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Regulatory Agency Paper Hcs 430

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Regulatory Agency Paper

Joshua Hernandez

HCS/ 430

November 24, 2015

Djuanique Slaughter

Regulatory Agency Paper

It’s not surprising that the United States has the highest incarceration rate of its own citizens throughout the entire world. The current population of state and federal prisoners stands at more than 2.4 million or roughly 1 adult male for every 100.  Whether you’re an advocate for lesser sentencing for non-violent offenders, or support the idea of throwing away the key on every prisoner, nearly everyone can agree that the cost of incarcerating prisoners is staggering.  With the current cost of incarceration per prisoner hovering at around $32,000, and that rate could change based on whether the prison is a state or federal facility and where it’s located.  Just like the health care costs of those of us who are law abiding citizens the costs regarding prison health care is also skyrocketing, and it’s up to the National Commission on Correctional Health Care (NCCHC) to provide quality care to every prisoner.  This paper will discuss the role, the impact, and the duties the NCCHC executes as they provide health care to over 2.4 million inmates, and how they validate that quality of care they provide.

Back in the 1970’s, the American Medical Association (AMA) research results found the prison health care system was inadequate, inefficient, and so poorly organized that it eventually resulted in the creation of the National Commission on Correctional Health Care.  The role of the NCCHC, with the aid of an army of correction, medical, and legal professionals, was to establish new written procedures, methods, and practices in to several volumes.  These volumes became known as the Standards, which provided all of the health care instruction for prisons, jails, correction detention centers, and mental health facilities.  These instructions not only covered everything from medical procedures but also the care of medical records, personnel, and legal

concerns pertaining to health care.

The research on the prison health care system in the 1970’s discovered a number of shocking concerns and medical violations that required intervention on the part of both the medical and legal system.  The research concluded that a number of prisoners that were confined actually had no business being incarcerated.  Why? they suffered from a mental illness, which resulted in some sort of criminal act that resulted in being incarcerated.    For example “In 1972 Marc Abramson, a psychiatrist in San Mateo County, published a study reporting a 36 percent increase in mentally ill prisoners in the county jail and a 100 percent increase in mentally ill individuals judged to be incompetent to stand trial”  (Torrey, Kennard, Elsinger, Lamb, & Pavle, (2010), p. 2).  There was a prison cliché back in the 1970’s that stated “break their spirit, just don’t break their bones”, and that was the kind of atmosphere that prevailed in the prison system.  The health care available was poor and just short of being referred to as nonexistent.  If it became necessary, inmates performed their on medical care on their fellow inmates, and at times, even on the corrections officers that contained them.  That medical care included dispensing pharmaceuticals, pulling teeth, and even performing minor surgical procedures.  The lack of initiative to maintain proper medical records or provide some sort of consistent care were issues that required a resolution.  It got worse, as difficult as it is to believe, the researchers also uncovered incidences of correction administrators refusing prisoners the right to medical care.  It should also be noted that the prison population back in the early 1970’s was only 200,000 inmates.  Now it has ballooned to over 2.4 million, and those thought processes that went in to the Standard volumes, when the prison population was at the 1970’s levels, needed to be updated and amended to keep up with the prisoner influx as well as the new advancements in medicine.

 With the creation and implementation of the NCCHC, advances in improving the care of prisoners began to take shape. Partly due to the new computerized technology, keeping track and updating prisoners health records was substantially easier to check and cross reference.  Another benefit of this technology insured prisoners had the basics of medical care, or at least on a semi-consistent basis.  Meaning a physical and dental checkup was provided at least once every 2 to 3 years.  The quality and training of the prison medical staff also improved, full-time nurses, physicians, and other medical support staff were now required to be on hand 24 hours a day.  If specialized medical treatment was not available at the prison, medical care could now be provided at the closest medical facility available.  The biggest contribution the NCCHC made to prison care has been to set the stage for improved correctional health care.  These improvements included behavioral health care, dental care, chronic care, communicable disease prevention, and a more comprehensive suicide prevention program.  There was a new interest in providing medical care to those prisoners who were at the end of their sentence and on the verge of being released back in to the general public.  The idea of sending a sickened, now former inmate, with a potentially contagious disease, back to their families and communities seemed counterproductive.  So it was certainly in everyone’s best interest to continue to provide medical care or pharmaceuticals to these former inmates to possibly prevent any relapse related to any previous illness or mental health issue.  There are certain moral conflicts medical care providers might experience that are uniquely specific to providing care within a prison.  How will the HIPPA laws apply to prisoners, especially if the Department of Corrections or federal authorities are conducting a criminal investigation involving a prisoner.  These conflicting issues could come in the form of providing bodily fluids, medical records, or even legal testimony if it is



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