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                                 March 2014 • Vol. 37 • No. 2           

In This Issue

ACA Plenary Sessions Highlight Hot Topics in Corrections

By Jenna Scafuri and Kate Shaw

As one of America’s leading voices in corrections, the American Correctional Association strives to stay at the forefront of major topics affecting the field. The Patient Protection and Affordable Care Act (PPACA) and the use of restrictive housing are two issues that correctional staff are currently facing. Two plenary sessions held at ACA’s 2014 Winter Conference in Tampa, Fla., addressed these important issues and offered solutions for staff: “The Patient Protection and Affordable Care Act Has Arrived: The Impact On Correctional Health Care Delivery,” and “Essential Components of Administering Safe, Humane and Constitutionally Sound Restrictive Housing Programs: Internal Assessment.”

PPACA

On March 23, 2010, U.S. President Barack Obama signed into law a package of sweeping health care reforms known as PPACA. Since then, the implementation of PPACA has changed the landscape for health care coverage nationwide. As a result, correctional agencies must make important health care coverage decisions for the offenders who are in their care. In order to help corrections professionals navigate the many provisions within the act, ACA held a plenary session on the topic. Moderated by Jim Welch, chief of the Delaware Department of Correction Bureau of Health Services, the panelists included Viola Riggin, director of health services, Kansas Department of Corrections; Kelly Smith, director of health services, Louisiana Office of Juvenile Justice; Gary Mohr, director, Ohio Department of Rehabilitation and Correction; Terri Catlett, deputy director of health services, North Carolina Department of Public Safety; David Weaver, sheriff, Douglas County (Colo.) Sheriff’s Office; and Susan Pamerleau, sheriff, Bexar County (Texas) Sheriff’s Office.

During the plenary, each panelist discussed how his or her state has responded to PPACA and its provisions. Of the states represented, Kansas, Louisiana, North Carolina and Texas chose not to participate in Medicaid expansion. Each nonexpansion state has developed programs to ensure that prison inmates have access to health care coverage upon release, with some states expanding those programs to county jails and juvenile facilities. In North Carolina, through the development of policies and programs aimed at reducing costs and increasing health care enrollment, the state saved nearly $30 million during the past three years by applying every inmate for Medicaid. Catlett also noted that in 2013, the state found that 51 percent of inmate hospital stays were eligible for reimbursement. In Ohio, which is an expansion state, health care costs were reduced from $233 million in 2010 to $200 million through several reforms — not including the additional $18 million the state will receive from Medicaid expansion.

Riggin recommended that agencies hire a health authority who can build relationships with other state agencies to develop health care coverage enrollment programs. Weaver, whose state is also an expansion state, also emphasized the need for correctional agencies to reach out to smaller jails, where available resources may not match those of larger county jails. Finally, the panelists emphasized the importance of bridging connections between departments of correction and local communities to allow for continuity of care once an offender is released.

Restrictive Housing

As the third plenary session in a series about restrictive housing, “Essential Components of Administering Safe, Humane and Constitutionally Sound Restrictive Housing Programs: Internal Assessment,” continued the conversation about the controversial topic. While previous sessions at the 2013 Winter Conference in Houston and the 143rd Congress of Correction in National Harbor, Md., examined legal, security, health care, public perception and advocacy concerns, this session focused on the standards, training, oversight and management of restrictive housing. Moderated by ACA President Christopher B. Epps, the panelists included: Jack Herron, major, Oklahoma County Detention Center; Michael L. Kenney, director, Nebraska Department of Correctional Services; Michael Dempsey, executive director, Indiana Youth Services, Indiana Department of Corrections; and Dean Aufderheide, Ph.D., director of mental health services, Florida Department of Corrections.

Each panelist offered a unique perspective on the use of restrictive housing. In jails, Herron noted that classification problems can easily arise as a result of the diverse populations that jails house. From his perspective, restrictive housing is an important tool to manage this population, and to maintain the safety and security of the facility. He acknowledged the importance of conducting weekly reviews of those who are housed in these units to make sure their assignment is appropriate. Similarly, Kenney indicated that the Nebraska Department of Correctional Services has embraced the idea that inmates’ behavioral problems need to be addressed while they are still in restrictive housing, instead of waiting until they are returned to the general population. This is done through the use of educational and incentive programs while behaviorally-disruptive inmates are in restrictive housing. Kenney sees this as an important step in preparing inmates to return to general population, which in turn prepares them to reenter the community.

While Dempsey acknowledged that there are legitimate reasons for placing inmates in restrictive housing, he also said the length of time they are in isolation matters, and should be for as short a term as possible. From his perspective, correctional facilities need to focus on reducing the use of restrictive housing, particularly with juvenile offenders. Dempsey said that too much time in restrictive housing can be counter-productive, placing youths at greater risk for mental illness and behaviors such as self-harm. Similarly, Aufderheide agreed that the harsher the conditions and the longer the duration of restrictive housing for the mentally ill, the more mental deterioration that will occur. With mentally ill inmates entering restrictive housing at a rate three times greater than the nonmentally ill, Aufderheide said that it is important for facilities to utilize a mental health classification system to determine the appropriateness of restrictive housing placements and duration.

Conclusion

After the panelists concluded their opening remarks, an open discussion was held at both plenary sessions that gave the panelists the opportunity to answer specific questions regarding PPACA and restrictive housing. Videos of both plenary sessions are available on YouTube. To view the full video of the PPACA plenary session, visit http://bit.ly/PPACAplenary. To view the full video of the restrictive housing plenary session, visit http://bit.ly/RestrictiveHousingPlenary.

Jenna Scafuri is ACA’s senior editor of periodicals, and Kate Shaw is ACA’s associate editor of periodicals.

 

 

 

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