Health System: Correctional Health Services (6300P)


Program Outcome Statement

Improve the health of children and adults in custody.

Program Services

  • Physical Health Services
  • Dental Services
  • Mental Health Services
  • Substance Use Disorder Treatment Services
  • Nutrition Services

Overview

Correctional Health Services (CHS) provides comprehensive and timely physical health, dental, mental health, and substance use disorder treatment services as well as quality, customer-oriented nutrition services to the incarcerated population of San Mateo County.

Number of Inmate Medical and Psychiatric Inpatient Hospital Days Under Discussion

Average Cost per Inmate Booked per Day for Medical and Health Services Meeting Target

Percent of Offenders Receiving Timely Histories and Physicals: Juveniles Meeting Target and Adults Below Target

FY 2017-18 Year-End Story Behind Performance

Number of Inmate Medical and Psychiatric Inpatient Hospital Days

CHS previously contracted with Santa Clara County to provide psychiatric beds.  This contractual arrangement was terminated in January 2016. The opening of Behavioral Health Pods (BHP) to stabilize and prevent deterioration has lowered psychiatric inpatient hospital days; however, severely mentally ill inmates require an acute inpatient psychiatric facility.  Therefore, the drop in utilization does not reflect the need.  CHS is currently working with the selected vendors to open a Lanterman Petris Short (LPS) Unit within the correctional facility for the acutely mentally ill in October 2018.  A new performance measure in conjunction with the LPS unit, and revised number of medical and psychiatric inpatient days will be determined in early 2019.

Average Cost per Inmate Booked per Day for Medical and Health Services

The fiscal year 2017-18 target was met due to staff position savings as well as services and supplies and fixed asset purchases delayed due to continued project implementation of the LPS Unit and medication dispensing machines.  Although the severity of inmate health issues has increased and more inmates are being sent for outside hospital services, the costs of these services have been reduced by the Medi-Cal Claiming Inmate Program (MCIP) that become effective in April 2017.  MCIP provides eligible inmates receiving inpatient care with Medi-Cal coverage for which the State has not fully billed CHS for non-federal share reimbursement yet. 


Percent of Offenders Receiving Timely Histories and Physicals

The Youth Services Center (YSC) census and CHS medical staff have been stable facilitating compliance with Institute of Medical Quality (IMQ) requirements to complete 100 percent of timely histories and physicals within 96 hours of intake for juveniles. For adults, a couple of history and physicals were delayed due to staff vacancies.  The Nursing Manager will review onboarding procedures to ensure training is sufficient, and the continuous quality improvement staff will perform oversight to ensure procedures are being followed and met.



Future Priorities

  • Continue pilot program behavioral health pods for women at Maple Street Correctional Center and for men at Maguire Correctional Center designating housing units for the seriously mentally ill where evidence-based psycho-social treatments and therapeutic milieu will be provided daily with the goals of increasing rates of medication compliance, decreasing dangerous events, and improving social functioning.
  • Continue to develop and expand tele-medicine between Maguire and Maple Street correctional facilities and San Mateo Medical Center (SMMC), and potentially outside providers, with the goals of providing timely access and continuity of care, improving staff efficiency, and decreasing costs related to transportation of inmates.
  • Implementation of an electronic health record (EHR), in conjunction with medication dispensing machines, in order to replace outdated systems while increasing patient safety and facilitating seamless communication with SMMC and other County health departments to improve continuity of care.  An EHR will also replace manual efforts to track patient care and collect and analyze data and performance measures, facilitating process improvement while increasing staff time dedicated to patient care.


Author: Gina Wilson, Chief Financial Officer, Health System     Contact Email: gwilson@smcgov.org     Last Updated: 08-20-2018