DRC General Medical Services
Correctional Institution Inspection Committee
May 8, 2013

DRC Medical Services

Medical Cost Controls

 A complete medical, dental, and mental
health screening is performed on each inmate
at the DRC’s reception centers.

 All medical services initiated by inmate request
carry a $2.00 copay charge, unless the inmate
is determined to be indigent (receiving less
than $12 per month).

 Inmates are instructed concerning access to
medical care, the grievance process, and
mental health services.
 Following assessment at reception, each
inmate is assigned a medical classification,
which is taken into consideration in the
assignment of a parent institution.
 A health screening is also conducted for each
inmate within eight hours of arrival at the
parent institution.
 Inmates are able to place requests for health
services for Nurse Sick Call on a daily basis.
 A priority system is used to schedule clinical
services, which are available to inmates at
least five days a week.

 All recommendations for outside medical
services, including specialty consults and
surgery, must be pre-approved through the
healthcare
utilization
review
program
facilitated by the DRC State Medical Director.
 In partnership with ODMH, the DRC converted
to a mail-order drug delivery system and
maintains
strict formulary
control for
pharmaceuticals.
 In partnership with OSU, the DRC pays
Medicaid rates for in-patient stays and
reduced costs for medical supplies.

Key Statistics

 Inmates in segregation receive at least a daily
visit from a nurse.

Total DRC medical spending peaked in FY 2010,
decreasing by 15.5% in FY 2012.

 The physician
develops
individualized
treatment plans for all inmates diagnosed with
chronic care illnesses, which involve regular
follow-up appointments.

In FY 2012, the DRC spent $67.7 million for state
medical services payroll; $32 million was spent on
contractors and temporary workers, including
$11.8 million for dental staffing and services.

 Inmates have access to specialty services,
including optometry, podiatry, dental, and OBGYN services.

The number of inmates per health care worker
has steadily decreased, from 65 in CY 2006 to 48
in CY 2012.

 Informed consent by the inmate is required
prior to surgery or other invasive treatments,
unless the inmate is determined to lack
mental capacity to give informed consent, in
which case the next of kin or person with
power of attorney is contacted.

In CY 2012, there were 133,923 Nurse Sick
Calls and 115,505 Doctor Sick Calls across the
DRC, a 25.5% and 29.6% decrease from 2009.
Female institutions reported the greatest
number of nurse sick calls in comparison to
population (NEPRC), as well as the greatest
increase in comparison to 2009 (DCI).

Correctional Institution Inspection Committee
Riffe Center, 77 S. High Street, 15th Floor, Columbus, Ohio 43215, PHONE (614) 466-6649, FAX (614) 466-6929

Total DRC Medical Services Spending
FY 2004 – 2012
250

200

Millions

150

100

50

0
2004

2005

2006

2007

2008

2009

2010

2011

2012

*Data provided by the Ohio Department of Rehabilitation and Correction.

Civil Service and Contractor Payroll Spending
FY 2004 – 2012
80
70

Millions

60
50
40
30
20
10
0
2004

2005

2006

2007
State Employee

2008

2009

2010

2011

2012

Contractor

**Data provided by the Ohio Department of Rehabilitation and Correction. Data includes payroll costs for medical staff in every
DRC institution, as well as at the DRC Operation Support Center, including administrative staff.

Correctional Institution Inspection Committee
Riffe Center, 77 S. High Street, 15th Floor, Columbus, Ohio 43215, PHONE (614) 466-6649, FAX (614) 466-6929

Number of Inmates per Health Care Worker
CY 2006 – 2012
70

60

50

40

30

20

10

0
2006

2007

2008

2009

2010

2011

2012

*Data provided by the Ohio Department of Rehabilitation and Correction. Rates were calculated based on the total number of healthcare workers reported by the
DRC compared to the total inmate population as reported on DRC’s annual institutional census reports.
** “Health Care Worker” includes physicians and other advanced level providers, registered nurses, licensed practical nurses, and health information technicians.
Chart does not include dental service providers.

Correctional Institution Inspection Committee
Riffe Center, 77 S. High Street, 15th Floor, Columbus, Ohio 43215, PHONE (614) 466-6649, FAX (614) 466-6929

Total Number of Nurse Sick Calls
CY 2009 – 2012
RICI
PCI
MCI
MACI
LECI
CRC
AOCI
BECI
ORW
NCI
SOCF
LORC
MANC
LAEC
NCCI
TOCI
TCI
GCC
CCI
LOCI
NEPR
RCI
SCI
FMC
DCI
WCI
OSP
HCF
0

5,000

10,000

15,000

20,000

25,000
2009

2010

30,000
2011

35,000

40,000

45,000

2012

*Data provided by the Ohio Department of Rehabilitation and Correction.
**Note that AOCI includes both the former Allen Oakwood Correctional Institution and Oakwood Correctional Facility; GCC includes the former Grafton Correctional Institution
and North Coast Correctional Treatment Facility. FMC includes the former Corrections Medical Center and Franklin Pre-Release Center. DCI includes the former Montgomery
Education Pre-Release Center.

Correctional Institution Inspection Committee
Riffe Center, 77 S. High Street, 15th Floor, Columbus, Ohio 43215, PHONE (614) 466-6649, FAX (614) 466-6929

Nurse Sick Calls per Inmate
CY 2012
10
9
8
7
6
5
4
3
2
1

0

Level
1/2

Level
3

Level
4/5

Reception

Special/
Female

*Data provided by the Ohio Department of Rehabilitation and Correction. Data was calculated using the total number of Nurse Sick Calls reported at each institution in
2012 in comparison to the average monthly population for each institution in 2012 (using the last weekly population count for each month).
**Note that the above numbers are rates only; some inmates attend Nurse Sick Call frequently, while others may not access medical services at all during their
incarceration, depending on need.

Correctional Institution Inspection Committee
Riffe Center, 77 S. High Street, 15th Floor, Columbus, Ohio 43215, PHONE (614) 466-6649, FAX (614) 466-6929

Change in Nurse Sick Calls
CY 2009 – 2012
150%

100%

50%

0%

-50%

-100%
*Data provided by the Ohio Department of Rehabilitation and Correction. Data was calculated comparing the total number of nurse sick calls in CY 2009 and 2012.
**Note that DCI transitioned from a male to a female facility in 2011; female inmates typically utilize health services more frequently than males do. GCI’s data in CY 2012
includes the inmates housed in the facility formerly privately operated as NCCTF. AOCI’s data includes the former OCF, previously the state’s correctional mental health
hospital, which transitioned to housing the state’s Protective Control unit and minimum security inmates.

Correctional Institution Inspection Committee
Riffe Center, 77 S. High Street, 15th Floor, Columbus, Ohio 43215, PHONE (614) 466-6649, FAX (614) 466-6929

Total Number of Doctor Sick Calls
CY 2009 – 2012
45,000

40,000

1-'

35,000

30,000

25,000

20,000

-I

+I-I-Itl 11

• 2012
• 2011
• 2010
• 2009

--1-1- -1-1- - -1-1-1-1-1

15,000

10,000

5,000

I

II

I I •; •

0

*Data provided by the Ohio Department of Rehabilitation and Correction.
**Note that AOCI includes both the former Allen Oakwood Correctional Institution and Oakwood Correctional Facility; GCC includes the former Grafton Correctional
Institution and North Coast Correctional Treatment Facility. FMC includes the former Corrections Medical Center and Franklin Pre-Release Center. DCI includes the
former Montgomery Education Pre-Release Center.
Correctional Institution Inspection Committee
Riffe Center, 77 S. High Street, 15th Floor, Columbus, Ohio 43215, PHONE (614) 466-6649, FAX (614) 466-6929

DRC Nurse and Doctor Sick Call
CY 2009 - 2012
Institution
AOCI
BECI
CCI
CRC
DCI
FMC
GCC
HCF
LAECI
LECI
LOCI
LORCI
MACI
MANCI
MCI
NCCI
NCI
NEPRC
ORW
OSP
PCI
RCI
RICI
SCI
SOCF
TCI
TOCI
WCI

NSC 2009

DSC 2009

NSC 2010

DSC 2010

NSC 2011

DSC 2011

NSC 2012

DSC 2012

11,459
6,911
6,240
7,272
2,010
4,378
6,169
1,975
6,560
6,661
4,964
2,839
8,867
5,604
8,907
5,167
6,083
3,748
9,672
2,382
12,015
6,812
16,562
3,235
10,839
5,397
4,688
2,448

9,304
4,587
7,878
4,556
2,356
4,257
8,240
3,103
2,975
5,351
5,289
8,577
5,472
6,733
5,640
4,647
5,371
4,183
9,129
1,903
16,486
6,078
11,925
2,768
3,486
3,231
3,592
6,861

6,201
6,178
6,189
7,694
2,374
4,719
6,824
2,270
6,645
7,441
5,324
7,498
6,758
6,367
8,517
6,395
6,908
4,695
5,089
1,874
7,954
4,464
13,314
4,768
6,054
6,109
5,313
2,416

7,322
5,468
5,563
4,582
2,618
4,161
7,152
2,763
3,393
4,296
7,832
8,014
4,458
5,978
4,382
4,633
5,078
3,603
6,364
1,892
9,738
5,758
10,626
2,268
4,225
2,760
7,145
5,249

6,500
7,149
4,308
5,677
2,982
3,034
4,924
1,771
5,991
7,471
4,424
7,310
6,725
5,812
7,323
5,709
6,452
5,177
5,371
3,163
7,373
3,046
8,157
3,954
4,989
4,479
7,454
1,739

6,744
5,051
5,282
4,462
2,856
2,839
5,975
2,883
2,937
3,337
7,338
7,159
4,077
5,865
5,645
5,607
4,841
3,232
5,222
2,426
8,646
3,238
4,881
1,794
3,520
2,096
6,933
3,644

2,412
6,244
3,117
6,137
4,878
1,671
2,745
1,049
3,966
5,819
4,031
6,074
5,924
5,673
6,734
4,850
6,604
5,002
6,267
2,810
10,673
2,707
6,815
4,483
3,683
5,440
4,290
3,825

5,412
6,385
3,250
4,106
4,540
2,554
3,804
2,015
2,600
3,304
6,618
5,418
2,071
4,962
5,730
5,006
5,284
3,535
5,833
1,499
9,279
2,898
5,048
1,347
4,149
1,606
2,738
4,514

TOTAL
55,354
47,973
41,827
44,486
24,614
27,613
45,833
17,829
35,067
43,680
45,820
52,889
44,352
46,994
52,878
42,014
46,621
33,175
52,947
17,949
82,164
35,001
77,328
24,617
40,945
31,118
42,153
30,696

Totals

179,864

163,978

166,352

147,321

148,464

128,530

133,923

115,505

1,183,937

Correctional Institution Inspection Committee
Riffe Center, 77 S. High Street, 15th Floor, Columbus, Ohio 43215, PHONE (614) 466-6649, FAX (614) 466-6929