When it comes to inmate health care, free does not always mean inexpensive--at least that is what the Iowa Department of Corrections discovered. Despite inmate care being provided courtesy of the University of Iowa Health Care's indigent patient outreach program, for years, officials have been concerned about the amount of time spent transporting inmates back and forth between the system's nine facilities. One facility, for example, is four hours away from the hospital. Officials also knew that the costs associated with transportation and staff overtime continue to rise, not to mention that each individual trip presents a potential security hazard.
In studying the situation, the department learned that the Fort Dodge Correctional Facility alone logged approximately 30,660 miles to transport 140 patients to University of Iowa Health Care during the first half of fiscal year 2000. The cost to the department was $50,000. "We estimate now that the annual cost to the department for vehicles and staff overtime costs associated with medical trips to the hospital is approximately $1 million," noted Lowell Brandt, warden of the Iowa Medical and Classification Center at Oakdale (IMCC).
Officials noted other systemic inefficiencies as well. "When inmates are admitted into the hospital, we're responsible for providing correctional officers on a one-on-one basis," Brandt said, adding that since the hospital primarily serves a civilian population, these correctional officers must know hospital rules and regulations as they pertain to inmate care. As a result of the "as needed" nature of health care services, IMCC tended not to know about appointments or surgeries far enough in advance to contact the correctional officers who have already been trained in patient transfers and hospital procedures to accompany the inmate patient. "When hospital transportation was necessary, we grabbed the first available staff member. One month, one group of individuals might handle transportation and supervision. The next month, a completely different group might be responsible for that same duty," Brandt added. In studying how the facility worked in the past, Brandt said, it was recognized that limiting the number of staff involved in the process, and providing those individuals with appropriate medical, hospital and security training, would be the most efficient use of limited resources.
A population forecast cemented officials' interest in...