Medical Staff in Federal Prisons Found Wanting

McClatchy Washington Bureau
Published: 3/28/2016 11:34:10 PM
Modified: 3/28/2016 11:34:53 PM

Washington — Fewer than a quarter of federal prisons have maintained adequate medical staffs in recent years despite a nearly $200 million increase in funding for medical care, investigators said in a report issued Monday.

Stymied by relatively low salaries, grim working conditions and remote locations, the prisons have a hard time competing for medical staff, the Justice Department’s Office of the Inspector General notes. And though the investigators focused on federal institutions, the problems they identified exist in state facilities, too.

“It’s a national struggle,” said Joyce Hayhoe, director of legislation and communications for California Correctional Health Care Services, which provides medical treatment to the state’s more than 135,000 prisoners.

The report comes at a time when federal and state governments are under increased pressure to overhaul their prison systems. Lawmakers from both parties are weighing legislation to reduce prison overcrowding, and the Justice Department has undertaken a clemency initiative.

Money spent on medical care in the 97 institutions run by the Federal Bureau of Prisons grew from $905 million in 2010 to $1.1 billion in 2014. That increase, however, did little to solve the shortages in medical staff.

Just 24 federal institutions were staffed at or above the level set by bureau policy, investigators note. Staffing at 12 institutions reached a “crisis level” in 2014, investigators said.

The report does not identify specific institutions, but it made the general consequences clear.

“The BOP is responsible for confining offenders in environments that are safe, humane, cost-efficient and appropriately secure,” the report says. “However, many institutions remain understaffed, limiting the amount of care that an institution can provide.”

In 2014, bureau-run prisons employed 3,215 health care professionals, 17 percent fewer than the Bureau of Prisons projected was necessary to “provide what it considers to be ‘ideal’ care,” the report says. These health care providers are taking care of some 160,000 federal inmates held in Bureau of Prisons facilities.

Civil service employees made up 74 percent of filled positions, while U.S. Public Health Service officers, who more easily could be used to fill high-priority vacancies, composed the rest.

Salaries are much higher for health care providers outside prison walls. A top-earning prison-based physician earns $114,872 annually, compared with more than $180,000 for the average nonprison-based physician, the report notes.

The general characteristics of many prisons — their isolated locations and their criminal populations — also tend to make them a harder sell to potential health care personnel.

“Part of the struggle in California is that our prison-building program in ‘80s and ‘90s ... ended up building prisons outside of urban centers,” Hayhoe said. “So when you talk about wanting to get health care professionals out there, it’s difficult.”

High-security prisons pose another problem. “If you’re a health care provider and you choose to work in a prison, you’ll pick a prison that has a little bit easier of a population to deal with,” Hayhoe said.

California — which lost control of prison medical care to federal oversight in 2006 after years of problems — and other states have taken to advertising vacancies in trade publications or job fairs and creating positions for recruitment specialists.

In its formal response, the bureau agreed with the recommendations, though it cited the difficulties the second one poses.

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