Health care is a major issue. The issue of health care, no matter who views, takes on many perspectives, however, the point of view of prison is a another world of its own. Federal and state laws in place states that correctional facilities and/or prisons must provide prisoners with medical facilities that would oversee their medical needs. This paper will identify a governmental agency that regulates prison health care, the impact on health care, the duties the agency carries out, this agency’s regulatory authority in relation to health care and the processes for accreditation, certification and authorization.
The Federal Bureau of Prisons
The Federal Bureau of Prisons (BOP) is an agency created on May 14, 1930. Its main headquarters is in Washington, D.C. The BOP is a subdivision of the United States Justice Department and is responsible for the administration of the federal prison system. Its sole purpose is to provide more open-minded and compassionate care to those who are federal inmates with the United States prison system. As time passed and laws were changed, The BOP’s responsibilities grew and by the end of 1930, the agency operated 14 facilities for well over 13,000 inmates (Federal Bureau of Prisons, 2015). By 1940s, the BOP grew to having 24 facilities with over 24,000 inmates.
As a result of Federal law enforcement efforts and new legislation that altered sentencing in the Federal criminal justice system, the 1980s brought an increase in the number of Federal inmates. According to the Sentencing Reform Act of 1984, “established determinate sentencing, abolished parole, and reduced good time.” During the 1990s, the population doubled as efforts to combat illegal drugs and illegal immigration contributed to a significant increase in conviction rates. To present date, the population continues to increase with Federal prisons reach a current population of over 210,000.
Impact on Health Care
To control rising costs of health care, since the early 1990s the BOP implement initiatives aimed at providing more efficient and effective inmate health care (Efforts to Manage, 2008). These on-going initiatives included assigned most inmates to institutions based on the care level, installing an electronic medical records system that connects institutions, implementing tele-health to provide health care services through video conferencing, and implementing a bill adjudication process to avoid costly errors when validating health care related invoices (Efforts to Manage, 2008). Since the early 1990s, BOP has attempted to increase efficiency and economy of health care delivery to prisoners through various cost containment initiatives, such as restructuring medical staff, obtaining discounts through quantity or bulk purchases, leveraging resources through cooperative efforts and other governmental entities and even privatizing medical services at selected facilities (Containing Health Cost for Inmate Population, 2008).
Duties of the Federal Bureau of Prisons
The mission of the BOP is to protect society by confining offenders in the controlled environments of prisons and community based facilities that are safe, humane, cost efficient and appropriately secure and that provide work and other self-improvement opportunities to assist offenders in becoming law abiding citizens (Federal Bureau of Prisons, 2015). This agency is responsible for providing medically needed health care to inmates in agreement with federal and state laws. One of the most negative aspects of the BOP is it is responsible for carrying out all judicially mandated federal executions, including lethal injection of inmates who have been sentenced to death for a crime they have committed (Federal, 2015).
This agency maintains the lethal injection chamber of a prison before, during, and after an execution, making sure that the lethal injection is set up appropriately. The structure of the BOP is made of several divisions with board of directors. Inmates are confined in facilities spread out across the United States. Each facility reports to a regional office, which provides close oversight and support to that site. At the headquarters, national programs are developed and functional support is provided to the entire agency by division (Federal Bureau of Prisons, 2015).
Regulatory Authority: Accreditation, Certification and Authorization
Accreditation is necessary for prisons as it contributes to making the prisons operations, policies and procedures clear as well as increase the accountability of those operating the prisons. Accreditation provides and verifies the standards that an organization is required to meet. The American Correctional Association (ACA) performs the function with regard to the general operational activities of the correctional facilities (Hamilton, 2015). The American Correctional Association developed national standards for safe, effective, and professional operation of the correctional facilities. These standards are essential guides to policies and processed that protect the health and safety of prisoners and facility staff. These standards are regularly revised by a 20 member committee.
Revisions are based on court decisions, and governmental agency practices and experiences (Hamilton, 2015). Although participation in the accreditation process is voluntary, many correctional facilities ask to be accredited. As these agencies ask for accreditation the ACE sends the appropriate standards material, a manual policy and procedure, and compliance checklist. At this point, a regional manager is appointed to serve as an adviser. The Joint Commission on Accreditation of Health Care accredits all of the BOP’s and health service units and medical referral centers. Many correctional facilities are also guided by the National Commission on Correctional Health Care (NCCHC) standard without seeking accreditation. The accreditation process is a difficult and challenging one, especially those seeking new accreditations.
It is the mission of the Federal Bureau of Prisons to protect society by confining offenders in the controlled environments of prisons and community based facilities that are safe, cost efficient and secure. Each facility reports to a regional office and this agency is spear headed by a Board of Directors. Each region has functional support and provided the entire agency by each division.