Correctional Health Care Assignment

You applied and were accepted in an internship program of a state-level, Female Correctional Health Care Operation in the South Eastern United States and your primary responsibility is to work on the assigned projects related to the provision of inmate health care.

Associated materials: 

The Health and Health Care of US Prisoners: Results of a Nationwide Survey

Public Health Behind Bars

Sample Tool Control Policy

Inmate Sick Call Procedures-Corrections

For the incarcerated population in the United States, health care is a constitutionally guaranteed right under the provisions of the eight amendment which is the prohibition against cruel and unusual punishment (see Estelle v. Gamble). This particular prison can hold in excess of 1,728 offenders and routinely houses between 1,600 and 1,700 women on any given day. This institution incarcerates all custody classes to include minimum security, medium security, close custody, death row, and pretrial detainees. 

The health care operation provides the highest level of care for the female offender in the state. The health care facility is a 101 thousand square foot, 150 bed, three-story building that cost the taxpayers $50 million dollars to construct and is a hybrid of an ambulatory care center, long-term care center, and a behavioral care center. The health care facility also houses an assisted living dorm.

The patient demographic includes women who have multiple co-morbidities including substance abuse, seriously persistent mental illnesses (SPMI), diabetes, cardiovascular disease, cancer, morbid obesity, HIV / AIDs, hepatitis, etc. On any given day there will also be 30 to 60 offenders who are pregnant, with 98% of those offenders having a history of substance abuse; all pregnant offenders are considered high-risk. The dental health of this patient population is exceptionally horrendous because of excessive drug abuse coupled with a sugary diet and poor oral hygiene practices. It is not uncommon for a 23-year-old to need all of her teeth extracted.

There are approximately 300 FTEs to include correctional staff that operate the facility and provide care to the offender population. The healthcare facility is comprised of the following directorates: (a) Medical, (b) Nursing, (c) Behavioral Health, (d) Pharmacy, (e) Dental, (f) Medical Records, (g) Health Service Support, and (h) Operations and Security.

Although the health care facility has a vast amount of capability, there limitations: (a) This facility does not have advanced cardiac life support capability (ACLS), (b) no surgical capability, (c) no ability to conduct telemetry, (d) no oral surgery beyond simple extractions, (e) no obstetrical capability beyond out-patient clinics, (f) MRI, (g) level 2 ultrasound, and the list goes on.

Those inmates who have medical needs that cannot be addressed by the health services staff at the correctional facility will need appointments with external health care providers who have a business relationship with the prisons in this area. On any given month, there will be approximately 300 offenders who will go to outside medical appointments and making certain that these appointments take place this is where the challenge lies. Similar to many health care operations, the prison Utilization Review / Case Management Department facilitates all external appointments and form the lynchpin between the correctional facility health care providers who refer offenders for specialty appointments, and the outside organization providing that appointment.  

Your assignment: You are the Case Coordinator. You have 300 patients that need to be scheduled for outside specialty appointments every month. You are tasked by the Administrator to develop a strategic plan organizing the out of the facility appointments without impairing internal services.

As the first step, develop a Memorandum addressing:

1. Provide an overview of Estelle v. Gamble and how that 1976 Supreme Court ruling pertains to the provision of inmate health care.
2. Examine the challenges of providing health care in a correctional environment.
3. What are the challenges of providing health care to a female offender population that may not exist in a male prison?
4. What framework would you apply to the strategic planning? Why? (HINT: Remember all the available frameworks that you learned in the previous classes as well as in this class to make a correct choice). 

Make sure to cite in APA format when appropriate. Support your statements with credible evidence. 

Write 22 pages with APA style on Design a multi-story reinforced concrete office building. The building is to consist of a 30 people meeting suite/conference, a restaurant, different sizes common room on the 3 floors of the building. Ground floor will consist of, conference room, restaurant, common room and all services associated. The remaining unused floor is aimed for facilities of leisure. 3.0 General Approach The general approach taken is to obtain the architecture of an office building:- Acquiring design of an office architecture of a multi-storey building basically adopted in the construction design (Alheyad, 2008). . Structural system establishment of the floors from the ground to first, second and third floor Foundation type, column design and system of resisting wind will be affected by taking into consideration the architectural drawings 4.0 Requirements for design Client’s requirements: The ground floor is to have: a reception, conference/meeting rooms, common room and entertainment room, a restaurant, and associated services. The remainder of the floor is to be occupied by the swimming pool. The main building is to include a small scale conference/meeting suite of a maximum 30 persons, a restaurant, a common room, as well as lodging. The minimum clear height for the ground floor is set to be3.0 m. The minimum spacing of vertical structural elements within the ground floor is to be 6.0 m. Access to bedrooms at the 1st and 2nd floor and the 3rd floor is by lifts or staircases located at the centre and end of the floors. The 1st and 2nd floor are different size offices with central access corridors. The floor upon completion will have a soffit height at the 1st and the 2nd floor of a minimum of 3.0 m in the floors and 3.6m in corridors, in addition to services allowance. All servicing plant including water tanks, heating boilers and lift mechanisms are to be located on top of the stair/lift towers at the ends of the building. Car parking of 450m^2is to be set near the hostel at ground level over an area of approximately 450 m2. There is need for allowance for future adjustments in demand for different types of services. This is achieved through structural arrangement not compromising the ability to adjust the width and mix of room compartments, though the central corridor arrangement will not be altered as per the client decision. A fire resistance period of 2hrs is to be put in the building. The building is to be exposed to XC-1 environment. Building requirements analysis The two-hour fire resistance requirement is vital in for the structural elements design of the building. According to Euro code 2, for two-hour fire resistance, the minimum width of a beam is 200 mm. The XC-1 environment that the building is exposed to implies the structure is always exposed to water or is dry. To attain this condition a minimum cement 240 kg/m3 for exposure to XC-1 together with a ratio of 0.07 environmental conditions. The set minimum cover for XC-1 environment is cmin = 15 m .This is calculated using the equation Cnom = Cmin + ?C, where Cnom is the nominal cover. (Eurocode 2). 5.