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With the general population of federal prisons growing older, the Bureau of Prisons (BOP) is looking for ways of analyzing its healthcare data in order to improve healthcare services for aging prisoners.
Last month, BOP published a document, known as a “request for information,” seeking data and suggestions for ways not only to deliver improved health services to the aging inmate population, but also to cut costs and manage its resources more efficiently. The request specifically invited input on such topics as the health of the BOP inmate population, care delivery methods, costs in planning and operating its healthcare services, financial management, research and regulatory compliance. BOP has set a March 29 deadline for responses to its health analytics information request.
Almost exactly a year before BOP issued the information request, the Department of Justice’s Office of the Inspector General issued a report on what it called the “serious challenge” BOP has faced in hiring and maintaining health professionals.
The subject of BOP medical understaffing was not a new one for the IG’s Office. It had previously issued reports on BOP understaffing, which it said had restricted older inmates’ access to healthcare, and required that they be referred to health professionals outside prison facilities, which resulted in higher costs to BOP.
A March 2016 IG’s report also suggested BOP’s making better use of its data analytics system could help the agency address its persistent problem of understaffing in its healthcare units. The IG’s report noted that in September 2014, over 600 vacancies existed in BOP’s health services units in BOP-run institutions. The report did not include contract prisons or residential re-entry facilities.
As a result, BOP had only 3,215 of its authorized 3,871 health services positions in its employ, or about 83 percent. Of the 3,215 filled position, 833 were held by Public Health Service officers and 2,382 by civil servants.
Even though BOP policy dictates the medical staff vacancy rate should not exceed 10 percent during any 18-month period, the IG’s report found that in September 2014 that standard was met at only 24 out of 97 BOP-operated institutions. BOP at the time operated a roster of 121 institutions, but the report counts multiple institutions co-located at one site as a single institution.
Another 12 institutions could not manage to keep medical staff at 79 percent of authorized strength, which a former BOP medical director had defined as a crisis level. In 20 institutions, the medical staff vacancy rates stood at 25 percent or more. In three locations, the vacancy rate hit or exceeded 40 percent.
The IG’s report noted a number of factors contributing to BOP’s chronic healthcare manpower shortage. A leading cause was BOP must compete with the private sector and is often at a disadvantage in the salaries, geographic locations and work settings it can offer.
But the IG’s report faulted BOP for not systematically coming to grips with its challenges in medical recruiting, but instead having “attempted in an uncoordinated fashion” to address them site-by-site. It also suggested BOP could make better use of the greater flexibility the agency has in making PHS officer assignments, so as to channel them toward the BOP locations demonstrating the greatest need.
Christopher Zoukis is the author of Federal Prison Handbook: The Definitive Guide to Surviving the Federal Bureau of Prisons, (Middle Street Publishing, 2017), and College for Convicts: The Case for Higher Education in American Prisons (McFarland & Co., 2014). He regularly contributes to The Huffington Post, New York Daily News, and Prison Legal News. He can be found online at ChristopherZoukis.com, PrisonEducation.com and Prisonerresource.com.
