A right path can help your correctional healthcare services

Ask those who work in your jail and see if this sounds familiar. An inmate pops a sprinkler head, causing a cell to flood, which causes the facility to go on lockdown. Oh yeah, this is right after you’ve given your diabetes patients their insulin before their evening meal and food service is now delayed.

No? Try this one. Your health services staff and your correctional staff don’t exactly “get along” because the flow of necessary information is fragmented. Still nothing? Here’s one everyone has dealt with. A person is booked into the jail and has mental health needs. They are already decompensating and getting worse on your watch. Now, they need to be monitored for suicide precautions. What are you going to do? What did your jail do?

After 22 years in law enforcement, the last nine as an assistant jail commander, and now as vice president of program development for the National Commission on Correctional Health Care, I have just about seen it all. During those jail years, I was the liaison to our health services unit. I worked alongside the health services staff, dealing with the scenarios I just described.

I remember one inmate who was in our facility for a number of years. Because of his charges, his personal actions and our placement criteria, he was isolated from normal daily interaction. Now, I am not talking “Cool Hand Luke” put-them-in-the-box isolated, but not “White Collar” minimum security resort, either. Due to factors outside our control, his health deteriorated to the point where it was necessary to get him court-ordered to a facility that could care for him appropriately. Six months later, he came back fixed; six months later, he was broken again. This pattern was repeated several times.

Jails across the country are facing many of the same problems. Lack of funding, inexperienced staff, lack of education and training, and not following nationally recognized standards leads to poor outcomes. For instance, jails struggle with not being able to force medications on people who need them or care for patients with chronic care needs. They struggle with lack of mental health professionals trained to meet this population’s needs, and they struggle with meeting unfunded mandates from their states.

So, where do we go from here? I had a very good relationship with my health services administrator and saw value in the nationally recognized standards for health care services in jails. With their help, we developed responses to critical incidents for when jail operations were disrupted yet health care services needed to continue. With their help, our administrative meetings became much more useful and our communication gap closed. With their help, we developed a safe and appropriate suicide prevention plan.

My health services administrator and our correctional leadership team had a plan and a path to follow. We used the resources available to us and to each and every jail across the United States. This helped our facility develop efficient and effective health care services and the path was easy to follow.

A thorough assessment of your health care system may warrant an external body to speak to you about what your goals are, where your facility currently stands and where you want to go. It is tough to take an objective look at what you are doing, but with an unbiased assessment, your team can develop a proactive approach and set the stage to meet your desired outcomes.

Education is key. Correctional health care is incumbent on all involved staff, not just the clinical and health care staff. Correctional officers are with the inmate population 24 hours a day. They are the eyes and ears of your facility. With proper training and preparedness, they can recognize changes in an inmate’s demeanor, health and mental stability before anyone else. Why limit them to the basic annual training requirements? Why not offer them more? Offering opportunities for specialized training not only increases quality of care, but also boosts staff morale.

Certification can help your staff develop professionally. If they are not already, allow them to become involved in a CIT program or become Certified Correctional Health Professionals. Those professional development opportunities can then be recognized in a number of ways, bolster self-confidence and enhance the working environment.

Pursuing accreditation and living the accreditation lifestyle is key for an efficient and effective health care and mental health care delivery system. Throughout the years, I have heard more than a few sheriffs tell me they follow national standards, but they do not pursue accreditation. In those cases, it is all too easy to “skip” a standard here and “fudge” one there. When corners are cut, good outcomes can turn into bad outcomes very quickly. Accreditation offers assurance both internally and publicly that a facility holds itself to high standards of care.

Recently, I began working with a clinician with an economics background. Together, we are seeking to prove that following these pathways and living the accreditation lifestyle will enable facilities to create an efficient and effective health care system while lowering health care costs at the same time.

A reactive approach is always more expensive than a proactive one. Those who choose to react after a bad outcome, and the lawsuit that almost inevitably follows, will spend more money on the back end than the cost of taking a proactive approach on the front. Don’t believe me? Google “jails sued.” In about 50 seconds, your search will result in more than 20 million headlines.

Listen to your own stories and ask yourself if you want to be in control of your own destiny. Using the resources that are available to you can improve a facility’s operational system, personnel and outcomes. Choosing the right path is critical.