I am an RN in the Health Care section of the Bureau of Prisons at Talladege Alabama. In the Bureau of Prisons between the Central office in Washington and the local health care providers are Regional Offices. In the Bureau of Prisons there are six Regional Offices. For saving money I suggest eliminating the Health Care section of the Regional Offices. The would save not only the salaries and other costs but would save the cost of the office space.
I do not make this suggestion frivolously nor do I make it without what I believe is sound reasoning. I propose eliminating the health care section of the Regional Offices because they provide at most very little health care. For evidence of this I ask that you look not only at my words but look at THEIR words, THEIR reports, THEIR findings and THEIR actions.
In a recent evaluation of out facility by a Health Care Program Review group their main finding was our dental section's instruments were not counted per policy. It was not that the instruments were not counted it was the way they were counted. By the Program Review group's own findings; not one instrument was lost, not one instrument was unaccounted for, no safety was compromised and no security was compromised. It was just that the documentation was done in the wrong place. Yet for this inspection lasting several days the taxpayers paid five salaries, five travel allowances, five meal allowances and five lodging costs. This is not to say the group did not provide a useful purpose or was not correct but is it worth the cost to the taxpayer?
In a recent evaluation by the Regional Pharmacist her main finding was the inmate/patient's medicine cups were being filled too early. To explain; certain of the medicines prescribed for inmates cannot be given to them in packages for them to take to their housing units. These medications are dispensed in a "pill line." Each of the patients has an assigned medicine drawer where his medicine(s) are stored in bottles. At each of the pill lines a dose of the medicines are taken from the bottle(s) in the patients drawer, placed in a small paper medicine cup and handed to the patient. What the Regional Pharmacist found was the paper cups were being filled more than the, per policy, one hour prior to dispensing. In this case I was was the one found to be filling the medicine cups too early, sometimes as much as three hours prior to dispensing. I placed the medicines in a cup the placed an empty cup over the the filled one and placed the cups back in the patient's drawer. The efficacy of medications are affected by light, temperature and air. Every pharmacist I spoke with said the medications in covered cups in a drawer would have a change in efficacy but it would take at least many hundreds of hours. Here the Regional Pharmacist, while absolutely correct by policy, was paid by the taxpayers to make an observation about medication dispensation when the change in efficacy, if it exists, is not measurable by any test known to man. I filled the medicine cups early because by doing it that way made staff time far more efficient, a fact that no one disputes.
The second finding of the Regional was where newly prescribed medications are documented. She correctly pointed out where the documentation of some newly prescribed medications are documented in the wrong place. There was no finding that patients did not receive their medication or did not receive their medication on time or that the documentation was not done, only that it was documented in one place instead of another. While the Regional Pharmacist was correct, per policy, in all her findings, are the salary and travel costs of someone to find that medication cups being filled three hours in advance instead of one hour in advance and medications documented in one place instead of another a necessary expence?
Our Regional Medical Director is located in a office in Atlanta. She confers with the local medical directors, the one who actually see the patients. She confers via closed circuit. From what I have seen she functions primarily to order delays in the treatments ordered by the doctors who see the patients. Many of the local doctor recommended treatments are done but done later. I suggest you look at the records of HER findings, HER recommendations and HER orders to see if her position warrants the expence of her salary, her costs and her ofice space.
Similar is the case of the Regional Health Care staff. Look at THEIR findings, THEIR actions, THEIR recommendations and THEIR orders and see how much health care the Regional Health Care staff actually provides.
From what I have been able to determine a significant cost to the BOP, paid by the taxpayers, are successful health care related lawsuits and settlements paid to inmates. I have been told that in these successful lawsuits and settlements the most frequent cause is not non-treatment or incorrect treatment but a delay in treatment. It appears that the tax payers are paying lawsuits and settlements due to overloaded providers; doctors, physician's assistants, nurse practitioners and registered nurses; while we have a Health Care group, the Regionals, who provide almost no direct health care.
A group I mentioned above, the Health Care Program Review group, who goes from one facility to another, while not full time, consumes salaries, travel expences, meal allowances and lodging allowances; while providing no health care. This group only inspects local health care facilities. The local health care facilities are also regularly inspected by two independent outside agencies. The American Correction Association (ACA) and the Joint Commission of Health Care Orginazations (JACHO). Hospitals from level three and four triage centers up to level one trauma centers are inspected by only one agency. What we are suggests inspection by the ACA and JACHO are in order but in this time of tight money do we really need to pay for a third inspection agency, the BOP's health care Program Review?
