Prison Health Care Criticized In Report

March 28, 2008
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An independent review of Michigan's prisons has cited significant problems with the health care provided to prisoners.

The governor's office commissioned the report in response to several high-profile inmate deaths in recent years.

One such case was the death of Timothy Souders, a 21-year-old Adrian man convicted of stealing toys. Souders died of dehydration at the Southern Michigan Correctional Facility in Jackson after being physically restrained for most of a four-day period. His guards were unaware that he was bipolar and had attempted suicide in the past, and mental health experts never examined him.

Some experts indicate the report, completed by the Chicago-based National Commission on Correctional Health, may be too little, too late. American Civil Liberties attorney Pat Streeter of Ann Arbor called the report a "pretty damning indictment" of the prison health care system.

"They missed a lot on the mental health component," said Streeter. "When they were compiling the report, they picked the files of prisoners already being treated."

She said that more than half of the state's inmates are mentally ill, possibly as many as a third seriously so.

Currently, Michigan contracts out health care to private, St. Louis-based Correctional Medical Services Inc., which provides prison health care in 24 states.

"Our goal is to provide the highest-quality health care at the lowest cost," said Russ Marlan, public information director for the Department of Corrections.

Under the current system, CMS charges the state what it spends on inmates. Marlan said the department wants to move toward a "shared-risk" system, in which the health care provider would receive a set amount of money at the beginning of the contract period and CMS would pay any additional cost.

Marlan cited one example from last year, in which a single prisoner's medical bills totaled nearly $800,000.

"Improving the quality of health care will decrease costs," Marlan said. "We also need to have a better use of time and a better use of resources."

Every inmate receives a yearly physical examination — something Marlan said is more than community standards because most people on the outside don't get an exam every year.

"An interesting way to look at it is that prisoners are the only group of people who are constitutionally guaranteed health care," said Marlan.

The department plans to cut costs by giving healthy inmates an exam every five years and to prioritize based on patients needs.

One of the report's major criticisms concerns the way prison health care providers keep records. Doctors and nurses currently keep medical records using computer software that the report charges is not effective. In addition, they often fill out mountains of paperwork for a single patient and send it to myriad individuals who often don't read them, the report said.

"For the most part, what we found was 'paper pushing' dictated by central office, rather than 'problem solving' specific to the needs of particular facilities," the report stated. 

The report found that the average health care professional saw only about nine or 10 patients a day, but should be able to see as many as 20.

The main thrust of the commission's recommendations, according to the report, is to make health care in prisons more effective and more efficient. HQX

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