.)
In a special medical unit/infirmary
In a special mental health services unit
In a segregation unit
On death row, special unit awaiting capital
punishment
Elsewhere within the prison facility
Please Specify:
Outside the prison facility (e.g., while on work release
or on work detail, etc.)
Elsewhere
<< AGENCY ID >>
Please Specify:
12. Had the inmate been receiving treatment for the medical condition after admission to your correctional facilities?
Exclude emergency care provided at time of death.
NOT APPLICABLE—Cause of death was accidental injury, intoxication, suicide, or homicide
a.
b.
c.
d.
e.
f.
YES
NO
DON’T KNOW
Evaluated by physician/medical staff ....................................................................
Had diagnostic tests (e.g., X-rays, MRI) ...............................................................
PLEASE PROVIDE A
Received medications ...........................................................................................
RESPONSE FOR EACH
Received treatment/care other than medications .................................................
ITEM (a – f).
Had surgery ..........................................................................................................
Confined in special medical unit ..........................................................................
13. When did the incident (e.g., accident, suicide, or
homicide) causing the inmate’s death occur?
NOT APPLICABLE—Cause of death was illness,
intoxication, or AIDS-related
14. Are the results of a medical examiner’s or coroner’s
evaluation (such as an autopsy, post-mortem exam, or
review of medical records) available in order to establish
an official cause of death?
YES
Morning (6 am to Noon)
Afternoon (Noon to 6 pm)
Evening (6 pm to Midnight)
Overnight (Midnight to 6 am)
CONTINUE TO Q15
Evaluation complete—results are pending
SKIP REMAINING QUESTIONS—YOU WILL
BE CONTACTED AT A LATER TIME FOR THE
CAUSE OF DEATH
No evaluation is planned
15. What was the cause of death?
CONTINUE TO Q15
*** Please SPECIFY cause of death as it is critical information ***
Illness—Exclude AIDS-related deaths [Specify]
Acquired Immune Deficiency Syndrome (AIDS)
Accidental alcohol/drug intoxication [Specify]
Accidental injury to self [Describe]
Accidental injury by other (e.g., vehicular
accidents during transport) [Describe]
Suicide (e.g., hanging, knife/cutting instrument,
intentional drug overdose) [Describe]
Homicide [Please provide description]
Other cause(s) [Specify]
16. Was the cause of death the result of a pre-existing
medical condition or did the inmate develop the
condition after admission? If multiple conditions
caused the death, select “Pre-existing medical
condition.”
Please add any additional notes here:
NOT APPLICABLE—Cause of death was
accidental injury, intoxication, suicide, or
homicide
Pre-existing medical condition
Deceased developed condition after admission
Could not be determined
<>
IMPORTANT: DO NOT ENLARGE, REDUCE OR MOVE the FIM and POSTNET barcodes. They are only valid as printed!
Special care must be taken to ensure FIM and POSTNET barcode are actual size AND placed properly on the mail piece
to meet both USPS regulations and automation compatibility standards.
3040 Cornwallis Road ■ PO Box 12194
Research Triangle Park, NC 27709-2194
■
NO POSTAGE
NECESSARY
IF MAILED
IN THE UNITED
STATES
USA
BUSINESS REPLY MAIL
FIRST-CLASS MAIL
PERMIT NO. 593
DURHAM, NC
POSTAGE WILL BE PAID BY ADDRESSEE
RTI INTERNATIONAL
ATTN: TIM FLANIGAN 0213149.001.102
PO BOX 12194
RESEARCH TRIANGLE PARK NC 27709-9935
Artwork for Envelope, Business, #10, 4 1/8 x 9 1/2 in (4.125" x 9.5")
Layout: sample BRM Env with IMB.lyt
February 23, 2011
Produced by DAZzle Designer, Version 9.0.05
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U.S. Postal Service, Serial #
Attachment J. Example of letters, emails and telephone
scripts for data quality and non-response follow-up for
DCRP jail respondents
Directed Email Prompt
September 29, 2011
Dear {Salutation}{Last Name}:
We are in the process of finalizing data collection for the 2010 U.S. Department of Justice’s Deaths in Custody Reporting
Program (DCRP). We recently contacted you by telephone because we have not received your 2010 Annual Summary Form.
We ask ALL agencies to complete the Annual Summary form (i.e., a CJ9A or a CJ10A) regardless if whether they
have experienced a death in custody during 2010.
The Annual Summary form has 4 short questions that should take you a few minutes to complete. We have enclosed this
form for you to complete and mail using the enclosed return envelope or fax back to us at 1-866-800-9179. Furthermore, if
you have experienced a death in custody during 2010, we ask that you complete the enclosed death report. Please make
copies of this form if needed for multiple deaths to report for 2010.
We would appreciate your response on or before: October 10, 2011.
If you would prefer to complete the form(s) online, our web page may be found here: https://bjsdcrp.rti.org/. Once there,
you will be instructed to enter a username and password:
Username:
Password:
«username»
«password»
After logging in, please select the green button: “Submit 2010 Deaths in Custody Data.” Next, click on the blue button to fill
out your 2010 Annual Summary Form. If you have any deaths to report, please click the green button entitled “Add a 2010
Death Report” so that you can begin entering death record data.
If you have any questions or concerns, please contact Tim Flanigan, the RTI Data Collection Task Leader, at 1-800-3348571, or [email protected]
We would appreciate your participation, as the continued success of this program depends on you.
Sincerely,
Margaret E. Noonan, Program Manager
Deaths in Custody Reporting Program
202-353-2060
[email protected]
William J. Sabol, Chief
Corrections Statistics Program
202-514-1062
[email protected]
Enclosures:
Annual Summary on Inmates Under Jail Jurisdiction (CJ-9A)
Annual Death Report on Inmates under Jail Jurisdiction (CJ-9)
Telephone script – missing or incomplete annual summary form
Good morning/afternoon, [Respondent].
My name is [your name] with RTI International and I’m calling on the behalf of the Bureau of Justice Statistics’ Deaths in
Custody Program.. Would you have a few moments to discuss the Deaths in Custody Reporting Program?
If the respondent indicates you’ve caught them at a bad time:
I understand. I can call you back at a more convenient time. What day and time would work best for you?
Make note of the respondents instructions.
Just to confirm, tomorrow afternoon at 2:00 is a time that works best for you? Thank you. I look forward to speaking to you
then.
If the respondent indicates that they have time to talk
Specifically, I’m calling about that status of your agency’s Annual Summary Form.
As you may recall, we ask all jails to complete this form even if your jail has no deaths to report. The data on this form is
critical to calculating mortality rates for all jails. It should take about five minutes for you to complete. If you would prefer I
can take this information over the phone.
If the respondent would like to enter the data on their own.
Our online tool is the easiest way to enter your data. Go to bjsdcrp.rti.org/ and enter your username and password to complete
your form.
Be prepared to provide the respondent with this information.
If the respondent would prefer to fax or mail their data, give them the fax number or the mailing address.
When you’re ready, you can fax your survey to 1-866-800-9179, which is a toll-free number. Please address the fax to Kim
Aspinwall.
When you’re ready you can mail your survey to RTI International, Attn: Kim Aspinwall. Project number
0212335.001.302.200, PO Box 12194, Research Triangle Park, NC 27709-2194.
If the respondent can provide the information over the phone:
That’s great. We can begin when you are ready.
Go through the items in order. Once complete thank the respondent for their time.
If you would like, I can provide you with a copy of your submission for your records.
Offer to provide a copy via email, or if they prefer arrange to fax or mail them a copy.
Thank you so much for your time and for participating in the Deaths in Custody Reporting Program.
Telephone script – missing death forms
Good morning/afternoon, [Respondent].
My name is [your name] with RTI International and I’m calling on the behalf of the Bureau of Justice Statistics’ Deaths in
Custody Program.. Would you have a few moments to discuss the Deaths in Custody Reporting Program?
If the respondent indicates you’ve caught them at a bad time:
I understand. I can call you back at a more convenient time. What day and time would work best for you?
Make note of the respondents instructions.
Just to confirm, tomorrow afternoon at 2:00 is a time that works best for you? Thank you. I look forward to speaking to you
then.
If the respondent indicates that they have time to talk
Specifically, I’m calling about that status of an inmate death that your jail reported. On your Annual Summary Form, you
indicated that your jail had an inmate death, but we have yet to receive the death form. Is it correct that your jail has an
inmate death to report?
If no, do the following:
OK, we’re going to edit your annual summary form to reflect the true count of zero. If you would like, I can provide you with
a copy of your submission for your records.
Thank you so much for your time and for participating in the Deaths in Custody Reporting Program.
If yes, follow the script below. If yes, but they’re waiting on data from the medical examiner or coroner, advise them that they
can begin the death record and complete it once the final cause of death ruling is available.
When you’re ready to enter your death record, our online tool is the easiest way to enter your data. Go to bjsdcrp.rti.org/ and
enter your username and password to complete your form.
Be prepared to provide the respondent with this information.
If the respondent would prefer to fax or mail their data, give them the fax number or the mailing address.
When you’re ready, you can fax your survey to 1-866-800-9179, which is a toll-free number. Please address the fax to Kim
Aspinwall.
When you’re ready you can mail your survey to RTI International, Attn: Kim Aspinwall. Project number
0212335.001.302.200, PO Box 12194, Research Triangle Park, NC 27709-2194.
If the respondent can provide the information over the phone:
That’s great. We can begin when you are ready.
Go through the items in order. Once complete thank the respondent for their time.
If you would like, I can provide you with a copy of your submission for your records.
Offer to provide a copy via email, or if they prefer arrange to fax or mail them a copy.
Thank you so much for your time and for participating in the Deaths in Custody Reporting Program.
Telephone script – death form missing information
Good morning/afternoon, [Respondent].
My name is [your name] with RTI International and I’m calling on the behalf of the Bureau of Justice Statistics’ Deaths in
Custody Program.. Would you have a few moments to discuss the Deaths in Custody Reporting Program?
If the respondent indicates you’ve caught them at a bad time:
I understand. I can call you back at a more convenient time. What day and time would work best for you?
Make note of the respondents instructions.
Just to confirm, tomorrow afternoon at 2:00 is a time that works best for you? Thank you. I look forward to speaking to you
then.
If the respondent indicates that they have time to talk
Specifically, I’m calling about that status of an inmate death that your jail reported. The inmate’s name is John Doe, and his
date of death is 12/31/2012. You indicated that you were awaiting the results of the autopsy. Are those results currently
available?
If no, do the following:
I understand. Do you have an idea as to when this information will be available? Make a note of the expected date. Once you
receive this information, please complete the record for John Doe at your earliest convenience.
Thank you so much for your time and for participating in the Deaths in Custody Reporting Program.
If yes, follow the script below.
If you prefer, I can take that information from you over the phone.
If the respondent can provide the information over the phone: You can also offer to set up a time to call them back if they’d
like to do it over the phone but don’t have the information in front of them.
That’s great. We can begin when you are ready.
Go through the items in order. Once complete thank the respondent for their time.
If you would like, I can provide you with a copy of your submission for your records.
Offer to provide a copy via email, or if they prefer arrange to fax or mail them a copy.
Thank you so much for your time and for participating in the Deaths in Custody Reporting Program.
If the respondent would rather enter the data on their own.
When you’re ready to enter your death record, our online tool is the easiest way to enter your data. Go to bjsdcrp.rti.org/ and
enter your username and password to complete your form.
Be prepared to provide the respondent with this information.
If the respondent would prefer to fax or mail their data, give them the fax number or the mailing address.
When you’re ready, you can fax your survey to 1-866-800-9179, which is a toll-free number. Please address the fax to Kim
Aspinwall. It’s not necessary to complete a new form, just reference your jail, the inmate’s name and date of death and
provide the final cause of death.
.
When you’re ready you can mail your survey to RTI International, Attn: Kim Aspinwall. Project number
0212335.001.302.200, PO Box 12194, Research Triangle Park, NC 27709-2194.
If you have any questions or concerns during this process, please don’t hesitate to contact me at (provide contact
information). Thank you for participating in the Deaths in Custody Reporting Program.
FIRST REMINDER MAILING – SENT USPS PRIORITY MAIL FOR THOSE WITHOUT EMAILS
Dear <>:
We appreciate your continued support of the Bureau of Justice Statistics’ (BJS) Deaths in Custody
Reporting Program (DCRP). As a reminder, you can report an inmate death at any time through the year.
If you have already entered some death reports in response to our letter in October, thank you for your
initial response.
If you have zero deaths to report, you have nothing to do at this time.
If you have any deaths to report at the close of calendar year 2011, please report these at your earliest
convenience. Submitting your forms online is the most efficient method of reporting the death records.
In order to report online, please log onto the DCRP website (https://bjsdcrp.rti.org) and use the
following login credentials:
USERNAME: <>
PASSWORD: <>
In early 2012, we will ask all jails to complete a brief annual summary form that collects population data
for your facilities and a final count of the number of deaths that occurred in your jurisdiction during
2011. This survey should take about five minutes to complete and the information collected is necessary
to calculate mortality in jails.
If you have any questions, please contact Kim Aspinwall at 1-800-344-1387, or e-mail us
at [email protected]. Please don’t hesitate to contact BJS directly at any time, using the contact
information below.
We thank you for your participation and look forward to our continued work together.
Sincerely,
Margaret E. Noonan, Program Manager
Deaths in Custody Reporting Program
202-353-2060
[email protected]
William J. Sabol, Deputy Director
Statistical Collections & Analysis
202-514-1062
[email protected]
NONRESPONSE EMAIL TARGETING “0” DEATH REPORT AGENCIES
We recently sent you 2011 reporting materials for the U.S. Department of Justice’s Deaths in Custody Reporting
Program (DCRP). We appreciate your participation, as the continued success of this program depends on you. To
date, we have not received your 2011 annual summary form. If you have recently submitted this, no further
action is requested.
Below are some questions you may have about our request.
What if we had no deaths in custody during 2011?
We would still like for you to complete the attached CJ9A form. This should take about five minutes
of your time. These data are critical to estimating mortality in jails. Please note that estimates for the
population/count questions on the form are acceptable.
What if we had one or more deaths in custody during 2011?
Upon completing the CJ9A, please also complete the first page of the attached CJ9 form and a
corresponding death report (CJ9 pages 2 and 3) for each inmate death.
How do I submit my reports?
ONLINE: https://bjsdcrp.rti.org/. I’ve included your username and password below for your convenience.
USER NAME: {FILL} PASSWORD: {FILL}
FAX: Fax (toll free): (866) 800–9179
MAIL: RTI International, Attn: Data Capture
Project Number: 0212335.001.302.200
3040 Cornwallis Road, P.O. Box 12194,
Research Triangle Park, NC 27709-2194
EMAIL: You can email your completed reports to: [email protected]
Please submit your completed reports no later than June 30, 2012.
If you have any questions about the 2011 collection or have difficulty accessing the website, please contact Kim
Aspinwall, the RTI Data Collection Task Leader at 1-800-334-1387, or [email protected].
Thank you for your time.
Margaret E. Noonan, DCRP Project Manager
Example of an email exchange with the field
From: Noonan, Margaret [mailto:[email protected]]
Sent: Tuesday, January 31, 2012 2:02 PM
To: Amy Hall
Subject: RE: Death in Custody Report
Hi [Retracted],
It was nice talking to you today. Sorry for the confusion about the separate collections. The CJ11 forms are the
arrest-related death forms, which I don’t work on.
Just as an FYI, if you ever need information on that collection, you can talk to Andrea Burch, here at BJS. Her
email is [email protected].
The packet you received has to do with death occurring in jails. We ask all jails, even those that have zero deaths to
report, to fill out our brief annual summary forms (the CJ9a). I’ve attached a copy of your agency’s CJ9A form
from 2010. It should take about five minutes for you to complete. It asks four questions on one-day inmate counts,
annual admissions, average daily population and number of inmate deaths, which is zero in your agency’s case.
Take a look at the attachment, and when you’re ready, you can fill it out online by going to the Deaths in Custody
Reporting Program website: https://bjsdcrp.rti.org/
Username: [retracted]
Password: [retracted]
Alternately, you can fax or mail your data following the instructions on the front of the CJ9A form.
Please don’t hesitate to contact me if you have any questions or concerns.
Thank you for participating in the Deaths in Custody Reporting Program.
Take care,
Margaret
Margaret Noonan
Statistician
U.S. Department of Justice
Bureau of Justice Statistics
810 7th Street, NW
Washington, DC 20531
(202) 353-2060
From: Amy Hall [mailto:[email protected]]
Sent: Tuesday, January 31, 2012 2:29 PM
To: Noonan, Margaret
Subject: Death in Custody Report
Ms. Noonan,
I am writing inquiring the status of the DCRP for Crawford County Kansas. I emailed the report form CJ-11
to [email protected] on January 6, 2012. We received a packet in the mail today that includes forms for
2011 and 2012. I just need to be certain that our report for 2011 has indeed been received. Thank you in advance
for your time looking into this matter.
Amy Hall
Records Clerk
Crawford County Sheriff’s Department
P.O. Box 157
225 N. Enterprise Drive
Girard, Kansas 66743
620-724-8274
| File Type | application/pdf |
| File Modified | 2013-08-16 |
| File Created | 2013-08-14 |