Improving the Quality of Health Care in California Prisons through Academic Partnership

Abstract: The incarcerated population in the U.S. continues to be as marginalized as any population in history, and the neglect of health care for this population exacerbates the health disparities of the poor, homeless, and racial/ethnic minorities. Not surprisingly, despite healthcare delivery models aimed at providing quality care as guaranteed by the 8th Amendment, the health care of the prison population is often abysmal. The recent health care crisis in California's State prisons demonstrates the depth of the problem. As of 2006, the federal judicial system has remanded improvement of that health care system to a Federal Receiver. The University of California-based Correctional Medicine Consultation Network is collaborating with the Receivership and with the California Department of Corrections and Rehabilitation (CDCR) to conduct an assessment of the health care quality and to effect necessary changes in the medical care for inmates. For the past two years, University of California primary care and HIV consultants have initiated quality of care interventions on individual and institutional levels. The model we utilize employs traditional academic methods, close collaboration with correctional facility leadership, creative consultative solutions (e.g. telemedicine), and ongoing evaluation of patients with chronic illness. Moreover, this model is laying the foundation for an evidence-based, constitutional level of care that is progressive and sustainable. Future directions include expansion to include multidisciplinary collaboration, such as the treatment of chronic pain.