This toolkit can help facilities with the following:
- Ensure the provision of adequate medical, mental health, substance use disorder, and dental care
- Eliminate preventable and facility-attributable deaths
- Improve healthcare providers’ accountability to the correctional facility
- Decrease legal liability
- Increase the connection of incarcerated individuals to community-based care and insurance coverage, thus potentially reducing repeat incarceration and disparities in access to care
- Increase cost efficiencies and obtain higher value in correctional health care
Benefits of Using the RFP Toolkit
Ensure the provision of adequate medical, mental health, substance use disorder, and dental care
Governments have a constitutional duty to provide people in correctional facilities with necessary health care (Estelle v. Gamble, 1976). However, there is significant variation in the quality of care delivered and how jurisdictions approach their funding models for healthcare services. In many cases, people who have chronic or serious illnesses fail to receive care (Lupez et al., 2024) and are substantially less likely to be treated compared to the general population (Curran et al., 2023).
In some cases, there may be differences between what courts have defined as “constitutionally adequate care” and the current standard of care because jurisprudence may lag behind the evolution of medical science and community norms. This Toolkit helps shine a light on practices agencies should adopt to keep patients safe based on current medical science.
Eliminate preventable and facility-attributable deaths
There is a heightened risk of suicide for people who are incarcerated and not receiving sufficient care. Facilities may experience other attributable deaths such as misdiagnosis, neglect, accidents, homicides, and overdose. The Correctional Healthcare RFP Toolkit may help increase safety and reduce the risk of suicide as well as other preventable or facility-attributable deaths by building increased accountability and performance expectations in healthcare provider contracts.
Improve healthcare providers’ accountability to the correctional facility
Contracts with healthcare providers often lack performance measures to hold contractors accountable to service requirements. The Correctional Healthcare RFP Toolkit will empower facilities to clearly communicate performance and outcome expectations to potential bidders. By incorporating specific performance measures within the contract negotiation process, facilities are much more likely to avoid conflict.
Decrease legal liability
Failure to provide adequate health care can result in undesirable litigation. Costly and lengthy litigation may result in expensive judgments, court-ordered settlement agreements, consent decrees, patient harm, negative media attention, and public mistrust. These outcomes may be avoided in part by prioritizing sufficient health care provision by using the Correctional Healthcare RFP Toolkit.
Increase the connection of incarcerated individuals to community-based care and insurance coverage, thus potentially reducing repeat incarceration and disparities in access to care
If provider contracts are deliberately designed, correctional facilities can play an integral role in larger health services systems. Many facilities participate in local or statewide health information exchanges, which increase continuity of care during and after incarceration. Some facilities assist with enrollment in Medicaid, other insurance coverage, or disability benefits through the SOAR model. Continuity of care can reduce costly post-release emergency room use, decrease the risk of a drug overdose, increase medication consistency, and promote linkage to community-based services.
Most people who are incarcerated in jails and prisons return to their communities. This resource can help facilities secure provider contracts that include reentry services and better facilitate the reintegration process and management of health conditions.
In addition, people of color are disproportionately represented in the U.S. criminal legal system. Correctional health care offers a unique public health opportunity to reduce the unequal impact of incarceration and poor health effects on communities of color through screening and assessment, treatment, connection to insurance, and linkage to post-release care.
Increase cost efficiencies and obtain higher value in correctional health care
Although there is pressure on correctional administrators to contain costs, it is vital that people who are incarcerated receive, at a minimum, constitutionally adequate care. The information provided in the RFP is how bidders build and price their plan of approach, yet many RFPs lack important facility information that bidders would need to propose an appropriate plan for delivering services at a realistic price (e.g., historical utilization data, population acuity and severity of needs, and anticipated staffing).
Facilities can also obtain higher value for their investment in health care when they make these expectations as clear as possible. From the potential provider’s perspective, not having this information gives an advantage to an incumbent contractor, because only the current contractor has accurate historical information upon which to base the bid. The lack of sufficient information also causes bidders to increase their price assumptions to factor in the risk. The Correctional Healthcare RFP Toolkit will help facilities and potential bidders communicate clear, realistic expectations.