Federal Bureau of Prisons Health Services Division Healthcare Quality Assessment

BOP, HSD

BACKGROUND

The Federal Bureau of Prisons (BOP) currently provides healthcare to more than 144,000 adults in custody (AICs) in 121 institutions geographically dispersed throughout the contiguous United States, Hawaii, and Puerto Rico. Medical services rendered to all federal AICs housed in BOP institutions are governed by federal law, comply with BOP policies/ procedures, and meet the accreditation standards of the American Corrections Association (ACA). The BOP’s Health Services Division (HSD) is responsible for medical, dental, and psychiatric mental health services for AICs in BOP facilities.

PROJECT DESCRIPTION

The National Academy of Public Administration (the Academy) was pleased to work on a project for BOP HSD to provide a comprehensive assessment of the quality of healthcare delivery and assess the alignment of BOP’s organizational structure with healthcare delivery and management. The Academy was a subcontractor on this project, and Jefferson Consulting Group was the prime contractor.

The Joint Study Team:

• Analyzed the BOP’s current medical and mental health process through the lens of the six domains of healthcare (safety, effectiveness, equity, patient-centeredness, efficiency, & timeliness) and provided guidance for improving the healthcare for adults in custody by providing clear, actionable recommendations.

• Studied the organizational structure to assess whether responsibility and authority for healthcare management were aligned and effective and provided both recommendations and a how-to for the BOP to pivot and transition to function and be seen more as a healthcare system.

• Provided a comparative analysis of the current utilization review and telemedicine processes by reviewing and comparing the processes alongside those of other government agencies and non-governmental organizations to identify effective practices.

SUMMARY OF FINDINGS AND RECOMMENDATIONS

• Overall, the BOP’s healthcare system has taken steps in the right direction but is hindered by inadequate staffing levels and resources.

• The final report includes 70 actionable recommendations, which can be largely distilled into seven themes: communications, training, financial management, collaboration, organizational wellness, electronic health records, utilization review, and telemedicine.

• Recommendations highlight how to enhance efficiencies in providing healthcare to AICs, many of which call for changes in process or procedure. Many recommendations are low-cost and can incrementally enhance initiatives aimed at better tracking healthcare costs, which may lead to improved stewardship of financial resources and further enhancement of the healthcare enterprise.

Study Fellows