Page 20 - Delaware Medical Journal - May 2016
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V incent F. Carr, DO, FACP
IntroductionThe Department of Correction in Delaware is a
and the “prison” sentenced inmates after trial. Because there is great emphasis on the intake screening process that occurs in the medical encounter outlined in the Bureau of Correctional Health Care’s policy 11-E-12, Continuity of Care. On average there are approximately 6,500 offenders housed in the 11 facilities of the Department, approximately 23 percent of which are pre-trial
detainees. As detainees enter, post bail if court-ordered, and are quickly released there is a large turnover of
this population averaging approximately 22,000 per year. While the pre-trial detainees and sentenced offenders are present in the facilities they remain
separated from each other, but the scope of medical care provided to each group is the same.
The intake screening process is similar to a triage of offenders entering a facility and focuses on situations that could threaten the life of the offender or the lives of others in the institution.
Each offender is asked a number of questions to gauge their
risk of self-harm, their potential to withdraw from alcohol or substance usage, and their need of medications to treat chronic conditions including diabetes, hypertension, seizure disorders, and HIV disease. As the housing in a prison brings offenders in close quarters with other offenders, there is a risk of spread of contagious disease such as tuberculosis or ectoparasites. Every offender entering a Department facility receives a skin test for tuberculosis and a screening for fever, cough, and weight loss that might suggest active tuberculosis. Other infectious disease diagnoses such as sexually transmitted disease, HIV disease, and hepatitis are not the focus of the intake screening process other than continuing the offender’s medications. The initial physical evaluation which takes place within a week of the offender’s arrival includes screening for these infectious diseases. The philosophy of the Bureau is to approximate within the security constraints and public safety, the medical care a person could readily access if they were not incarcerated.
The Bureau of Correctional Healthcare Services has contracted for the direct patient care of the offenders and the Bureau oversees the provision of medical services and pharmaceutical services
to the offenders. This oversight function ensures the contract
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Del Med J | May 2016 | Vol. 88 | No. 5
