Private Nursing Homes as Alternative to Prison Health Wards

On a few ocassions, we have blogged about the graying of the prisons, and most recently, we had a post in December on Medicaid expansion under the ACA and prison populations.  Now, Governing has a new article about using private facilities to provide health care for the sickest of prisoners. Chris Kardish wrote the February 27, 2014 article States Look to Nursing Homes to Lower Prison Health Care Costs

While many states have special programs within their correctional systems for prisoners with severe health needs, few have partnered with outside facilities, which allows a state to save money through Medicaid and Medicare. States can apply for reimbursements through those health programs for inmates who need health services in facilities outside the prison system, effectively shifting significant costs to the federal government.

The article acknowledges the issues prisons face, caused by rising health care costs, longevity and the “strict sentencing laws”. Further, statistics show that older inmates’ health care costs are higher than younger, well inmates. 

The article references the “Connecticut model” (nursing home with private contractor). Although the state had been looking into using nursing homes for prisoners close to or eligible for parole, the facilities themselves weren’t as interested.  The legislature gave the Department of Corrections the power “to release certain prisoners with severe medical problems who pose no danger to society” with them remaining under DOC oversight with interim medical status checks.  Connecticut then issued an RFP and hired a company to run the 95 bed facility, currently with 12 residents and more than double that in referrals from the Department of Mental Health and Addiction Services.

Since this facility has been operational less than a year, it’s too soon to see if this model is going to save the state money by shifting the costs from the state budget to the federal one. The biggest issue evidently has been a variation of NIMBY-neighbors objecting to the facility in their backyard for concerns of rising crime, but because the inmates are so ill or frail, the neighbors’ concerns have not materialized. 

The article also mentions other proposals being considered elsewhere.