RD207 - An Examination of Inmate Health Care Costs - September 30, 2011


Executive Summary:
In response to the increased need for funding to provide medical care to offenders housed in state correctional centers and state responsible offenders housed in local/regional jails, the 2011 Acts of Assembly requires the following:

“The Department of Corrections, with the support of the Department of Planning and Budget, shall conduct a thorough examination of, inmate medical expenses, with the goal of substantially reducing the increase in costs. Among the areas to be examined are the appropriate level of the use of part-time contracted physicians, the rate schedules of hospitals and other private medical providers utilized by the department, and enhanced treatment of offenders with chronic medical conditions with department personnel. The department shall examine those correctional facilities for which it has contracted with a private company to provide medical services to determine if the department could provide comparable medical services to inmates in those facilities at a lower cost, as well as the benefit of issuing a new request for proposals to take effect in FY 2012 when the current contracts are subject to renewal. In addition to these areas and steps, the department shall examine any other areas or issues if feels may result in cost decreases. The department shall submit a report, outlining its findings, the steps it has taken, and any recommendations for policy changes it feels are needed to reduce increases in inmate medical costs, to the Secretary of Public Safety and the Chairmen of the House Appropriations and Senate Finance Committees by September 30, 2011”. (Item 379.M)

The delivery of medical and mental health treatment to offenders is articulated in §53.1-32, Code of Virginia. Grounded in the Eighth Amendment prohibiting cruel and unusual punishment, offenders have a Constitutional right to healthcare. The legal system has further defined that healthcare is adequate and necessary if it meets the community standard of care. Therefore, the Department of Corrections (Department) is charged, by the Commonwealth of Virginia, to provide healthcare to the offender that is equivalent to community healthcare and one that is cost effective. Correctional facilities provide varying levels of healthcare to offenders as their medical needs indicate. The Department of Corrections’ Health Services encompasses a comprehensive group of dedicated administrators, physicians, nurses, dental staff, and mental health staff who provide adequate, medically necessary, and cost-effective health care services to offenders.

The following report focuses on actions taken by the Department to curb the growth in expenditures in the area of salaries, off-site health care services and pharmaceuticals. It also provides a comparison of the offsite healthcare costs for offenders compared to a large employer group as well as data which reflect the impact of catastrophic claims on increased medical costs. The report also includes an example of how the state of Texas provides medical services to its offenders and proposes recommended policy changes that could reduce medical service costs within the Commonwealth.