WISCONSIN LEGISLATIVE AUDIT BUREAU
AUDIT SUMMARY
Report 01-9
May 2001
Prison Health Care
The Department of Corrections spent $37.2 million and employed 232.5 full-time equivalent
medical professionals and other support staff to provide health care to approximately
14,900 adult inmates in fiscal year
Inmates have a constitutional right to health care that meets minimum adequate standards, and the Department provides most health care through health services units that operate like outpatient clinics at each of the 14 adult institutions. It contracts with the University of Wisconsin Hospital and Clinics for specialized medical care, which is also provided at local hospitals and a 64-bed infirmary at Dodge Correctional Institution. Mental health care is provided in each institution, in special units at both Dodge and the Columbia Correctional Institution, and at two facilities operated by the Department of Health and Family Services: the Wisconsin Resource Center and the Winnebago Mental Health Institute.
Health Care Expenditures Are Increasing
Both the number of inmates and the cost of their health care have increased significantly
from
Although expenditures increased significantly in all health care categories, spending
for pharmaceuticals increased over 400 percent since
Salary and fringe benefit costs for permanent and limited-term health care employees
increased from $7.9 million in
Based on the number of inmates for whom psychotropic medications have been prescribed, 2,642 inmates have a diagnosed mental illness. Approximately 15 percent of inmates currently at Supermax are receiving psychotropic medications. Resources to provide mental health services vary considerably by institution and do not appear to be related to the incidence of mental illness among the population. For example, there are 132 mentally ill inmates for every psychological services staff position at Taycheedah, which houses most of the State’s female inmates, and 14 at Jackson.
Management of Contracts Could Be Improved
We include a number of recommendations to improve the Department’s contracting
practices for professional medical services. Currently, the Department contracts with
315 different vendors for laboratory, optical services, dental, and other medical
services that health services units cannot provide with available staff or cannot
provide cost-effectively. Expenditures for these services have increased 160
percent since
In
The Governor’s Budget Proposal Includes a Request for Increased Staffing
The Governor’s proposed budget seeks an additional $37.6 million in general purpose revenue funding and authority for 157.5 new positions related to prison health care. Most of the funding and positions have been proposed for new institutions and facility expansion, but $2.3 million and 39.5 positions have been proposed to increase health care staffing levels at existing institutions.
We reviewed alternatives for management improvements or other changes the Department could adopt to offset these costs. They include improving contract management, seeking Medical Assistance eligibility for some inmates, improving the process for transporting inmates to medical appointments, increasing the use of telemedicine, and increasing the co-payment fee for inmate-initiated visits to health services units. We also reviewed various measures for assessing and improving the quality of prison health care. They include conducting internal or external peer reviews, seeking accreditation by a national organization, monitoring the licenses of health care professionals, reviewing the legal challenges made in lawsuits, and conducting mortality reviews.
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