Report: Overhaul needed to avoid ‘untimely’ health care for inmates

Department of Correction

Chart from a consultant’s plan to redesign inmate health care system

The system of providing healthcare to nearly 14,000 inmates in state prisons is on a path to “inadequate staffing” and “untimely healthcare,” according to consultants hired by the state Department of Correction.

The consultants, A Health Adventure Inc., wrote in a December report that planned decreases in state funding and rising costs for care under the current model would sacrifice quality and would probably increase legal costs. The consultants made their findings after reviewing the cost – and quality – of health care behind bars.

Inmate healthcare is currently provided by UConn Health under a contract with the correction department worth about $140 million this year, but the department will take over control in July.

“Mounting health care litigation costs are at hand,” the report warned. Unless changes are made, “legal costs may soon rival California ($5M+ annually in court monitoring; plus settlement, litigation, decree implementation costs).”

To address the problems, the consultants recommend redesigning the system using a “hybrid model” that would rely more heavily on community providers for certain services while transitioning most current fulltime health staff from UConn to the correction department. The plan would give the system more care providers while reigning in future costs, the consultants said.

The report was released Tuesday afternoon – nearly six weeks after it was first requested by The Connecticut Mirror, which was initially told it was not public information. On Wednesday, Senate Republican leaders are set to hold a press conference at the state Capitol complex to call for more transparency and a legislative examination of inmate medical care at the state’s 32 prisons and halfway houses.

There is currently limited oversight over medical and mental health care for inmates, The Mirror reported last month. The consultant’s report released Tuesday is largely focused on changing the current delivery system rather than the status of the existing one.

The Department of Correction announced last month that the consultant’s findings were the principal reason they decided to begin managing inmate health care rather than UConn Health. UConn Health has been managing inmate health care for more than two decades.

The current setup is fiscally unsustainable, the consultants found.

“Long-term state costs for current delivery framework are high and reducible under a new model of care,” they wrote. “Better health outcomes and timely delivered care results in safer workplace for employees and reduced state costs.”

They recommended shedding 87 existing full-time staff – a 17 percent reduction – with the transition and having private providers take on a large role in delivering care. Hit hardest by the change would be dental assistants, dentists, pharmacists and pharmacist technicians.

The plan calls for reducing labor costs by $18.8 million beginning in the fiscal year that starts July 1 – a 37 percent reduction. Community providers would be allocated $14.6 million for services they weren’t previously responsible for. The plan also would eliminate $7.5 million in administrative costs.

Annual savings would grow over time with the redesigned system, with estimated annual savings of $20 million in the fourth fiscal year and $46 million by 2026.

In releasing the report, a spokesman for the correction department emphasized details in the report are just recommendations.

“We cannot stress enough that specific details regarding the transition of management of inmate healthcare from UConn Health to DOC remains a work in progress,” said Karen Martucci, director of external affairs. “A determination of the final organizational structure has not been determined… The independent consultant presented DOC with several suggestions – some of which will be incorporated into DOC’s action plan, and several others that will not be implemented. It’s also important to note that the transition is fluid and DOC continues to evaluate many entities to align and best prepare the agency to provide a community standard of care.”

The final page in the report shows detailed proposed changes to spending, which would bring overspending of the inmate health care budget down from $2.3 million this year to $427,000 next year. The state is slated to cut funding for inmate health by $8 million next year.