CJMS 620OS Version 5 Assignment 3
Papеr 3 (15%) Budget and Polіcу Realities: Inmate Medical Care (7 pages, 5 References) Background: Paper #1 focused on the growth of adult correctional populations in the United States in general terms. This paper will fine tune that discussion, and applу it to a practical, real world management problem facing every prison system. This paper targets medical programs and specifically addresses the consideration of inmate populations, budget constraints and policy alternatives for toplevel management to consider. The topic of this paper involves the thorny legal, fiscal and political policy arena of controlling inmate medical care cost. The objective of this assignment is to apply what you have learned thus far concerning the impact of population and budget constraints on a specific program area within a prison system: medical care. Background information for the essay: The following real budget numbers from a prison system will be used for this exercise. This reflects the results of budget negotiations that took place reducing the original budget request to insure that the state budget remained within the projected revenue, which is a requirement of state law. This state cannot appropriate more funds than it receives in revenues (taxes are the bulk of the revenue). You may use the following data to illustrate your discussion and argument in this case. This is an approximation of the budget expenses of what might be a typical small prison system. These numbers add some reality to the essay and the question scenario. For example, you cannot exceed the annual budget of the institution. There is always room to make adjustments, but those adjustments have to be articulated. If a director/commissioner makes a decision that will increase the medical cost per inmate dramatically, then money must be transferred from one of the other categories into the medical budget or face the unpleasant reality of having to appear before the legislature for a supplemental appropriation (which requires the Governor’s approval). Prison average population: 13,696 inmates Annual budget: 282.9 million dollars Average yearly cost per inmate: $20,656 Average yearly medical cost per inmate: $3,544 ANATOMY OF THE PRISON BUDGET 75% PERSONNEL (hiring, training and retention costs) 15% MEDICAL (total inmate medical expense) 5% INMATE DRIVEN (items such as food and clothing which is allotted per inmate in the system) 2% OPERATING AND ASSESSMENTS (utilities, etc.) 2% BUILDING MAINTENANCE AND EQUIPMENT. (Repairs, replacement , routine maintenance, etc.) The Problem: In a study of the screening results of a random population of 469 prisoners for the Hepatitis C Virus Infection (HCV) by Fox et al in 2015 of the California state correctional system, here are the article findings and conclusions (excuse the inability to indent these two paragraphs properly in this text box): “Results. The prevalence of HCV infection was 34.3% overall (95% confidence interval [CI], 30%38%) and was 65.7% among those with a history of injection drug use (IDU), compared with 10.2% among those with no history of IDU (odds ratio [OR], 17.24; 95% CI, 10.5228.25). Significant differences in HCV antibody positivity were found in association with age at first detention but not with the nature of the crime. Independent correlates of HCV infection included age, history of IDU, cumulative time of incarceration, biological sex (OR for females subjects compared with males subjects, 0.35; 95% CI, 0.130.96), and a history of having sex with a male IDU (OR, 4.42; 95% CI, 1.4613.37). We identified significant differences in risk factors between male and female subjectsnotably, that the risk of HCV infection was significantly elevated among female nonIDUs who reported having sexual partners with a history of IDU. Among nonIDUs, correlates of HCV infection included history of receipt of blood products and cumulative years of incarceration. Conclusions. HCV infection is pervasive among the California prison population, including prisoners who are nonIDUs and women with highrisk sexual behavior. These results should promote consideration of routine HCV antibody screening and behavioral interventions among incarcerated men and women.” (p. 177) ” A US populationbased survey showed that 1.8% of the general population has been infected with hepatitis C virus (HCV) [1]. This study, however, omitted incar cerated persons, among whom the prevalence of HCV infection is projected to be much higher, because many of them originate from highrisk backgrounds and have a history of risk behaviors for bloodborne infection in particular, injection…