Assessment of Children's Access to Health Care at Two Mother-child Prison Programs in California

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 such programs. Allegations of children being denied access to health care emphasized the need for further investigation. Methods: Incarcerated mothers completed a quantitative and qualitative survey followed by in-person interviews. Additionally, 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 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. Conclusions: Children living in mother-child prison programs appear to have limited and/or delayed access to health care, which adversely impacts their health. This study creates a compelling call for a state audit of mother-child prison programs and underscores the need for professional oversight to ensure access to quality health care for these children.