An audit of state prisons released on Tuesday found concerning information about health care provided to inmates, including lack of follow-up monitoring for patients and improvements needed in administrative oversight.
The audit, performed by the Office of the Legislative Auditor General, recommended the Utah state prison system's Clinical Services Bureau improve systemic deficiencies, ensure patients have access to direction from health care professionals — including correct treatments and medications — and follow internal policies and best practices for inmate health care.
A medical consultant looked at 76 sample cases before deciding that "several inmates were given inappropriate or inadequate care," the audit report states. The bureau is tasked with providing health care services to over 5,000 inmates.
Brian Nielson, executive director at the Utah Department of Corrections, said that they appreciate the effort and professionalism of the auditors while collecting information.
"We believe that the results of our combined efforts will ensure improved healthcare in Utah's prisons. We concur with the recommendations in this report and have outlined our actions and timelines to demonstrate our agreement," Nielson said in a written response to the report.
The audit found, specifically, that inmates with diabetes are not adequately monitored and that insulin is not given at the correct times, according to prison protocols or professional standards.
The report said prisons have used EMTs for nonemergent situations that they are not trained for. Additionally, medical charts at the prison need more information and personal health information is not protected, according to state and national standards.
Two inspections from the auditors found that prescription packets containing
unused medication and personal health information were found in a public dumpster outside of the prison, according to the report.
According to the audit, the bureau is not compliant with national standards for prison health care. It explained that protocols have not been reviewed recently, when they are supposed to be reviewed annually.
"It is critical that bureau management regularly review policies, procedures, and training materials for the proper administration of inmate healthcare. A regular review ensures the safety and protection of both medical staff and inmates," the audit states.
Auditors said that the bureau should develop policies that are compliant with U.S. Centers for Disease Control and Prevention standards for medical issues, including the COVID-19 pandemic. Because of the pandemic, lack of patient monitoring, accurate data and getting inmates care quickly were more concerning than usual, the audit explained, but these things are also concerns that extend outside the ongoing pandemic.
"The lack of documentation for inmates who contracted COVID-19 is concerning. Insufficient information on individual medical charts made evaluating the level of care increasingly difficult. In several of the COVID-19 cases, care was reportedly given, for which no documentation exists," the audit report states.
The audit determined that response timelines given for inmate health care requests are calculated in a way that is more favorable to the prisons, because they are initially submitted in a written format and later entered electronically. The audit states that response times that were reported are misleading.
Despite that, both the Draper and Gunnison prison sites have not met the triage timelines, although the Gunnison prison has done a better job.
The audit also states that the Clinical Services Bureau should be more transparent about funding allocations, noting that there are 30 unfilled positions in the agency that are still being funded.