A Small Step Forward

" ALBUQUERQUE, N.M. (KRQE) – The University of New Mexico Hospital (UNMH) is the new healthcare provider for inmates at the Metropolitan Detention Center (MDC). Officials say the new partnership makes sense for providing improved care for the facility, which averages about 1,500 inmates each day..."

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The transfer of responsibility for inmate health care in Albuquerque provides a window to understanding issues and problems in jails and prisons throughout the country.  

Firstly, the city has made the change because of deficiencies in care provision by the private provider, Corizon Health, in regard to routine care as well as in-custody mortality. Such poor performance is typical of private providers nation-wide.  Those private companies win contracts for prison management and service provision by unrealistically low bids.  Once in place, the companies inevitably find it impossible to achieve profitability and to meet contract requirements without corner cutting.

A frequent corner cut to preserve profits is short staffing in health care programs.  That further exacerbates general staff shortages which plague prison management, whether it is being performed by private management companies or by local and state-run institutions. Twenty-five percent shortages seem to be the rule nation-wide.  As a result of such deficits, security is frequently compromised and, in the case of health care needs, inmates often are denied needed care simply because there is no staff person available to walk them down a hall for scheduled appointments. The inevitable outcome is a failure to control chronic health conditions, as well as a higher than acceptable inmate death rate.

Underlying all of the above is the fact that there are a lot of people in jails and prisons who should not be there.  On any given day about about five hundred of the 1500 MDC inmates on entry have no fixed address -- they are the homeless.  The majority of those have been arrested for minor offenses like trespassing and even jaywalking, and mental illness and substance abuse are very likely to be contributing factors.  Even in the unlikely event that conditions are optimal, imprisonment is not therapeutic. Inmates with mental health issues are quite likely to be discharged in poorer shape than when they entered.

Most of the above is a summary of a recent fifteen minute interview on New Mexico In Focus of  reform advocate, Peter Cubra. Definitely worth a look.