"Financing health care for inmates can be a significant portion of state correctional spending for some states with health care costs ranging from an estimated 6 percent to 33 percent of institutional corrections spending in 2008, the most recent estimate available. The combination of expanded Medicaid eligibility and enhanced funding for those newly eligible as allowed under PPACA [Patient Protection and Affordable Care Act] gives states additional incentives to enroll inmates in Medicaid and obtain federal matching funds, and increases the federal responsibility for financing allowable services for inmates. Questions exist about the potential costs to the federal government, because little is known about how many inmates are eligible for Medicaid or the extent to which states are obtaining federal matching funds for allowable services … In this report, we provide information on the proportion of inmates eligible for Medicaid, and state efforts to enroll inmates in Medicaid and obtain federal matching funds for allowable services" (p. 2). While a large percentage of inmates will be eligible for Medicaid in the 27 states that have expanded Medicaid eligibility, only a very small percentage will be eligible for federal Medicaid funds. The impact to federal spending will be extremely limited.
This report "[p]resents the prevalence of medical problems among state and federal prisoners and jail inmates, highlighting differences in rates of chronic conditions and infectious diseases by demographic characteristic. The report describes health care services and treatment received by prisoners and jail inmates with health problems, including doctor's visits, use of prescription medication, and other types of treatment. It also explains reasons why inmates with health problems were not receiving care and describes inmate satisfaction with health services received while incarcerated. Highlights: In 2011–12, an estimated 40% of state and federal prisoners and jail inmates reported having a current chronic medical condition while about half reported ever having a chronic medical condition; Twenty-one percent of prisoners and 14% of jail inmates reported ever having tuberculosis, hepatitis B or C, or other STDs (excluding HIV or AIDS); Both prisoners and jail inmates were more likely than the general population to report ever having a chronic condition or infectious disease. The same finding held true for each specific condition or infectious disease; Among prisoners and jail inmates, females were more likely than males to report ever having a chronic condition; High blood pressure was the most common chronic condition reported by prisoners (30%) and jail inmates (26%); About 66% of prisoners and 40% of jail inmates with a chronic condition at the time of interview reported taking prescription medication; [and] More than half of prisoners (56%) and jail inmates (51%) said that they were either very satisfied or somewhat satisfied with the health care services received since admission" (BJS).
This is an excellent introduction to compassion fatigue (CF) (aka corrections fatigue) experienced by correctional health care staff. "While there is some literature on CF and burnout among correctional officers, there is scant information on how these phenomena affect correctional health care staff. This article discusses ways that CF may adversely impact the well-being of qualified mental health professionals who work in jail and prison settings. When left untreated, CF may result in serious and detrimental personal costs to the individual and organization. These costs can be mitigated by positive self-care, which also will be addressed in this article" (p. 10). Sections of this article cover: what compassion fatigue is; the role of trauma; why we neglect ourselves; the importance of prevention; compassion satisfaction—the flip side of CF; calendar it—planning ahead for self-care; organizational considerations; and taking care of yourself.
This report is an excellent introduction to the relationship between incarceration and public health and its significance for society. It is essential reading for anyone working within the fields of corrections and public health. Sections cover: the burden of disease behind bars—mental health, substance use and addiction, infectious disease, chronic disease, violence and self-harm, greater health disparities for women, and geriatric health; conditions of confinement and health—overcrowding, solitary confinement, sexual victimization, and quality of care; the health of communities--family structure, education and employment opportunities, housing stability and social entitlements, health insurance, and political capital; a political landscape ripe for reform; and the potential of the Affordable Care Act (ACA)—bolstering community capacity, strengthening front-end alternatives to arrest, prosecution, and incarceration, bridging health and justice systems, enabling outreach and care coordination, enrolling across the criminal justice continuum, granting Medicaid waivers and innovation, advancing health information technology, and regional challenges with the ACA.
"Every day, in communities throughout America, correctional officers, sheriff’s deputies and federal marshals must transport inmates from secure facilities to medical clinics and hospitals for treatment. Every transport is a risky venture for corrections officials, medical staff and the public, because the possibility that the inmate may seize an opportunity to escape is ever-present. This article will examine the problems posed and the risks inherent anytime an inmate is removed from the security of a correctional institution and taken to a medical facility where proper security is difficult to maintain" (p. 77). Sections cover: inmate medical needs; medical transportation; the dangers of transporting inmates to medical facilities; general best practices for transporting inmates; medical transportation practices; transporting officer preparedness; collaboration between EMS, hospital personnel, and correctional officers (i.e., security plans, weapons safety, telemedicine, and learning from past experiences); and five recommendations to increase safety during inmate medical transport.
“This report lays out ways that departments of corrections can consider to reduce inmate medical costs without affecting high standards for inmate medical services. Strategies for cost savings are presented that might be used by a department of corrections directly or included in contracts for outsourcing inmate health care. One or more prisons or jails across the nation use each strategy identified” (p. 4). This report is divided into two sections. Section 1—Summary: the issue of why so much money is spent on inmate health care; and the most promising cost-reduction approaches. Section 2—Detailed Analysis: reduce demand/need for medical care (i.e., improve the health of the inmate population, reduce unnecessary consumption of medical services, and divert/release sick individuals; reduce the cost for treating an inmate (i.e., reduce cost of pharmaceuticals, reduce cost of using outside medical care, use in-house medical services when less expensive, and tighten contracting and auditing); and synergistic approaches to health care cost reduction.
“This report was designed as a resource for the justice and health fields to: Identify the full range of beneficial information exchanges between the criminal justice and healthcare systems; Provide detail on specific information exchanges within the context of routine criminal justice and health operations; Serve as a guide to policymakers and practitioners seeking to implement information exchange, by offering detail on workflow and implementation issues; and, Offer a “blueprint” to certain specific information exchanges through the development of technical use cases” (p. 13). Sections comprising this document are: executive summary—issue overview, key findings according to beneficial uses by the criminal justice system and by healthcare providers, types of information to be exchanged, and implementation of information exchange, and next steps; background; implementation issues and potential challenges—privacy and consent, technical considerations, cost, and organizational factors like trust and leadership; catalog of beneficial criminal justice and health information exchange—criminal justice and health connections Matrix, and 34 information exchange synopses; implementation scenarios for reentry into the community after incarceration, and community-based treatment with effective criminal justice supervision; and next step recommendations. Appendixes provide: a list of acronyms and abbreviations; contributors; Phase II recommendations; additional implementation challenges information (HIPAA, HITECH Act, and 42 CFR Part 2); related information, standards, and guidelines; and success stories for SMART and WITS, BHIPS/CMBHS, and the Hampton County Sheriff’s Department.
"Organizations in both the health care and criminal justice fields have been using predictive analytics for a while, but predictive analytics are just beginning to be used in what may best be described as the hybrid field of health care and criminal justice. Predictive analytics are deployed in this hybrid field to anticipate the health needs of the justice-involved, and use this information to treat mental illness as well as other health problems. The underlying assumption is that these pre-emptive actions will reduce the risk of reoffending and reincarceration and thereby promote public safety. In the field of criminal justice, predictive analytics have already been shown to increase public safety through crime prevention" (p. 1). This issue paper presents three case studies showing how predictive analytics is being used by hybrid health and criminal justice systems. The case studies are: the Otsuka Digital Health (ODH) platform in Miami-Dade County used to divert the mentally ill from the local justice system; the utilization of Impact Pro by Centurion (the correctional health care provider for the states of Tennessee, Minnesota, Massachusetts, and Vermont) to treat incarcerated individuals; and the web-based RNR Simulation Tool which generates evidence-based treatment recommendations for the offender.
Join the National Institute of Corrections (NIC), Federal Bureau of Prisons (FBOP) and the Centers for Disease Control (CDC) to learn about how current community hepatitis A outbreaks are affecting correctional jurisdictions, and how you can prevent cases from becoming outbreaks in your own facilities.
Information and resources that address the unique challenges of providing health services to youthful offenders are provided through this 20-hour training program. This manual is divided into the following sections: adolescent development; trends and health issues; organizational/administrative issues; security and classification; the role of the medical staff; professional boundaries; mental health disorders; substance abuse; suicide prevention/intervention; sexual/physical/emotional abuse; behavior management; female health issues; action planning; and supplemental readings.