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Documents: Latest batch of state audits of Maryland prison health care facilities

BCDC visitorsWith Maryland Gov. Larry Hogan recently deciding to shut down the Baltimore City Detention Center immediately, I wanted to take a look at health care delivery quality in the state-run pre-trial facilities in Baltimore and in correctional institutions around the state.

I filed a Maryland Public Information Act request on Aug. 4, 2015, with the Office of Health Care Quality, which falls under the Maryland Department of Health and Mental Hygiene. OHCQ is the state agency responsible for overseeing and auditing all health care facilities in Maryland, making sure they’re following state laws and regulations.

A OHCQ spokesman responded four days later with the documents, which may be a record turnaround in the history of Maryland public information act requests. (Kudos to you, OHCQ.)

The document notes some deficiencies at the Baltimore City Detention Center for women, and, as is often common in correctional settings, a few problems with medication administration and record-keeping by prison health care staffers, who admittedly work in a fairly constrained environment.

The various facilities are required to file corrective action plans that address the deficiencies noted by state regulators. Those corrective action plans were not immediately available, as many had not been filed yet, according to an OHCQ spokesman.

These latest OHCQ audits, which date from 2012 to this year, are just one snapshot of a state prison system that also does its own tracking and auditing of inmate health care, and is subject to outside accreditation reviews.

More than 10 years ago, when I used the Maryland Public Information Act to get OHCQ audits and write an investigative story for The Baltimore Sun about the state’s prison health care system, the documents at the time showed significant problems with prison health staffing shortages, deteriorated facilities,  and poor medical record-keeping.

By comparison, this latest batch of audits showed far less dire conditions, which is a good indicator for inmates, correctional staffers, and Maryland taxpayers. Some in society take an unforgiving approach to inmate health care, believing criminals shouldn’t have access to “Cadillac” treatment. The reality is they hardly get that level of care, but they are due a standard of care that does not violate their Constitutional rights.

Many detainees (who are innocent until proven guilty) and inmates end up back in society, and if their acute or chronic health issues aren’t properly treated, they can become even greater burdens on their families and taxpayers.

I forwarded the OHCQ audit documents (embedded below) to the Maryland Department of Public Safety and Correctional Services for comment. A spokesman explained the various processes the department has in place to provide appropriate levels of health care to inmates.

The department’s comment in full:

Individual cases of noncompliance with processes does not reflect the overall standards met regarding care in the facilities. Our pre-trial facilities, such as the Baltimore City Booking and Intake Center and the Baltimore City Detention Center, which includes the Women’s Detention Center, are certified as being in compliance with the National Commission on Correctional HealthCare. The department also contracts with a clinical pharmacologist who monitors and audits for outdated medications and refrigerator temperatures for medications and generate corrective action plans for the medical teams to improve upon the medical administration processes. Equipment purchases to maintain American Disabilities Act compliance are part of the agreement with our contractors. If physical plant space does not allow bed scales for handicap inmates, there are other sites that can accommodate the inmate. Our facilities in Cumberland, the Western Correctional Institution and North Branch Correctional Institution, are certified by the American Correctional Association, a coveted certification nationally. And all of our facilities are audited by the Maryland Commission on Correctional Standards. The department has located in each of the regions, Continuous Quality Improvement nurses who conduct audits regarding clinical processes conducted by the privatized healthcare companies used in our system. The department has for these very old facilities a certified industrial hygienist and sanitation officers who conduct audits of the facilities related to sanitation and improvements.

What have you heard about the state of inmate health care in Maryland? Let us know. Leave a comment below or send tips to info@cityexplainer.com. Or share documents with us via our document uploader tool.

More to come.

View and download the file in Google Docs. Please credit to CityExplainer.com.

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  • Elizabeth Alexander

    I have a fair amount of experience in evaluating the quality of accreditation reviews performed by the National Commission on Correctional Health Care (NCCHC). The actual standards of the NCCHC are generally appropriate, although often too vague. The actual accreditation reviews, however, are close to useless because the reviewers have traditionally looked only at whether appropriate formal policies have been adopted at a particular facility, rather than actual practice. As a result, NCCHC has accredited a number of facilities that were thereafter found to violate the Eighth Amendment because actual practice was such that responsible officials knew that the health care posed a substantial danger of serious harm to the prisoners confined there. There is a simple explanation of the failures of this accreditation process: the fees that prisons and jails pay to the NCCHC to conduct the surveys is the major source of income for the organization. NCCHC, as well as some other organizations in the same field, have resisted changes that would remove the financial incentive from decisions to accredit a particular facility.

  • @gussent

    Thank you for comment, Elizabeth.

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