HB 398 Inmate Health Care Study 2019 Report

Background:

The Inmate Health Care Study (IHCS) Committee was formed pursuant to the passage of H.B. 398 – Substance Use and Health Care Amendments by Representative Brad Daw and Senator Todd Weiler during the 2019 Utah Legislative Session. H.B. 398 directed the Commission on Criminal and Juvenile Justice (CCJJ) to convene a committee to study certain health care and other services provided to inmates in a correctional facility (i.e., prisons and county jails). These services were to be studied and evaluated through the collection of identified policies, procedures, and protocols from correctional facilities in the state. The policies identified for study included:

1. Screening, assessment, and treatment of an inmate experiencing a substance use or mental health disorder, including withdrawal from alcohol or other drugs;
2. Providing medication and mental health treatment for inmates who are transferred between county jails and the Department of Corrections;
3. Providing contraception to a female inmate in a correctional facility;
4. Providing health care and treatment for a pregnant inmate in a correctional facility, including any restraints required during a pregnant inmate’s labor and delivery; and
5. Body cavity searches of an arrestee or inmate in a correctional facility.

After CCJJ collected the policies and convened the IHCS Committee, the charge was to:

1. Survey the policies, procedures, and protocols submitted by a correctional facility taking the following into consideration:
   • The needs and limitations of correctional health care, particularly in rural areas of the state;
   • Evidence-based practices;
   • Tools and protocols for substance use screening and assessment;
   • The transition of an inmate from treatment or health care in a correctional facility to community-based treatment or health care; and
   • The needs of different correctional facility populations.
2. Based on the results of the survey, develop recommendations related to:
   • Whether model policies, procedures, and protocols for correctional facilities are necessary; and
   • Development and implementation of any model policies the committee finds necessary.

This report evaluates policies and practices related to a variety of health care issues in the correctional population and makes recommendations accordingly. In order for correctional facilities to properly diagnose and treat many of these conditions and confront common health care-related situations, there must be financial support and proper funding streams equal to the task – both from the State and the counties. A continuum of care should include, first and foremost, diversion from incarceration for low risk offenders – particularly those with mental health and substance use disorders better served in a non-correctional setting. If diversion is not available, this continuum of care should also include: screening, assessment, and evaluation; triage; emergency intervention; treatment, including medication assisted treatment; and the capacity to address more chronic, longer term needs. Lastly, evidence based practices and protocols should guide public policy development on this issue.