Health Rehabilitation Services HARS Alaska Department of Corrections
Health & Rehabilitation Services (HARS) Alaska Department of Corrections (DOC)
HARS Overview Services • Patient population • Staffing and environment •
What is DOC health care? Providing services to individuals incarcerated in Alaska’s State operated correctional facilities • • • Services Medical care Behavioral health care Dental care Vision services Pharmaceutical services
Essential care Indispensable care to prevent the progression of disease or the deterioration of health Services
Providing care • • Booking In-custody care Correctional officer/Nurse Services
Booking (Remand) • • Services Safe to enter the facility? Identify medical/mental health needs
Safe to enter the facility? Correctional officer/Nurse Services
Pre-booking screen • • • Services Unconscious or unable to be roused with voice/physical stimulation? Obvious pain, bleeding, signs of trauma or illness suggesting immediate need for emergency service? Unable to stand walk with one person offering minimal assistance?
Post hospital screen Correctional officer/Nurse Services
Identify medical or mental health needs • • Services Post booking observation Booking screen
Post booking observation Services Correctional officer/Nurse
Booking screen • • Vital signs Allergies Medications Substance use • • • Tuberculosis Mental status Medical history Nurse Services
In custody care • • • Written or verbal request Medication administration Emergency response Nurse Services
Focus of services • • • Early identification of high risk patients Provision of essential care Emergency response Correctional officer/Nurse Services
Who is our patient? • • 4, 200 inmates in custody at 12 Alaska facilities 400 offenders housed in eight Community Residential Centers 160 offenders in 15 contract jails Fiscal year 2016 • 33, 497 bookings • 26, 473 releases Patient population
Ill and complex • • • 65% have a mental illness 22% experience a severe and persistent mental illness 20 -30% have hepatitis C 40% report a chronic medical condition 25 -30% have high blood pressure 60 -75% are overweight, obese or morbidly obese 80% have a substance abuse disorder 65 -75% of females report having been sexually victimized Age 50+ is the fastest growing prison population Patient population
Relatively poor health Compared to other Americans of the same age… • 100 -300% more likely to have a serious mental illness • 31% more likely to have asthma • Twice as likely to have high blood pressure • More than twice as likely to use tobacco • 55% more likely to have diabetes • 90% more likely to have a heart attack • Twice as likely to have a sexually transmitted disease • 1200% more likely to have hepatitis C Patient population
Relatively poor health • Often first diagnosis and/or treatment • Severe mental illness • Prenatal care • Dental care • Cancer • Hepatitis • Renal disease Patient population
Alaska’s largest provider of: • • • Patient population Mental health services Substance abuse treatment Drug & alcohol detoxification services
Staffing and environment “I’m one of those exclusive doctors who only takes care of patients in Alaska’s gated communities. ” Dr. Bob Lawrence Chief Medical Officer Alaska Dept. of Corrections Staffing/environment
“I want to be a jail nurse” Staffing/environment
Who provides DOC health care? • • • RNs LPNs APRNs PA-Cs MDs DOs Psychiatrists Mental health clinicians Dentists Dental hygienists Staffing/environment • • Dental assistants Social workers Pharmacist Pharmacy technicians Medical records assistants Substance abuse counselor Accounting clerks Community providers
Our staff… • • • 125 Nurses (full time) 40 Mental health clinicians 15 Mid-level providers (APRN, PA-C) 3 Physicians 2 Psychiatrists 2 Dentists 1 Medical social worker/1 Social worker 1 Pharmacist 48 Professional service contracts Staffing/environment
Our facilities… • • • Anchorage Nome Fairbanks Wasilla Eagle River Ketchikan Staffing/environment • • • Juneau Palmer Seward Kenai Bethel
Anchorage Correctional Complex ( 863 inmate capacity)
• • • Booking Clinic Infirmary Community residential centers Acute mental health unit Sub-acute mental health unit ACC Intake facility
• • • 24 hour nursing coverage On-site medical provider On-site psychiatrist On-site mental health clinicians Visiting dentist ACC Primarily male population
Anvil Mountain Correctional Center ( 128 inmate capacity)
• • • 11 hour nursing coverage Contract medical provider Telepsychiatry Contract mental health clinician Contract dentist Intake facility Male & female population AMCC
Fairbanks Correctional Center ( 259 inmate capacity)
• • • 24 hour nursing coverage On-site medical provider Telepsychiatry On-site mental health clinician Contract dentist Intake facility Male & female population FCC
Goose Creek Correctional Center ( 1472 inmate capacity)
• • Clinic Infirmary Point Mackenzie Correctional Farm Sub-acute mental health unit GCCC Male population
• • • 24 hour nursing coverage On-site medical provider Telepsychiatry On-site mental health clinician On-site dentist GCCC
Hiland Mountain Correctional Center ( 404 inmate capacity)
• • • Clinic Acute mental health unit Sub-acute mental health unit HMCC Primarily female population
• • • 24 hour nursing coverage On-site medical provider On-site psychiatrist On-site mental health clinicians Visiting dentist HMCC
Ketchikan Correctional Center ( 58 inmate capacity)
• • 11 hour nursing coverage Contract medical provider Telepsychiatry Contract mental health clinician Intake facility Male & female population KCC
Lemon Creek Correctional Center ( 232 inmate capacity)
• • • 20 hour nursing coverage Contract medical provider On-site mental health clinician Telepsychiatry Contract dentist Intake facility Male & female population LCCC
Matsu Pretrial Facility ( 102 inmate capacity)
• • • 22 hour nursing coverage On-site medical provider On-site psychiatric provider (weekly) Visiting mental health clinician Telepsychiatry Visiting dentist Intake facility Male & female population MSPT
Spring Creek Correctional Center ( 551 inmate capacity)
• • • Sub-acute mental health unit 20 hour nursing coverage On-site medical provider Telepsychiatry On-site mental health clinicians Visiting dentist SCCC Male population
Wildwood Pretrial/ Correctional Center ( 441 inmate capacity)
• • • 23 hour nursing coverage On-site medical provider Telepsychiatry On-site mental health clinicians Visiting dentist WPT/WCC Intake facility Male & female population
Yukon-Kuskokwim Correctional Center ( 200 inmate capacity)
• • • 11 hour nursing coverage Contract medical provider Telepsychiatry Intake facility Male & female population YKCC
HARS Overview Services • Patient population • Staffing and environment •
Questions? Contact: Kim Culross Chief Nursing Officer 550 W. 7 th Ave, Ste 1800 Anchorage, AK 99501 907 -269 -7302
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