REVIEW OF HEALTH SERVICES IN CORRECTIONAL FACILITIES IN THE UNITED STATES

• NCJ Number: 54699
• Journal: Public Health Reports Volume: 92 Issue: 6 Dated: (NOVEMBER-DECEMBER 1977) Pages: 564-569
• Author(s): J NEWPORT
• Date Published: 1977
• Length: 6 pages
• Grant Number(s): H500874
• Sponsoring Agency: US Dept of Health, Education, and Welfare
• Corporate Author: US Dept of Health, Education, and Welfare
• Sale Source: John Newport University of California at Los Angeles
• Publication Format: Article
• Language: English
• Country: United States of America
• Note: ARTICLE BASED ON A PAPER PRESENTED AT THE 103D ANNUAL MEETING OF THE AMERICAN PUBLIC HEALTH ASSOCIATION IN CHICAGO, IL, NOVEMBER 20, 1975

Annotation

HEALTH SERVICES IN LOCAL JAILS AND STATE PRISONS ARE CONSIDERED, AND THE FEASIBILITY OF HEALTH MAINTENANCE ORGANIZATIONS AS AN INNOVATIVE WAY OF DELIVERING NEEDED MEDICAL CARE TO INMATES IS DISCUSSED.

Abstract

PRISONERS WITH SERIOUS MEDICAL PROBLEMS ARE OFTEN DENIED ACCESS TO NEEDED MEDICAL CARE, AND THE CARE THAT IS PROVIDED IS OFTEN INADEQUATE IN TERMS OF QUALITY AND ACCESSIBILITY. REFLECTIVE OF THEIR DISADVANTAGED BACKGROUNDS, PRISONERS ARE MORE LIKELY THAN THE GENERAL POPULATION TO HAVE SERIOUS AND UNDETECTED HEALTH PROBLEMS. ALCOHOLICS, WHO REQUIRE MEDICAL TREATMENT RATHER THAN INCARCERATION, COMPRISE ABOUT ONE-THIRD OF PERSONS ARRESTED. THE NATIONAL ADVISORY COMMISSION ON CRIMINAL JUSTICE, THE AMERICAN CORRECTIONAL ASSOCIATION, AND OTHER ORGANIZATIONS HAVE ESTABLISHED STANDARDS THAT SPECIFY MINIMUM CRITERIA FOR PRISON HEALTH SERVICES. ACTUAL CONDITIONS CHARACTERIZING HEALTH SERVICE PROGRAMS IN LOCAL JAILS, HOWEVER, CONTRAST SHARPLY WITH THESE STANDARDS. IN A 1970 CENSUS, IT WAS REPORTED THAT 49 PERCENT OF THE COUNTRY'S 4,037 LOCAL JAILS MAINTAINED NO MEDICAL FACILITIES. AN AMERICAN MEDICAL ASSOCIATION SURVEY IN 1972, YIELDING 1,159 USABLE RESPONSES, SHOWED THAT SLIGHTLY LESS THAN 30 PERCENT OF THE COUNTRY'S JAILS HAD MEDICAL FACILITIES. ONLY 6 PERCENT OF THE RESPONDENTS REPORTED THAT INMATES WERE GIVEN MEDICAL EXAMINATIONS UPON ENTRY. IN 77.8 PERCENT OF THE JAILS, THERE WERE NO FORMAL ARRANGEMENTS FOR MEDICAL COVERAGE OR SURVEILLANCE. A SIZABLE NUMBER OF JAILS HAD NO ARRANGEMENTS FOR THE HOSPITALIZATION OF PRISONERS. A STUDY OF STATE PRISONS IN PENNSYLVANIA REVEALED THAT ENTERING PRISONERS WERE GIVEN ONLY CURSORY MEDICAL EXAMINATION, ACCESS TO MEDICAL CARE WAS OFTEN IMPEDED BY GUARDS WHO LACKED TRAINING IN MEDICAL TRIAGE, SPECIAL DIETS WERE VIRTUALLY NONEXISTENT, PSYCHIATRIC SERVICES WERE INADEQUATE, MEDICAL AUDITS WERE LACKING, AND THE ALLOCATION OF HEALTH CARE PERSONNEL AND EQUIPMENT WAS UNPLANNED AND NOT REFLECTIVE OF ACTUAL NEEDS. IN A CLASS ACTION SUIT BY STATE PRISONERS AGAINST THE ALABAMA CORRECTIONAL SYSTEM, SOME SEVERE DEFICIENCIES IN THE STATE PRISON SYSTEM WERE DOCUMENTED. PRISONERS WITHOUT FORMAL TRAINING ROUTINELY DISPENSED DANGEROUS DRUGS, EXTRACTED TEETH, OPERATED X-RAY EQUIPMENT, AND EVEN PERFORMED MINOR SURGERY. HOSPITAL FACILITIES CONSISTED OF AN 80-BED UNIT WITH NO FULL-TIME MEDICAL STAFF AND NO NURSING COVERAGE AT NIGHT OR WEEKENDS. THERE WERE FLAGRANT ABUSES OF INDIVIDUAL PRISONERS. BASIC COMPONENTS OF A CORRECTIONAL FACILITY HEALTH MAINTENANCE ORGANIZATION FOR THE INMATE POPULATION OF A RELATIVELY LARGE JAIL OR PRISON ARE A FULL-TIME AND ADEQUATELY SALARIED HEALTH CARE STAFF THAT INCLUDES PHYSICIANS, NURSES, TECHNICIANS, AND OTHER APPROPRIATE MEDICAL PERSONNEL AND MEDICAL EVALUATION AND FOLLOWUP CARE (INTAKE MEDICAL EVALUATION, ONSITE PRIMARY CARE SERVICES, BASIC MENTAL HEALTH SERVICES, CONTRACTUAL ARRANGEMENTS FOR HOSPITAL CARE, SPECIALIZED OUTPATIENT SERVICES, HEALTH EDUCATION, NUTRITION SERVICES, AND DENTAL SERVICES). STATISTICAL DATA ON CORRECTIONAL FACILITIES AND INMATES ARE PROVIDED, AND IMPROVEMENTS THAT HAVE BEEN MADE IN HEALTH SERVICES FOR INMATES ARE NOTED. REFERENCES ARE CITED. (DEP)