“Healthcare professionals, who build their careers in the field of correctional healthcare, do so because of a personal mission to improve the lives of this population, and as a company, we share that mission.”
– Corizon Health’s Senior Vice President of Nursing Becky Pinney, MSN, RN, CCHP-RN
When the Charlotte County Sheriff’s Office arrests a person, it is common to hear them referred to as “in custody.” The term custody in this case refers to imprisonment, but it also carries the dual meaning of “protective care or guardianship.” While in custody at the Charlotte County Jail, the Sheriff’s Office is statutorily responsible for the care, custody, and control of all detainees until their release. In the interest of providing reputable and quality medical care to the detainees, as required by federal and state law, the Charlotte County Sheriff’s Office contracts with Corizon Health for medical and mental health services.
A Corizon nurse screens arrestees’ during their intake process in the jail. The screening is comprehensive, covering the detainee’s past and present medical history. If the detainee presents an emergency medical problem or something that the jail’s infirmary cannot treat, the detainee is transported to a local emergency room. During this process, the detainee is able to sign medical record release forms if they are currently prescribed medication that they believe they will need during their stay in the jail. Physicians are on call after hours and nurses are on staff 24/7 to receive detainees. In December of 2018, 502 intake evaluations were completed.
The largest challenge faced during this step in the process is the cooperation of the detainee. Information regarding drug and alcohol use is often excluded during the medical evaluation, and detainees have trouble recalling local doctor information or where they receive their medications. This information has to be researched and confirmed by Corizon staff prior to beginning new medications or treatment. When a person is arrested while under the influence, they are often unable to participate in a medical screening until they have time to become sober.
In cases where there is a medical concern but a lack of documentation or records, the detainee is transferred from intake to the infirmary and monitored by medical professionals until records are obtained. Many detainees with mental health concerns enter the jail presenting polypharmacy, in that they advise they take multiple medications from varying doctors, which they fill at multiple pharmacies. The use of prescribed medication is also combined with illegal drugs and alcohol. In these cases, some medications may actually conflict with one another due to multiple doctors issuing the prescriptions. Upon entering the jail, the medical staff with Corizon is now responsible for the health and well-being of the detainee, leading to a comprehensive and responsible re-evaluation of the medications.
In some cases detainees are placed in a detox protocol to get them to a baseline for continued treatment. Corizon staff noted there is a 15% mortality rate when detoxing from benzodiazepines and alcohol if not done correctly. The detox time can last between 1 to 2 weeks depending on the patient.
Correctional facilities house a complicated medical population, and Corizon professionals focus on integrated, evidence-based patient care. “Integrated care, which requires coordination of physical health, mental health and substance abuse services, is particularly effective in the patient population we serve, where we find a much higher rate of comorbid chronic health conditions than outside the correctional environment,” states Corizon Chief Executive Officer Steve Rector.
In addition to the medical screening at intake, detainees are provided the opportunity several times throughout each day to fill out a sick call slip, at which time they report their injury or ailment and can be transferred to the infirmary or visited by a nurse. Medicine is delivered to detainees in their pods on a routine basis and as needed. In December of 2018, 82% of the detainee population at the jail was on a prescription medication.
Prescribed medicine is the primary topic of the grievances filed regarding medical care in the jail. In many cases, it is a reaction to the management of the polypharmacy concerns, or a denied request for potentially dangerous medication during detox. When a grievance regarding medical care is filed by a detainee, the Corizon Health Services Administrator (HSA) investigates it in a timely manner. Following the investigation, the HSA provides the detainee the findings in writing and in person if warranted. The Charlotte County Sheriff’s Office also utilizes an independent contract monitor to participate in quarterly review meetings of detainee healthcare.
During the last quarterly review, there was only one grievance per month for October-December of 2018 and all three grievances were in regards to a problem with medication. The grievances can range from concern that the pill is a different shape or brand from what was received from their personal pharmacy to disagreeing with the Corizon physician’s evaluation of necessary medications. These are often resolved once the detainee is able to have a more in-depth conversation with medical staff about their medicine and the concern for their well-being.
The Charlotte County Sheriff’s Office’s Detention Bureau has achieved accreditation through the National Commission on Correctional Healthcare. Corizon Health, our consistent provider since 1999, also has one of the highest percentages of Correctional Health Professional certification program professionals among correctional healthcare providers. This dedication to maintaining quality standards is reflected in the integrity and professionalism of both detention deputies and Corizon staff as they provide supervision and care to detainees in custody.
We have nothing to gain and everything to lose if our detainee population is not properly cared for.
Sheriff Bill Prummell