What is the purpose of the program?
The purpose of health services
is to provide comprehensive medical, dental, mental health, and associated ancillary services to inmates.
Do inmates get the same health care as free citizens?
The Department of Corrections is constitutionally required to provide a health care delivery system that ensures adequate care to all inmates and achieves correctional health care standards. Federal and state law, whether constitutional or statutory, sets forth minimum standards that the department must meet in order to provide minimally adequate medical and mental health care for inmates under its care and supervision.
What routine health care do inmates get?
Newly committed inmates are processed into the state correctional system through one of the department's reception centers
. While in one of the reception centers, inmates receive
- a comprehensive mental health screening, including sex offender screening and substance abuse identification;
- a comprehensive physical exam; and
- a visual dental exam.
After inmates are placed at a permanent correctional facility, they receive
- a bi-annual dental examination until age 50, and annually thereafter;
- a periodic medical screening every five years until age 50, and annually thereafter;
- access to health care 24 hours a day for urgent or emergency reasons;
- access to sick call Monday through Friday; and
- other physical, dental, and mental health services as required, including enrollment in chronic illness clinics and inpatient/outpatient mental health services as clinically indicated.
Do inmates pay for health services?
For each non-emergency visit by an inmate to a health care provider that is initiated by the inmate, the inmate must make a co-payment of $5. However, an inmate may not be denied access to health care as a result of not paying any co-payment. Additionally, a co-payment may not be charged for the required initial medical history, for visits for approved inmates with issues related to Americans with Disabilities Act (ADA) accommodations, and for physical examination of the inmate.
Do private providers deliver inmate health care?
Beginning in March 2013, comprehensive health care services, with the exception of pharmacy services, are provided through private health care contractors.
Under this model, department staff oversees the delivery of health care services and provides technical assistance to contractors. In addition, the department continues to provide pharmacy purchasing and dispensing services, with the private health care providers stocking and administering medications to inmates.
Do all prisons provide health care?
Inmate health care services are delivered at a variety of locations. Each major correctional institution is staffed and equipped to provide primary and urgent health care. When inmates need emergency care that cannot be provided at the institution, they are transported to the nearest community emergency room. Specialty services are provided at most reception centers. The private health care providers negotiate contracts and price agreements with local emergency room facilities and community health care providers and specialists for services that cannot be delivered in-house (e.g., some surgeries and orthopedics).
Each major institution has an inmate infirmary. In addition, the department and vendor operate the Reception and Medical Center Hospital, located in Lake Butler, which is a licensed 120-bed hospital that provides acute care for inmates. The department and its vendor also maintain a secure hospital unit at Memorial Hospital in Jacksonville (23 beds) for inmates requiring additional hospital-level care. The department and its vendor maintain a 12-bed secure hospital unit at Larkin Community Hospital in Miami-Dade for hospital care for inmates in South Florida.
Are inmates housed based on their health?
The department assigns inmates to correctional facilities based on several classification factors. The department assigns inmates in Florida prisons a health grade based on the inmate's physical capacity and mental health functioning. The department uses the medical and mental health grades, in addition to other classification factors such as custody status, work status, transportation, and impairments, to properly place inmates at a correctional facility that will best meet their needs (e.g., education, medical, substance abuse treatment). The department aims to reduce costs by grouping inmates with specific health care needs. The department uses a medical grading system that reflects needed medical care and assigns inmates to specialized medical groups when appropriate.
Are inmates tested for HIV/AIDS?
Section 945.355, Florida Statutes
, requires the department to test all inmates for HIV/AIDS no less than 60 days before their release.
Prior to their release, the department must provide HIV-positive inmates with information on preventing HIV transmission, referrals to the county health department and HIV primary care services, and a 30-day supply of medications. This is accomplished through the HIV Pre-Release Planning Program
, a Ryan White Grant funded through the Department of Health
. The department also is required to notify the Department of Health and relevant county health departments
where the inmate plans to reside about the inmates' HIV status.
Can inmates be released from prison because of poor health?
The Florida Commission on Offender Review
, in conjunction with the Department of Corrections, is required by s. 947.149
, Florida Statutes
, to establish the conditional medical release
program. An inmate is eligible for consideration for release under the conditional medical release program when the inmate, because of an existing medical or physical condition, is determined by the department to be permanently incapacitated or terminally ill. The conditional medical release term of the inmate is for the remainder of the inmate's sentence, without diminution of sentence for good behavior. Supervision of the medical release must include periodic medical evaluations at intervals determined by the commission at the time of release. During Fiscal Year 2018-19, the department recommended 76 inmates for conditional medical releases; the Florida Commission on Offender Review granted release to 38 inmates (50%).
How is the provision of inmate health care monitored?
The department's Office of Health Services monitors the delivery of health care services by the private health care providers. The contracts with the private health care providers include 46 reporting requirements and 70 performance measures covering health services administration and medical, dental, mental health, and pharmacy services. The department has a total of 21 clinical and administrative monitors who use a standardized monitoring instrument to review performance at each institution at least twice per year. The private health care providers are required to develop and implement a corrective action plan for each monitoring finding.
The Director of Health Services and other department staff in Tallahassee oversee the corrective action process. In addition, they are responsible for a variety of other oversight functions, such as policy development; administration of a statewide quality management program; handling administrative grievance appeals; responding to health care inquiries from inmates' family members and other interested parties; and ensuring private health care providers respond to issues identified during Correctional Medical Authority (CMA) reviews.
The Correctional Medical Authority assists in the delivery of health care services for inmates in the Department of Corrections by advising the Secretary of Corrections on the professional conduct of primary, convalescent, dental, and mental health care, and the management of costs consistent with quality care; advising the Governor and the Legislature on the status of the Department of Corrections' health care delivery system; and assuring that adequate standards of physical and mental health care for inmates are maintained at all Department of Corrections' institutions.
What is the inmate cost per day for health services?
For Fiscal Year 2018-19, the department reported that the average statewide per diem cost for health care for all inmates, excluding those in private prisons, was $17.84.
How are these activities funded?
Fiscal Year: 2020-21
PROGRAM: HEALTH SERVICES
INMATE HEALTH SERVICES
Where can I find related OPPAGA reports?
Health Care Study: Florida Department of Corrections, Report 19-FDCMed, November 2019
Where can I get more information?
Correctional Medical Authority agendas, minutes, surveys, and reports are available on the authority's website.
Use of Telemedicine in Inmate Health Care, Florida Senate, Issue Brief 2012-213, September 2011.
Inmate Trust Accounts, Inmate Health Care Services Contracts, and Prior Audit Follow-Up, Auditor General Report No. 2016-179, March 2016.
The Auditor General reports on department operations are available on its website.
Websites of Interest
American Correctional Association
Centers for Disease Control and Prevention
Correctional Medical Authority
National Commission on Correctional Health Care
Performance measures and standards for the department may be found in its Long Range Program Plan.
Performance measures and standards for the department may be found in its Long Range Program Plan
What are the applicable statutes?
Sections 20.315(3)(c)(2) (O
rganizational Structure), 945.047
, (Physician Licensing Requirements), 945.6034 (M
inimum Health Care Standards), and 945.6037
, (Inmate Co-payment for Non-emergency Medical Services), Florida Statutes
Whom do I contact for help?
Department of Corrections, 850-488-5021