HMGT 495 – strategic planning and leadership

Correctional Health Care Assignment

You applied and were accepted in an internship program of a
state-level, Female Correctional Health Care Operation in the South
Eastern United States and your primary responsibility is to work on the assigned projects related to the provision of inmate health care.

Associated materials:

The Health and Health Care of US Prisoners: Results of a Nationwide Survey

Public Health Behind Bars

Sample Tool Control Policy

Inmate Sick Call Procedures-Corrections

For the incarcerated population in the United States, health care is a
constitutionally guaranteed right under the provisions of the eight
amendment which is the prohibition against cruel and unusual punishment (see Estelle v. Gamble).
This particular prison can hold in excess of 1,728 offenders and
routinely houses between 1,600 and 1,700 women on any given day. This
institution incarcerates all custody classes to include minimum
security, medium security, close custody, death row, and pretrial
detainees.

The health care operation provides the highest level of care for the
female offender in the state. The health care facility is a 101 thousand
square foot, 150 bed, three-story building that cost the taxpayers $50
million dollars to construct and is a hybrid of an ambulatory care
center, long-term care center, and a behavioral care center. The health
care facility also houses an assisted living dorm.

The patient demographic includes women who have multiple
co-morbidities including substance abuse, seriously persistent mental
illnesses (SPMI), diabetes, cardiovascular disease, cancer, morbid
obesity, HIV / AIDs, hepatitis, etc. On any given day there will also be
30 to 60 offenders who are pregnant, with 98% of those offenders having
a history of substance abuse; all pregnant offenders are considered
high-risk. The dental health of this patient population is exceptionally
horrendous because of excessive drug abuse coupled with a sugary diet
and poor oral hygiene practices. It is not uncommon for a 23-year-old to
need all of her teeth extracted.

There are approximately 300 FTEs to include correctional staff that
operate the facility and provide care to the offender population. The
healthcare facility is comprised of the following directorates: (a)
Medical, (b) Nursing, (c) Behavioral Health, (d) Pharmacy, (e) Dental,
(f) Medical Records, (g) Health Service Support, and (h) Operations and
Security.

Although the health care facility has a vast amount of capability,
there limitations: (a) This facility does not have advanced cardiac life
support capability (ACLS), (b) no surgical capability, (c) no ability
to conduct telemetry, (d) no oral surgery beyond simple extractions, (e)
no obstetrical capability beyond out-patient clinics, (f) MRI, (g)
level 2 ultrasound, and the list goes on.

Those inmates who have medical needs that cannot be addressed by the
health services staff at the correctional facility will need
appointments with external health care providers who have a business
relationship with the prisons in this area. On any given month, there
will be approximately 300 offenders who will go to outside medical
appointments and making certain that these appointments take place this
is where the challenge lies. Similar to many health care operations, the
prison Utilization Review / Case Management Department facilitates all
external appointments and form the lynchpin between the correctional
facility health care providers who refer offenders for specialty
appointments, and the outside organization providing that appointment.

Your assignment: You are the Case Coordinator. You have 300
patients that need to be scheduled for outside specialty appointments
every month. You are tasked by the Administrator to develop a strategic
plan organizing the out of the facility appointments without impairing
internal services.

As the first step, develop a Memorandum addressing:

1. Provide an overview of Estelle v. Gamble and how that 1976 Supreme Court ruling pertains to the provision of inmate health care.
2. Examine the challenges of providing health care in a correctional environment.
3. What are the challenges of providing health care to a female offender population that may not exist in a male prison?
4. What framework would you apply to the strategic planning? framework types
   a) OGSM (prefer)
   b) Ansoff Matrix
   c) Hoshin Kanri
   d) 7S Model
   e) Balanced Scorecard
   f) Blue Ocean