Nevada gets low marks for inmate health spending
CARSON CITY — State spending on inmate health care in Nevada is among the lowest in the U.S., according to a national Pew study released recently.
The study also ranks the state’s rate of health care staffing as the fourth-lowest out of 43 states surveyed. But the study highlighted the Nevada Department of Corrections for gathering data on its health care delivery system to measure outcomes and effectiveness.
The 140-page study by the Pew Charitable Trusts sheds light on Nevada’s system. Among the findings:
— On average, state corrections systems spent $5,720 annually per inmate in fiscal year 2015 on medical, dental, mental health and substance abuse treatment. However, Nevada was one of five states that spent less than $3,500 per inmate. Four states, including California, spent more than $10,000 per inmate.
— From fiscal 2010 to fiscal 2015, the most recent year for which figures are available, Nevada’s annual per-inmate health care spending dropped by 21 percent, from $4,126 to $3,246.
— Nevada had 24.5 full-time equivalent health care staff in 2015 for every 1,000 inmates, the study found. That’s the fourth-lowest among the 43 states surveyed. The three states with lower rates were Louisiana, Illinois and Oklahoma. The study reported a 40.1 median staffing level per 1,000 inmates.
NDOC response
Robin Hager, medical director of the NDOC, said in an email that the “primary reason” for its drop in health care spending is the state’s Medicaid expansion through the Affordable Care Act.
“Prior to Fiscal Year 2014, NDOC was paying for the hospital stays of inmates, but with Medicaid expansion the state share of the hospital stays is now being paid by Medicaid,” Hager said.
Maria Schiff, a senior officer with Pew Charitable Trusts’ correctional health team, said: “Any of the states that experienced or reported a decrease in spending certainly caught our eye in this day and age where we kind of expect that health care expenses only go in one direction.”
She noted the study does not capture costs for adjusting to disabled and aging inmates, such as facility changes to accommodate wheelchairs or removing bunk beds for inmates unable to climb up.
Staffing efforts
On the staffing front, the department “struggles with hiring medical professionals,” Hager said, adding that this is “particularly true in the rural areas of Nevada.”
The state is working to re-certify seven facilities with the National Health Service Corps. That move is intended to help the NDOC attract fourth-year medical and dental students to work for the agency and participate in a loan repayment program, Hager said.
Additionally, the department is making efforts to improve the delivery of inmate health care services. Efforts include a $2.3 million electronic medical records system that the Legislature appropriated funding for in 2017.
That system will help inmates receive consistent medical and mental health care when they transition from prison to the community, Hager said.
Monitoring program
In one bright spot for the NDOC, the study found that Nevada is among 35 states with a prison health care quality monitoring system, but one of just six states that have built-in measures to employ legislative oversight based on the findings in monitoring.
The system, which came from a 2012 regulation, is a “medical quality management program” intended to monitor and improve health care delivery to Nevada inmates.
The information is used for making decisions and is provided to lawmakers for oversight.
Editor’s note: This story has been change to correct the fiscal year in which Nevada spent $5,720 on inmate health care. It also has been corrected to note that while Nevada is among 35 states with a prison health care quality monitoring system, it is one of six states that have built-in measures to employ legislative oversight based on the findings in monitoring.
Contact Ben Botkin at bbotkin@reviewjournal.com or 775-461-0661. Follow @BenBotkin1 on Twitter.
