Thirty-one of 38 U.S. correctional systems responding to the current survey said that their budgets for providing inmate health care had continued an upward trend. Mississippi, Montana and Utah stated that their health care budgets had remained about the same as in the previous budget year, while Oklahoma, Rhode Island, West Virginia and Wisconsin reported that their health care budgets had decreased. Responses from the two Canadian systems are noted on each of the tables, but are not included as comparisons in this summary.
As in past surveys, population growth was the leading reason for the increases, followed by inflation and several other factors such as changes in contractual agreements, increased need for hospitalization, growth in number of elderly inmates and expansions in services.
The total actual expenditures for the budget categories noted on Table 2 from the 38 reporting systems is $3.18 billion. Ten years ago, Corrections Compendium published a similar survey and found that health care expenditure was, on average, 9.87 percent of total correctional budgets; the average figure in this survey is 13.98 percent.
To accommodate the growth in population or opening of new facilities, 21 systems indicated that, their staff also had increased, while 12 of the systems noted little or no change. There were decreases in staffing stated by Alabama, Louisiana, Nevada, Oklahoma and Rhode Island, primarily caused by budget changes, though Nevada closed one facility.
Table 2 identifies the types of services provided by the 38 reporting systems--whether internally or contracted/outsourced. The services listed as internally provided are alcohol addiction, drug addiction, dental care, sex offender, mental health, obstetrics/gynecology, tuberculosis, HIV/AIDS, hepatitis C, cancer, diabetes and dialysis. Among the services contracted or outsourced are doctors, advanced clinicians, nurses, medical staffing, medical management, pharmacy, laboratory, radiology, dental care, eye exams, mental health, hospitalization, podiatry, medical transport, physical therapy and specialized services when indicated.
When not specifically included in health care budgets, alcohol and drug treatment, and sex offender and mental health programs are the primary services funded elsewhere in separate department budgets or by other sources. Medical transport and hospitalization were also noted as not funded within health care budgets. For...