ACH solves problems and makes lives easier… that is our purpose.
Throughout our 15 years of business, we have found many of the patients requiring medical care in our facilities may not have accessed medical or mental healthcare outside of the jail. Our goal is to provide a high standard of correctional healthcare to patients while they are in our facilities to improve their quality of life.
Many things have changed in the correctional healthcare industry in the past 15 years. Pharmacy prices continue to drastically increase, and laws are constantly evolving. The rise in drug addiction—opiates, in particular—has coincided with the reduction of available mental health services and the aging of jail populations. All of this has increased the burden of financial responsibility on county budgets; fewer county jails are able to handle the complexities of rapidly changing healthcare within their facilities.
What is Correctional Healthcare?
Correctional healthcare is the federally mandated standard of care that is provided to detainees/inmates in a jail or prison environment. There is a common misconception that healthcare in a jail or prison environment is below standard. Nothing could be further from the truth. Virtually all studies we have seen indicate that people, given their lifestyle in the free world, are actually healthier and live longer in a jail or prison environment. This may seem difficult to believe, but studies reviewing the control of diabetes, hypertension and other chronic diseases indicate people are healthier while they are in jail.
As a correctional healthcare provider, Advanced Correctional Healthcare, Inc. (ACH) specifically focuses on the jail population. The difference between jail and prison is that jails usually consist of detainees who are being incarcerated for a short-term period by counties. Typically, these are detainees who are pre-trial, as opposed to inmates in prisons, who are sentenced and incarcerated in state-run facilities for a longer period of time. In a jail, the county is legally and financially responsible for the care of their detainees. This is a heavy burden to carry, especially paired with the strains on county budgets.
Consequently, we are seeing a conversion from county-organized jail healthcare to contracting with private companies to supply necessary medical and mental healthcare services. This is where we step in, helping the county plan to provide medical and mental healthcare for their detainees.
It’s been said that the U.S. correctional system is actually the largest mental health provider in the country. While ACH does not provide services to prisons, mental health is one of the most important parts of healthcare in a jail environment. As such, we have developed an entire division of our company that focuses solely on mental healthcare. This program was developed by Dr. Melissa Caldwell and is currently operating in 112 facilities in 12 of the 17 states we service. In addition to working with our own mental health team, we frequently partner with mental health providers from other agencies that have been contracted directly by the counties. Both systems work well, and we are able to easily coordinate between medical and mental health services.
The biggest problem for many detainees is trying to understand why they do not get all of their medications when they come to jail. For example, if a patient is on morphine for back pain and has been for 10 years, can they be weaned off of it and still function? Opioids are heavily abused, and they aren’t always in the patient’s best interest. The issue is that many practitioners are loosely prescribing heavily addictive medications when a less dangerous option may be available, offering the same benefits without as many of the side effects. Our goal is to improve the patient’s quality of life by getting them away from a highly addictive drug that potentially has side effects, while finding them an equally effective substitution with less addictive qualities and negative issues.
The opioid crisis heavily impacts corrections. Currently, it is impacted more from improper physician prescribing than from heroin use, although both are significant. Because we must constantly think of patients going into withdrawal or overdosing, we have recommended that a number of our practitioners become board certified in addiction medicine. This helps us stay on the cutting edge of treatments and protocols throughout the correctional system.
In the free world, most patients' “wants” are accommodated over their “needs.” For example, if you go to a practitioner and say you are feeling pain and want a painkiller, most likely that practitioner will prescribe you some sort of painkiller to ease your pain. In a jail environment, we must do what is best for the patient, which is not necessarily easy or what the patient wants, but may be what they need. This causes our practitioners to really analyze cases and find the root cause of an issue, instead of just treating the symptoms. Is your pain caused by something larger than what we are seeing? What do you need to function? This basic philosophy leads to superior healthcare in a correctional environment.
Is it Safe to Work in a Jail?
There has always been a misconception that working in jails or prisons is dangerous. That is mostly propagated by television programs, which do not coincide with the reality of a jail environment. Recently there was an article in the New England Journal of Medicine concerning safety from assault in general medicine. The key point: working in jails is one of the safest areas in which a medical or mental health professional can work. As a doctor, I have personally witnessed assaults in emergency rooms, nursing homes, and even once in my own private practice. Yet I have never been assaulted in a jail. The reason has to do with jail security and the fact that the sheriff (jailer) provides correctional staff, who are present with us at all times. In fact, corrections can even be a “Great Place to Work”!
In August 2016, ACH was certified by Fortune magazine as a Great Place to Work. In order to receive the certification, companies are rated in six areas by current employees in an anonymous survey. These areas rate the quality of the company’s challenges, atmosphere, rewards, pride, communication and bosses. In addition, the company provides details about its programs and practices, and the results are analyzed to determine if the 70-percent average score is met. We were honored to hear we exceeded that score—that 84 percent of our employees say their workplace is great—so we received the certification. ACH is the only correctional healthcare company, and the only company currently headquartered in Peoria, to have received this certification. (You can check out their review at reviews.greatplacetowork.com/advanced-correctional-healthcare-inc.)
Is Your Job Secure?
Some studies show incarceration rates are declining, yet ACH has seen a steady growth in our company. This comes from adding contracts, as well as seeing the majority of our contracts increase their average daily populations. In 2002, we started with eight contracts. We are excited that in 2017, we started with over 290 contracts. In 2016, we showed a 96-percent retention rate; we were the largest provider, by county, in six states; and we served over 34,000 patients on average. While overall incarceration rates have been declining, ACH’s average daily population has steadily risen for 15 years.
ACH is organized entirely around a strong strategic planning and execution system, which we feel makes the company strong for future growth. We review our corporate mission, vision and purpose annually to make sure we are achieving our goals. As our staff focuses on the purpose of the company and on their own purpose, each person solves problems every day for our clients and patients. This is our prime focus as we analyze a potential client’s facility to reduce their areas of waste. This is our primary thought as we redesign healthcare for individual patients to make it as easy and effective as possible.
This focus on problem-solving explains why we find it necessary and beneficial to have a mission, vision and purpose statement. We magnify that by having our core values and corporate word of the year tie into our corporate culture through a recognition program. Employees are encouraged to recognize each other based on our core values, which promote a great work ethic while connecting employees to the corporate culture.
In addition to our recognition program, ACH has created an extensive training program for our healthcare employees and correctional staff. We feel that if we can provide training and a higher level of competency in the industry, we all win. Our extensive training program for correctional officers helps them understand the unique position they are put in by civil rights laws. It is one of the few situations that a non-medical person can be sued for medical issues. Our program includes a combination of didactic lectures and extensive video training with pre- and post-tests, and we are currently developing an online learning system for our clients. The training is not meant to turn a non-medical person into a medical professional, but provide them with the information they need to function as a correctional officer in healthcare-related situations.
We must also deal with the fact that correctional healthcare doesn’t always get great press, but those of us who work in corrections know the truth. We aim to change this perspective by making sure the stories of the good people in the corrections industry are shared, and by educating the public on what correctional healthcare really is. We are proud of the strides ACH has taken in the past 15 years, and we are proud to call Peoria our headquarters. We look forward to many more years in Peoria and the correctional healthcare industry. iBi
Norman R. Johnson, MD, FACP, ABAM, CCHP and Brenda J. Johnson founded Advanced Correctional Healthcare, Inc. in 2002. Serving over 290 counties in 17 states, ACH is the largest privately-owned provider of correctional healthcare to jails in the U.S. For more information, visit advancedch.com.