The 2018 Special Session I Acts of Assembly, Chapter 2, Item 391, P., directs the Department of Corrections (DOC) to report on its long-term facility needs with respect to providing medical care to the state responsible (SR) offender population:

The Department of Corrections shall assess its long-term facility needs with respect to providing appropriate levels of medical and mental health care lo its offender population. At a minimum, the assessment shall include (i) a summary of the Department's existing clinical, geriatric, assisted living, and mental health capacity, and an assessment of the sufficiency of this existing capacity to meet the current and future needs of the Department's offender population; (ii) a prioritized list of capital projects which may be needed to address the Department's current or future needs for capacity in relation to (i) which shall include a discussion of the methodology used by the Department to prioritize projects and the estimated cost of each project; and, (iii) a short-term plan to house offenders in a manner which reduces the risks related to transmittable diseases. The Department shall provide the results of its assessment to the Director, Department of Planning and Budget, and the Chairmen of the House Appropriations and Senate Finance Committees no later than October 1, 2018.

The DOC houses more than 30,000 offenders each year, many of whom arrive with immediate medical needs that often stem from a lack of regular healthcare prior to incarceration. In addition to chronic conditions, many offenders come to the DOC with serious conditions arising from years of substance abuse and with infectious diseases such as HIV, Hepatitis, sexually transmitted diseases, and tuberculosis.(*1)

The DOC is meeting its constitutionally-mandated duty to provide a community standard of care to the offenders in its custody; however, current correctional settings are not designed to provide the level of care required by many in the SR population. The DOC faces rising costs, which create challenges to providing higher levels of care, especially given the number of offenders needing specialized care.

Deficiencies in medical facilities and physical plants, space restrictions, limited staffing (both medical and security), and insufficient technologies create operational, financial, and legal hardships.

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(*1) Anno, B. Jaye (2001). Correctional Health Care: Guidelines for the Management of an Adequate Delivery System. Chicago, IL: National Commission on Correctional Health Care. p. 264.