Currently, Michigan Department of Corrections (MDOC) arranges for and administers medically necessary health care to approximately 45,000 prisoners annually at 30 correctional facilities and three reentry centers. MDOC operates the Duane Waters Health Center (DWH) in Jackson, which has 112 inpatient beds, and houses prisoners whose medical needs cannot be met at other correctional facilities within the state. DWH provides acute medical, outpatient, surgical, and long-term care. DWH also administers a program outside the health center to care for 64 extended-care patients who do not require inpatient care at DWH, but whose needs could not be met in general population.
Providing non-deliberately indifferent health care to prisoners is a constitutional obligation of the MDOC. MDOC's employees and contractors could be liable in federal court for failing to meet this minimal standard of care. However, MDOC endeavors to provide a much higher level of care equivalent to that in the community.
Health care services are provided to prisoners using a standard of medically necessary care in accordance with court decisions, legislation, accepted correctional and health care standards, and MDOC policies and procedures. MDOC is working toward accreditation from the National Commission on Correctional Health Care (NCCHC) utilizing the NCCHC standards of care and the National Council on Quality Assurance (NCQA) standards as the MDOC's acceptable standards for providing health care services to MDOC prisoners.
The Department currently operates under a federal (Hadix) consent decree at the Charles E. Egeler Reception and Center, DWH, C-Unit, and the dialysis unit at the Ryan Correctional Facility. The MDOC has been, and continues to address and resolve, the issues necessary to close the consent decree. Federal court-appointed experts monitor MDOC's compliance with the consent decree. The current level of medical, dental, and psychological care provided by the Bureau of Health Care Services allows the Department to begin final compliance hearings for resolution of health care issues in the Hadix case.
Mental health services are provided through the Department's Psychological Services staff as well as through a contract with the Department of Community Health (DCH). MDOC's psychological staff provides reception testing, sex-offender treatment, assaultive-offender treatment, crisis intervention, suicide evaluation, and follow-up of mentally-ill prisoners discharged from the acute care continuum provided by DCH staff.
As a result of concerns over the quality of health care being provided to prisoners by the MDOC, Governor Granholm ordered an independent comprehensive review of prisoner health care to assure that the current health care delivery system meets its commitments of providing quality, medically necessary health care to prisoners that meets program goals, in an efficient, cost-effective manner. In January 2007, a contract was awarded to the National Commission on Correctional Health Care (NCCHC) through a competitive bid process. The NCCHC report, "A Comprehensive Assessment of the Michigan Department of Corrections Health Care System" (January 2008) identified 56 recommendations for systemic change to improve the effectiveness and efficiencies of MDOC's health care system.
MDOC is in the process of redesigning key health services contracts, reorganizing management structure, and improving contract management. By changing the business process, attaining greater compliance and accountability, and meeting performance measurements, a culture of quality will be created.