Ohio Saves $7.2 Million In Prison Prescriptions After In-Sourcing Health Care

Ohio has saved millions in the past three fiscal years since the state revamped its prison health care system and replaced contracted doctors with in-prison medical staff, according to the Ohio Department of Rehabilitation and Corrections.

A new report by the nonpartisan Correctional Institution Inspection Committee found the state bought nearly 300,000 fewer prescriptions for inmates in 2011 than in 2009. Ohio has been an experimental ground for prison reform after a lawsuit in 2003 alleged that the abysmal medical care in prisons amounted to cruel and unusual punishment under the Eighth Amendment. Since the lawsuit, the corrections department has been supervised by a federal court as they restructured health care operations and policy in state prisons. This summer, the court ruled Ohio’s new system is constitutionally compliant. The reduction in prescriptions is largely due to the installment of new in-prison doctors:

Hudson said the state now has in-prison doctors, rather than contracted physicians who float in and out of one or more prisons. With no rapport between doctor and patient, contracted doctors wrote prescriptions to address symptoms instead of working with the patient to resolve underlying problems.

Now, there is at least one doctor and nurse practitioner at each facility. That alone is maybe the biggest single reason why prescriptions are down, he said.

“When you have a physician that works in the facility eight hours a day, five days a week as opposed to a contractor that comes and goes … you don’t have that continuity of care (with contractors),” he said.

Besides eliminating outsourced health care, Ohio’s sentencing reforms has also led to fewer prisoners in the system. The state has eliminated the disparity in sentencing for crack and cocaine, reduced mandatory minimums for some drug crimes, and expands parole eligibility, among other important measures that help reduce the prison population.

However, the drop in medications also stems from prison privatization, which removes prisoners from the state health care system. In an unprecedented move, Ohio sold a prison to Corrections Corporation of America (CCA) last year. But abuse and neglect runs rampant in the privately owned prison, which racked up 47 violations of state law. Prisoner health care in the CCA facility was found to be far below state standards, with inmates’ requests for treatment often delayed or ignored entirely.

Quality health care is often sacrificed by private companies trying to turn a profit, leading to appalling conditions all over the country. Arizona recently fined its private health care provider for contaminating medicine and failing to dispense medications to prisoners. A report this summer found similar abuses in 20 states.

Ohio’s sentencing reform and the correlated drop in prison population is a huge threat to CCA and its peers. In an attempt to lure states, the company has offered to buy prisons across the country in exchange for a 90 percent occupancy guarantee, a requirement that could only be satisfied if states halted the decline of prison populations and started jailing more people for longer periods of time.