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According to the Corrections and Conditional Release Act (CCRA), Correctional Service Canada (CSC) is mandated to provide health services to all federal offenders. In addition to providing quality health services to inmates, the CSC needs to keep a record of health information data. This report will focus on the issues with the data deliverance to the inmates who are up for parole or who are being released back into the public. In closing, it will propose a solution to solve the problem. While major steps have been made in providing the type of health care that meets the goals as set out by the CCRA, there are still gaps that need to be fixed in the data collection in order to allow the inmates to have access to their medical information upon release from jail.
Each inmate’s medical record is kept within the penitentiary system, and that file begins as soon as the person is incarcerated, (Sapers, 2011). The file contains a checklist that covers relevant health information about the inmate. Also, the inmate signs a disclosure form, as well as medical forms. A registered nurse helps complete this task within the first 24 hours that the inmate arrives to prison. A basic screening process is administered, and this includes testing for acute medical conditions, dental conditions, mental conditions, communicable conditions, conditions that require continual treatment, and activity limitations, (FORUM, 2012). The CCRA states that the health services that are provided should encourage individual responsibility, contribute to safe communities, and promote healthy reintegration into society, (FORUM, 2012). Also, CSC is responsible for providing “every inmate with essential health care and reasonable access to non-essential mental health care that will contribute to the inmate’s rehabilitation and successful reintegration in the community” (Correctional, 2013). However, there is no specification on whether this reintegration includes making medical information readily available to the inmate.
Much of the information about the type of health care that patients receive is not known by the public. The 50 federal penitentiaries in Canada consist of about 1,150 health care professionals, including nurses, physicians, pharmacists, psychologists, social workers and epidemiologists. Nurses are the most prominent health care figures in the care of inmates. The inmate demographic requires much more care than the average person because they often suffer from chronic diseases, mental illnesses, and infectious diseases. Their conditions are closely monitored on a daily basis by nurses, (Froomkin, 2013). However, a doctor’s care is sometimes required at a nearby hospital. But while general information about the care that inmates receive is readily available, it becomes a greater challenge to find the specifics about that care, and for the inmate to receive their information upon release. In an attempt to discover specifically how the health care practices are specifically carried out at penitentiaries, 86 female inmates in Abbotsford, British Columbia were studied, as well as the records integration.
At the penitentiary in the study, the medical records were kept on all of the individuals who entered the correction system. When the person was finished incarceration, the medical record was opened, but the information was not always provided to the individual in a timely manner, (Goldstein, 2012). The population demographic variance is similar to what it is outside of prison. Many offenders are from countries outside of Canada, and others were either born in Canada, or have lived in the nation for a considerable amount of time. The ratios in prison are similar to what is seen in Canada. This is part of the information contained on the inmate’s health record, and needs to be taken into consideration when deciding which medication to prescribe, and what conditions they could be suffering from, as specific conditions are more common among people of a specific race, for example. This specific documentation, along with the specific medication that are needed, are important for the inmate to transition back into society, which as the reader has seen is a portion of the CSC’s mandate.
In addition to the person’s race, the health record contains the patient’s ID number, name and date of birth. The record consists of seven sections, including Mental Health, Administrative, Progress Notes, Radiology, Infectious Disease, Consultations, and Miscellaneous. Each section has a special form, and the person who is filing the same forms in the Mental Health section, for example, also uses the same file in the health facility, (Goldstein, 2012). The members of the health services keep detailed records of the various occurrences and the interactions take place with the offenders. The patients’ medical information is only available to those who are in medical contact with the inmate, or those who need to know the information contained in the files. The health records rarely even need to leave the care facility; however, there are four situations where this can occur. However, these outcomes are not always met, (Goldstein, 2012).
· There is a direct transfer to another facility
· The health record may be given to the inmate if they are going to a health centre in another province
· The health record is transferred with a liaison officer when the offender is transferring to a provincial mental health centre.
· The file can also be transferred to a regular health care provider if the offender is released from prison, (FORUM, 2012).
Following the release of an inmate, the health record is kept for two years at the facility where the prisoner served time. After that point, the health record is under the protection of provincial law, and it is kept within the government. If the former inmate goes back to prison, the penitentiary requests the file back from the government that is holding it. Whenever inmates enter the facility, whether it is for the first time, or subsequent times, the provincial government is not required to pay for the inmate’s health, (FORUM, 2012). Much of the expenses are paid in house by the penitentiary’s funding. So, in a sense, the government is still paying for the health care. Part of the costs covered by the penitentiary itself are related to the lab work, receiving physicians to do the PAP tests instead of gynecologists and sending the radiology to a separate federal facility, (FORUM, 2012). Despite this detailed information, however, it is not made readily available to the inmate upon their release.
In order to gain a clear picture about the attitude towards the preservation of private information about the inmate’s medical information, it is important to take a look at a real-life case. In Cleary v. Correctional Service of Canada & National Parole Board, the plaintiff was slated to attend a detention hearing in front of the Board. The Parole Regulations state that the Board gives the inmate a summary in writing of important information that it is in its possession of, no more than 15 days prior to the hearing date. However, the Correctional Service of Canada employees were on strike during that time, and the material was not delivered within the 15 days; it was delivered 9 days prior to the hearing. At that point, Cleary applied to the Federal Court to have an Order quash the National Parole Board’s decision. However, the Court dismissed the application because the 15-day guideline was not mandatory, but a direction, (FORUM, 2012). This non-release of the pertinent medical information created a burden for Cleary, and shows there should be safeguards in ensuring that the appropriate information is available to the inmate in a reasonable timeframe. While the case, as described by the CSC, did not say whether the medical information was needed by Cleary so that he could be provided with the appropriate medical documents, this information may have very well been an important component to his physical well-being. This calls for the availability of the medical information to the inmate if they make the request, particularly if the inmate is on parole, or is about to go on parole, as that information could be vital for them showing a doctor so they can receive needed medication.
In order to fix this problem, inmates should have access to a website or telephone number that they can call and have their personal health information sent to them. The information that is gathered while behind bars is vital for the life of the inmate after they leave the penitentiary, and they should have full access to their records in a timely fashion. In the case of Cleary v. Correctional Services of Canada and the National Parole Board, it became evident that there is a long lag time between when the information is needed and when it is received. The case was an anomaly, due to the fact that there was a correctional service workers’ strike, but the information could just as easily not be given to the inmate if a strike to last a longer period, for example. If the inmates do not have quick access to their personal medical information at the time of their release, this could result in them not receiving the proper prescriptions, and in the worst-case scenario, this would result in death.
Works Cited
“FORUM on Corrections Research.” (2012). Correctional Service Canada. Retrieved from
http://www.csc-scc.gc.ca/text/pblct/forum/e023/e023o-eng.shtml
Froomkin, D. (2013). The Too-Many Prisoners Dilemma. Harvard University. Retrieved from Prisoners-Dilemma.aspx
Goldstein, M. (2012). Health Information Privacy in the Correctional Environment. George Washington University. Retrieved from http://sphhs.gwu.edu/departments/healthpolicy/DHP_Publications/pub_uploads/dhpPu blication_C199DFF7-5056-9D20-3D2099CBB55AC369.pdf
Sapers, H. (2011). Annual Report of The Office of the Correctional Investigator. Office of the Correctional Investigator. Retrieved from
http://www.oci-bec.gc.ca/cnt/rpt/pdf/annrpt/annrpt20102011-eng.pdf
