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Report Presents Bleak Analysis of BOP Medical Bureaucracy

by Derek Gilna

The Federal Bureau of Prisons (BOP) is arguably a failed institution, and that fact is no more obvious than in the substandard medical care it provides to the prisoners in its custody. Although the BOP’s bloated bureaucracy absorbs an ever-increasing percentage of the Department of Justice’s financial resources, it never seems to be able to deliver even a mediocre level of medical care, and has become a magnet for prisoner tort claims and federal civil rights lawsuits. For too many prisoners with serious health needs, a stint in the BOP can turn into a death sentence.

That is the inescapable conclusion one derives from a March 2016 report on the BOP’s medical system by the DOJ’s Office of the Inspector General (OIG). According to the report, “recruitment of medical professionals is one of the BOP’s greatest challenges and staffing shortages limit inmate access to medical care, result in an increased need to send inmates outside the institution for medical care, and contribute to increases in medical costs.”

One could argue that such shortcomings are a direct result of the BOP’s practice of building prisons in remote or rural areas, to save money on construction costs and salaries of staff drawn from economically-depressed communities. It should come as no surprise to the BOP that doctors and skilled medical personnel don’t find positions in remote, rural prisons particularly attractive.

Staffing shortages are not the only problem with BOP medical care. Since salaries are not competitive and working conditions not ideal, it also should come as no surprise that the federal prison system does not attract the most qualified applicants. Therefore, it likewise should not be surprising that medical practitioners willing to work in federal prisons typically do not provide the highest level of competent care.

The OIG report made the following observations: The BOP’s compensation and incentives offered to medical staff are insufficient to alleviate staffing shortages, the BOP does not identify or address recruiting challenges in a strategic manner, and the BOP does not use the authority it has to assign Public Health Service (PHS) officers to positions in federal prisons based on greatest need.

The OIG recommended that BOP officials correct these failings, including the better use of PHS employees to address critical medical staff shortages. The report noted that “As the BOP struggles to fill its medical staffing needs, and as medical costs continue to rise, the BOP must collect better information on its priority health services vacancies and find solutions to meet the medical needs of its inmates.”

However, the OIG failed to identify the primary problem facing the federal prison system, which is a systemic lack of commitment to providing adequate medical treatment to prisoners who have no other options for their healthcare needs.

Also working against the BOP is its reluctance to utilize the compassionate release process to address a steadily increasing number of extremely ill, elderly and infirm federal prisoners. Instead of releasing such prisoners to their families, the BOP allows them to remain incarcerated where they are at the mercy of a failed medical system. [See: PLN, Dec. 2014, p.50].