December is here and time to reflect on noteworthy correctional healthcare news of the year past. News items continues to be dominated by concerns over our aging and mentally ill inmate population. Healthcare costs are rising and there is continual concern for how to provide adequate care with shrinking budgets. Many news stories chronicle lapses in medical attention or missed diagnoses. It can be difficult to attend to health issues in a secure environment with a transient patient population lacking prior healthcare or who have neglected their health for so many years. Here are my top picks for noteworthy news from 2013.
National Report on Prison Healthcare Spending
Pew Charitable Trusts released a report on prison healthcare spending that provides objective data on what we already know – state prisons are struggling with increasing healthcare spending. One chart shows that in just 7 years, between 2001 and 2007, average growth across the state systems was 52%. This report chronicles efforts underway in several state systems to improve healthcare while containing costs and is a good resource for all correctional settings, including jails.
Avoiding Entry or Encouraging Early Release
Medical and geriatric parole is one trend reported by Pew as gaining traction in an effort to reduce healthcare costs. Examples of medical parole include stories from Texas and the Federal Bureau of Prisons. Correctional settings are actually seeking to reduce costs at both ends of the continuum through avoiding entry in the system and encouraging early release. Greater strides are being made in avoiding system entry as the skittish public is none-to-happy about releasing criminals early. Examples of avoiding system entry include mental health courts in Michigan and California, and drug courts in Washington and North Carolina. There is also a progressing movement toward veteran’s courts, building on the success of the mental health and drug courts concept.
The Last Civil Rights Case?
The criminal justice system can lag behind in some areas of social change and that is definitely true in the case of HIV management. In September, following a court order, Alabama became the last state to move HIV-positive inmates into general population; closely following South Carolina’s policy change in July. Most segregation policies emerged during the turbulent 1980’s when the disease and it’s transmission was a mystery. Now that HIV treatment is considered chronic care and the epidemic under control, continuing segregation became an issue of stigma and discrimination in the prison system.
Mixed Messages
The Prison Rape Elimination Act (PREA) is on everyone’s mind this year, although the act was passed back in 2003. Created to protect, detect, and respond to rape in the criminal justice system, PREA standards did not hit the federal register until mid-2012 and the first 3-year audit cycle began this fall. In the midst of PREA standards ramp-up we get news that California is considering making condoms available to inmates. While infection transmission is greatly reduced with the correct use of condoms, providing condoms to the incarcerated population can be a surprising mixed message in the face of efforts to reduce coercive sex in the criminal justice system.
Do you have thoughts on the top correctional healthcare news? Did I miss an important theme? Share your views in the comments section of this post.
