Student Health Assessment: A Closer Look at Two Mother-child Prison Programs and their Impact on Children's Access to Health Care

Background: California's mother-child prison programs allow a limited number of incarcerated mothers to serve time at minimum security prisons with up to two children under the age of six. San Francisco State University Masters in Public Health students partnered with Legal Services for Prisoners with Children to conduct an assessment of children's access to health care in two mother-child prison programs, the Family Foundations Program in San Diego and the Community Prisoner Mother Program in Oakland. Governor Schwarzenegger recently appropriated funds for the expansion of these types of programs even though these programs have never been formally evaluated. Allegations of children being denied access to quality health care at these facilities emphasized the need for further investigation. Methods: Fifty-one surveys collecting both quantitative and qualitative data were mailed to incarcerated mothers with a 43% response rate. Fourteen of the 22 respondents volunteered to further share their children's experiences through in-person interviews. In addition, eleven key informant interviews were conducted with former program staff and experts. Respondents were queried about mothers' experiences regarding their children's access to health care, barriers mothers face accessing quality health care for their children, and current policies and practices regarding access to health care for children. Key findings included: (a) mothers' dissatisfaction with access to health care for their children, (b) mothers' reporting little or no involvement in decisions made regarding their children's health care, (c) reports of unlicensed staff making medical decisions, (d) reported delays in children accessing health care, (e) reported inadequate nutritional programs for children, and (f) the presence of environmental hazards such as exposure to mold. Conclusions: After a full review of the data collected, it is evident that children living in mother-child prison programs appear to have limited and/or delayed access to health care, which adversely impacts their health. Prior to the Governor's proposed prison expansion, this study creates a compelling call for a state audit of all mother-child prison programs and underscores the need for professional oversight to ensure access to quality health care and ultimately improve the overall conditions of confinement for children living in these facilities.