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Rick Scott, Governor
Florida Department of Corrections, Secretary Michael D. Crews

Florida Department of Corrections
Michael D. Crews, Secretary

Health Services



Dr. Mathews Mr. Burke Dr. Thomas
Charles Mathews, M.D.
Assistant Secretary
(850) 922-6645
SUNCOM 292-6645
John Burke
Chief of Health Services Administration
David Thomas, M.D.
Chief of Health Services

"The Assistant Secretary of Health Services...shall be responsible for the delivery of health services to offenders within the system and shall have direct professional authority over such services." (F.S. 20.315(3)(g))

The Office of Health Services' 2,900 staff members provide access to comprehensive medical, dental, and mental health services for male and female offenders statewide. This includes health education, preventative care, and chronic illness clinics at the minimum community standard of care. During FY 1996-97, the department provided 2.8 million health care encounters. The scope of health services ranges from emergency care to inpatient hospitalization, and specialty care, as required.

Accomplishments in FY 1996-97:

Cost Containment Continues

The daily direct medical care costs for all DC inmates has increased from $8.14 in 1992-1993 to $8.81 in 1996-1997, an increase of only 8.2%. Over these five fiscal years the increase averaged 1.6% per year. This is despite an increase in the average daily population and the fact that the department over the last six years has absorbed price level increases. (The medical component of the Consumer Price Index has averaged 6.7% annually during this period.)

Consolidation

In recent years there has been considerable focus on the consolidation of health services, both in Florida and nationally. Although improved quality is often said to be the goal of consolidation, it is driven by the emphasis on managed care and more specifically, cost effectiveness. Consolidation basically has come to mean providing for an expanding need for medical care with more limited resources. To this end, the Office of Health Services is aggressively pursuing various cost containment methods, including, but not limited to the following:

    Dental Work
  • Creating cluster pharmacies in which Health Services staff, records, equipment and pharmaceutical inventories are consolidated at select institutions, which then provide pharmacy support to neighboring institutions;

  • Consolidating dental services, which will generate approximately $2.5 million in annual continuing cost avoidance in FY 1997-1998.


Cost Containment

  • Negotiating a contract to provide radiation therapy services at a cost of 120% of Medicare rates. This is 27% of the cost of the previous provider. For the 1,032 treatments projected this fiscal year, this can generate close to $1 million in cost avoidance.

  • Negotiation of contracts for physical and speech therapy, outpatient labs, Computer-Assisted Tomography (CAT)scans, and an outside radiologist will, combined, save approximately $175,000 at North Florida Reception Center (NFRC).

  • Using a mobile surgical surgery suite that is entirely self-contained in a semi truck and trailer. Since its inception in April 1997, 210 surgeries have been completed at an average savings of $702 per surgery. This equates to a savings of $147,420 for a three month period, or almost $600,000 a year.

Utilization Management

The utilization management program is centralized at NFRC and aggressively ensures appropriate utilization of health care resources by closely managing the appropriate movement of inmate patients to contract hospitals, NFRC's hospital and institutional infirmaries. This is expected to save about $3 million this fiscal year.

Health Services Partnerships

While the Department of Corrections has its own 153-bed licensed hospital at North Florida Reception Center, the DC also contracts with five major central hospitals and 32 regional hospitals to provide access to necessary community emergency room services and hospitalization beyond the capability of the department. These partnership arrangements provide significant cost avoidance over the usual and customary hospitalization charges at many hospitals. Under the five major hospital contracts the department pays 56% of the usual and customary hospital charges.

Health Sciences Television Network (HSTN) Educational Partnership

Use of the HSTN's educational programs provided health care staff at the institutions, regions, and central office with the most current health care practices to ensure quality healthcare for inmates while containing training costs.

Continuing Education

Cooperative partnerships with various providers of continuing education credits have facilitated the use of their educational programs for health care staff at the institutions, regions, and central office to meet professional licensure standards while containing training costs.

Mental Health Internships

In cooperation with a number of graduate training programs throughout Florida, such as the University of Central Florida, Florida Institute of Technology, and Florida Mental Health Institute, Department of Corrections institutions are available as training sites for internship and practicum rotations. DC mental health staff provide on-site supervision in accordance with the institution's requirements and design training experiences in accordance with the trainee's interest and educational experience.

Nurse with inmate
A member of Wakulla CI's Health Services staff takes an inmate's blood pressure.

Nursing Internships

In cooperation with a number of educational facilities, such as Florida State University, the University of Florida and community colleges, the DC has made internships available in areas such as nursing, advanced registered nurse practitioner, physician assistant, licensed practical nurse, and emergency medical technician to give students experience they need.

Florida Mental Health Institute (FMHI)

Periodic training and support services are provided in a partnership arrangement between the DC and Florida Mental Health Institute (FMHI) staff. FMHI staff has developed training modules employing a Train-the-Trainers approach to upgrade correctional mental health staff skills in specific areas. Correctional mental health staff is also invited to workshops and other training events sponsored by FMHI. FMHI also provides continuing education credit for DC-sponsored events.

DC Dental Services / UF Partnership

There is an endodontic and oral surgery referral service between the Department of Corrections and the University of Florida. Residents of the University come one day a week to North Florida Reception Center to handle cases beyond the scope of general dentists. Inmate patients are screened and prioritized for these referral specialty dental services.

Other Community Health Care Private Partnerships

There are three major statewide health services contracts for the services of electrocardiograms, clinical laboratory services, and radiographic services in DC institutions and over 175 other community health care contracts to provide a variety of health care services.

Community-Based Mental Health Partnerships for Aftercare Services

Nineteen (19) Department of Corrections facilities provide links to community-based mental health treatment resources for those inmates in need of continued care. On-site mental health staff contact area providers, arrange appointments, and provide information needed for continuity of ongoing care as inmates return to the community.

Focusing on HIV and AIDS

In addition to the legislatively mandated educational training for inmates and staff regarding HIV/AIDS, the DC also implemented the following this fiscal year:

Lawtey CI - Inmate Peer Educator Project

The Department of Health and the Department of Corrections implemented a project partnership to reduce the incidence of HIV/AIDS by educating inmates and staff members in the prevention of HIV/AIDS. The project focuses on enhanced counseling and peer education. Inmate participation in the project is voluntary with the aim of referring inmate graduates from this Peer Educator Project to the appropriate Department of Health community office or community organization at the time of inmate's release.

New Cape Orlando Special Needs Facility

A special needs facility that will include terminally ill AIDS patients was constructed and is scheduled to be open in early FY 97-98. Its purpose is to consolidate many aspects of HIV/AIDS care. Through economies of scale, reduced hospitalization and security costs, it is expected to improve the quality of care for inmates with AIDS as well as to reduce the growing cost of care for these inmates. This facility will include all special support functions for inmates with AIDS requiring special housing and health care support. The conception, design, and planned support for this special needs facility has grown out of a Department partnership with Florida Hospital, the University of Miami, and Dr. Margaret Fissell.

Facts about AIDS in Prison

Inmate AIDS Deaths
Inmate AIDS Deaths
* Preliminary count due to outstanding death certificates/autopsy reports necessary to confirm cause of death.
  • HIV antibody testing is available to inmates on request, or if they have been involved in an incident involving the exchange of body fluids.

  • Inmates infected with HIV or who have AIDS are not housed separately from other inmates, though a facility is opening next year to house terminally ill AIDS patients.

  • Inmates with HIV or AIDS have access to current drug therapy to combat their illness.

  • Inmates with AIDS may receive medical clemency under certain circumstances, and if their families agree to care for them upon release.

  • Care following release is coordinated with the Department of Health.