Correctional Health Continues to Provide Quality Care
Maynard, Gary D., Corrections Today
On Nov. 9, 1973, a Texas inmate was injured performing a work assignment. The inmate was dissatisfied with the medical care he received and took his case to court. His complaint ultimately made its way to the U.S. Supreme Court where, in 1976, the Supreme Court declared that inmates have a constitutional right to medical care. No other group in the United States has ever been officially given such an entitlement.
On one hand, outrage came from opponents who felt that the impoverished in the community should have a right to health care--not those who committed felonies. On the other hand, proponents of inmate rights were skeptical because the inmate was only entitled to freedom from "deliberate indifference" to "serious medical needs." Would the level of quality be comparable to back alley medicine or approach community standards? Would medications prescribed reflect the most effective available in the community or something less?
As time has passed, these concerns have proved to be unfounded. The "right" to care has served correctional administrators as one of the primary keys to tranquility within an institution (together with food, jobs and visits). From the community perspective, returning a healthy individual to the community is recognized as an imperative component of the public safety mission. For example, no one wants a person with undetected tuberculosis released into the community. ACA has been a leader in guaranteeing this direction through its adoption of performance-based standards for both medical and mental health practice.
The articles in this month's edition of Corrections Today reflect just how far correctional health care has come. Correctional health care is on the forefront of the battle against sexually transmitted diseases, including HIV/AIDS. Facilities offer more concentrated hepatitis C diagnosis, monitoring and treatment than anywhere else in society. The scope of mental health disorders for which treatment is available in institutions surpasses that available to indigents in the community, and prisons constitute the largest source of residential mental health treatment available in the country. In short, correctional institutions have become an indispensable component of the nation's public health system, delivering quality health care to those who otherwise might find it inaccessible.
This means that prison health care faces the same challenges currently being experienced by all public health care providers--and then some:
Health care is expensive. Growing inmate populations place a greater demand on resources in an era of tightening budgets. The consumer price index for medical costs in urban areas last year exceeded 5 percent, compared to the 2 to 3 percent rise in other economic sectors. In addition, health care clamors for a greater percentage of the overall budget as a result of increasing costs and a greater need for services.
Health care employees are scarce. …