Research Memo - Wyoming Legislature Memo ||P a g e 11 RESEARCH AND INFORMATION SERVICES • 213...

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WYOMING LEGISLATIVE SERVICE OFFICE Research Memo | 1 Page RESEARCH AND INFORMATION SERVICES 213 State Capitol Cheyenne, Wyoming 82002 TELEPHONE 307-777-7881 FAX 307-777-5466 EMAIL [email protected] WEBSITE http://legisweb.state.wy.us 16 RM 006 Re: Wyoming Department of Corrections Inmate Healthcare Questions 1. What is the statutory or other legal basis for the administration of inmate treatment programs within the Wyoming Department of Corrections (WDOC or Department) prison facilities? 2. What is the scope of services and related costs for inmate healthcare provided by the WDOC? 3. What are the processes and procedures related to administering inmate healthcare by the WDOC? 4. What is the current census of WDOC inmates by age and length of minimum sentence? Answers 1. Both statute and federal legal precedent help establish the structure of healthcare services provided to inmates of WDOC’s prison facilities. Wyoming statutes 25-1-104 and 25-1-105 create the WDOC and provide a structure for the administration of the “care and maintenance” of inmates (25-1-104). Wyoming statute 25-1-105 addresses the requirements of care for Wyoming inmates located in facilities outside of the State of Wyoming. Additionally, subsection (b) clarifies inmate care in these instances by stating that the Department may contract with the federal government or other states for the care of persons housed outside of Wyoming. Those services may include medical services, counseling, and special treatment programs or other special needs programs. The WDOC is also required to establish rules and regulations regarding the minimum standards for such facilities and standards for the care and treatment of correction inmates. In the United States Supreme Court case, Estelle v. Gamble (1978), the Court reversed the U.S. Court of Appeals for the Fifth Circuit and ruled that inmates have a right to receive “adequate health care” by stating that the principles of the 8 th Amendment to the U.S. Constitution were applicable. The court stated: These elementary principles establish the government’s obligation to provide medical care for those it is punishing by incarceration. An inmate must rely on prison authorities to treat his medical needs; if the authorities fail to do so, those needs will not be met…” Date: November 16, 2016 Author: Jennifer Lockwood, Associate Research Analyst

Transcript of Research Memo - Wyoming Legislature Memo ||P a g e 11 RESEARCH AND INFORMATION SERVICES • 213...

Page 1: Research Memo - Wyoming Legislature Memo ||P a g e 11 RESEARCH AND INFORMATION SERVICES • 213 State Capitol ... TELEPHONE 307-777-7881 • FAX 307-777-5466 • EMAIL lso@wyoleg.gov

WYOMING LEGISLATIVE SERVICE OFFICE

Research Memo

|| 11 P a g e

RESEARCH AND INFORMATION SERVICES • 213 State Capitol • Cheyenne, Wyoming 82002 TELEPHONE 307-777-7881 • FAX 307-777-5466 • EMAIL [email protected] • WEBSITE http://legisweb.state.wy.us

16 RM 006

Re: Wyoming Department of Corrections Inmate Healthcare

Questions

1. What is the statutory or other legal basis for the administration of inmate treatment

programs within the Wyoming Department of Corrections (WDOC or Department)

prison facilities?

2. What is the scope of services and related costs for inmate healthcare provided by the

WDOC?

3. What are the processes and procedures related to administering inmate healthcare by

the WDOC?

4. What is the current census of WDOC inmates by age and length of minimum sentence?

Answers

1. Both statute and federal legal precedent help establish the structure of healthcare

services provided to inmates of WDOC’s prison facilities. Wyoming statutes 25-1-104

and 25-1-105 create the WDOC and provide a structure for the administration of the

“care and maintenance” of inmates (25-1-104). Wyoming statute 25-1-105 addresses

the requirements of care for Wyoming inmates located in facilities outside of the State

of Wyoming. Additionally, subsection (b) clarifies inmate care in these instances by

stating that the Department may contract with the federal government or other states

for the care of persons housed outside of Wyoming. Those services may include

medical services, counseling, and special treatment programs or other special needs

programs. The WDOC is also required to establish rules and regulations regarding the

minimum standards for such facilities and standards for the care and treatment of

correction inmates.

In the United States Supreme Court case, Estelle v. Gamble (1978), the Court reversed the

U.S. Court of Appeals for the Fifth Circuit and ruled that inmates have a right to receive

“adequate health care” by stating that the principles of the 8th

Amendment to the U.S.

Constitution were applicable. The court stated:

“These elementary principles establish the government’s obligation to provide medical

care for those it is punishing by incarceration. An inmate must rely on prison authorities

to treat his medical needs; if the authorities fail to do so, those needs will not be met…”

Date: November 16, 2016

Author: Jennifer Lockwood, Associate Research Analyst

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2. Services provided by the WDOC include a variety of medical, dental, mental health and

substance abuse, and special needs care. Tables 1, 2 and 3, below, summarize the basic

costs and type of services provided within WDOC facilities. More specifically, Table 1

indicates the total number of inmates who were treated for services within the five

correctional institutions, including the Wyoming Medium Correctional Institution

(WMCI), Wyoming State Penitentiary (WSP), Wyoming Women’s Center (WWC),

Wyoming Honor Conservation Camp and Boot Camp (WHCC/WBC), and the

Wyoming Honor Farm (WHF).

Table 1. Wyoming Department of Corrections’ Facilities Healthcare Services

by Service Category, FY2016.

Source: Legislative Research summary of Wyoming Department of Corrections data.

The table lists each type of medical service provided with the cumulative number of patient visits

at each facility. According to this information, mental health services, nurse sick calls and

provider sick calls are the most widely used treatments within WDOC. The WDOC also notes

that inmates are eligible for regular recurring check-ups and preventive dental care once every

two years, if they submit a request to receive those services. If the provider determines more

frequent dental cleanings or care are necessary, they will be scheduled accordingly. Finally,

inmates also receive full wellness physicals on the following schedules:

Inmates who are under 40 years of age receive a full wellness physical every three years.

Inmates who are between 40 - 49 years of age receive a wellness physical every two years.

Anyone age 50 and older receives an annual wellness physical.

Anyone with a chronic medical condition is seen quarterly.

Services Category WMCI WSP WWC WHCC WHF Total

Mental Health 9,261 348 4,937 -- 1,550 16,096

Nurse Sick Call 2,888 200 2,379 2,468 1,395 9,330

Provider Sick Call 1,829 140 1,914 1,835 937 6,655

Dental Visits 2,657 130 707 689 937 5,120

Chronic Care Clinic 2,210 86 448 471 730 3,945

MH-Psychiatrist visits 1,286 51 1,605 -- 234 3,176

Intake Medical Assessments 849 -- 137 -- -- 986

Optical Visits 505 27 99 134 59 824

TB Assessments -- 613 -- 135 -- 748

Offsite Transfers -- 46 -- 339 328 713

Flu Vaccines -- 515 -- 136 -- 651

Inmates with Labs Drawn -- 67 -- 358 -- 425

Hepatitis C Vaccines -- -- -- 149 -- 149

Flu Vaccines Refused -- -- -- 117 -- 117

EKG’s -- -- -- 76 -- 76

Physical Therapy (on-site) -- -- -- 42 -- 42

Total 21,485 2,223 12,226 6,949 6,170 49,053

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Table 2, below, depicts the cost of off-site care of four medical services (inpatient, outpatient,

diagnostic, and pharmacy) provided to inmates for FY2016 by each facility. Of the services

mentioned, the majority of costs for treatment were in the areas of outpatient treatment and

pharmacy, with the majority of funds expended for WMCI inmates.

Table 2. Wyoming Department of Corrections Off-Site Healthcare Services Cost, by Service

Category and Correctional Facility, FY2016.

Facility Name Inpatient Outpatient Diagnostic Pharmacy Total

Wyoming Medium Correctional Institution

(WMCI) $889,784 $776,400 $182,538 $590,468 $2,439,190

Wyoming Women’s Center (WWC) $13,445 $96,321 $29,775 $86,565 $226,106

Wyoming Honor Farm (WHF) $61,400 $169,709 $16,450 $112,227 $359,786

Wyoming Honor Conservation Camp and

Boot Camp (WHCC) $25,535 $150,048 $10,776 $70,807 $257,166

Wyoming State Penitentiary (WSP) $23,460 $377,395 $71,380 $259,123 $731,358

Total $1,013,624 $1,569,873 $310,919 $1,119,190 $4,013,606

Source: Legislative Research summary of Wyoming Department of Corrections data.

Table 3, below, provides the appropriated funding and program expenditures for each biennium from

FY2011-2012 to FY2015-2016 for each facility as well as overall WDOC administration. It should be

noted that there may be additional costs when an inmate is in need of an evaluation by a specialist or a

required out of state hospitalization. In those instances, the additional costs of transportation, security

staff for hospital duty, lodging and meals may increase the Department’s overall cost of treatment.

These additional costs are not paid out of the facilities’ healthcare services budgets. See Attachment A

for the WDOC’s summary of monthly costs of services, on-site and off-site, for the FY2015-2016

biennium.

Table 3. Financial Summary of General Fund Appropriations and Expenditures for WDOC

Facilities’ Healthcare Services, FY2011-2016.

Inmate

Medical

Services

FY2011-12

Appropriations

FY2011-12

Expenditures

FY2013-14

Appropriations

FY2013-14

Expenditures

FY2015-16

Appropriations

FY2015-16

Expenditures

WHCC $6,822,782 $4,658,064 $6,317,924 $4,678,007 $4,946,599 $5,042,617

WWC $4,790,824 $4,711,771 $6,166,912 $4,426,994 $4,989,854 $4,406,907

WHF $5,862,800 $3,628,974 $5,356,373 $3,931,975 $3,894,447 $4,801,177

WSP $16,530,670 $14,386,702 $15,609,055 $12,556,340 $14,527,337 $12,231,568

WMCI $15,069,334 $13,559,005 $15,126,146 $12,182,653 $13,869,482 $12,570,295

Health

Services

Admin.

$906,598 $814,700 $1,183,117 $682,433 $1,186,233 $687,241

Total $49,983,008 $41,759,216 $49,759,527 $38,458,402 $43,413,952 $39,739,805

Source: Legislative Research adaptation from Wyoming Department of Corrections data.

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3. The WDOC contracts with multiple vendors to provide healthcare services for inmates.

Prison Health Services was the primary medical provider until its merger with Corizon

in 2011. Corizon has remained the provider since the 2011 merger. The current

contract expires in June 2018, but may be renewed without bid for up to two years.

Therefore, a new, rebid contract will go into effect not later than July 1, 2020.

For off-site services (outside the corrections facilities), the WDOC has contracted with

Corizon under a fifty-fifty risk share agreement. The agreement stipulates that the

WDOC and Corizon share financial responsibility for inmates care required outside the

WDOC’s facilities. Each entity is responsible for 50% of the associated costs, and the

WDOC is billed on a monthly basis. The contractor agrees to provide the WDOC with

monthly documentation of services provided. See Attachment B for a complete list of

contract stipulations.

Each WDOC facility has a nursing staff. Both the Wyoming Medium Correctional

Institution (WMCI) and the Wyoming State Penitentiary (WSP) have a full-time nursing staff

which is dedicated to the facility on a twenty-four hour, seven days per week basis, with one

full-time physician. The remaining facilities have a nursing staff which is available sixteen

hours per day as well as a physician who is contracted for specific hours during the week.

In terms of the basic steps required to request and administer medical care to inmates, a

specific policy is followed at each location in order to coordinate services. If an inmate is in

need of medical services, he or she is required to fill out a Health Services Request Form

which is forwarded to the medical department at the facility where the inmate is located. The

request is reviewed by medical staff and an appointment is then set up for the inmate, which

is coordinated by security and the medical nursing staff.

Mental health and dental appointments are addressed in a similar way, requiring the inmate

to request the appointment. When necessary, an appointment can also be scheduled with a

physician or physician’s assistant. Outside medical attention can be contracted when

necessary for the inmate’s care. In the case of inmate hospitalization, WDOC security staff

provide 24/7 security in the inmate’s room, and daily communication takes place between

hospital staff and the WDOC facility where the inmate is housed.

In the case of an emergency, each institution has emergency medical procedures and staff are

trained in CPR, emergency first aid and are first responders. Additionally, a nurse can

respond to the inmate’s location and the inmate can then be transported to the infirmary or by

ambulance to an appropriate care facility or setting. Medical staff will only enter an area that

has been determined safe by security staff.

4. Table 4, on the next page, summarizes the current population of inmates across all

WDOC facilities according to their age and minimum sentence requirements. The table

indicates that 436, or about 21%, of all inmates are aged fifty-one or older. Of this

subgroup, ninety inmates (about 4.4% of the total population) are currently serving

sentences of more than thirty years, life, or life without parole. As the inmate

population continues to age, additional or more complicated medical conditions may

require more costly healthcare services. Please note that some inmates, on the date this

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information was gathered, may have recently entered a facility and their minimum

sentence is not yet entered into the data system and is listed as “unknown.” See

Attachment C for tables related to the individual correctional facilities’ population and

sentencing statistics.

Table 4. Census of Wyoming Correctional Facilities’ Inmates by Age and Minimum Sentence,

September 2016.

Age

Category

Years to Minimum Sentence

0-

5

6-

10

11-

15

16-

20

21-

25

26-

30 > 30 Life

Life

w/o

Parole

Death

Past

Proj.

Min

UK Total

18-20 38 3 0 1 0 0 0 1 0 0 2 0 45

21-25 175 7 4 0 1 2 2 5 1 0 58 2 257

26-30 226 13 2 1 4 1 0 6 5 0 75 4 337

31-35 198 13 10 4 1 2 5 2 5 0 60 3 303

36-40 173 18 9 6 5 2 1 16 10 0 63 1 304

41-45 114 18 4 6 1 0 1 16 2 0 46 1 209

46-50 91 16 5 6 2 1 2 19 0 0 30 0 172

51-55 84 12 9 4 5 0 1 26 6 0 21 1 169

56-60 75 13 1 3 3 1 0 23 3 0 12 0 134

61-65 26 3 4 2 2 1 0 8 1 0 13 0 60

66-70 12 3 2 0 0 1 0 12 2 0 9 0 41

71-75 11 0 1 0 1 0 0 5 0 1 4 0 23

76 or

older 2 1 0 1 0 0 0 3 0 0 2 0 9

Unknown 2 0 0 0 0 0 0 0 0 0 0 0 2

Total 1,227 120 51 34 25 11 12 142 35 1 395 12 2,065

Source: Legislative Research adaptation of Wyoming Department of Corrections data.

If you need anything further, please contact LSO Research at 777-7881.

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Attachment A

Table A1. Monthly Encumbrances for Inmate On-Site and WDOC Share of Off-Site Healthcare Costs,

by WDOC Facility Type, FY2015-2016.

MONTH

WHCC WWC WHF WSP

On-Site

Cost

Off-Site

Cost

On-Site

Cost

Off-Site

Cost

On-Site

Cost

Off-Site

Cost

On-Site

Cost

Off-Site

Cost

July 2014 $198,141 $9,315 $182,235 $4,690 $174,812 $10,204 $494,747 $36,423

August 2014 $210,714 $2,314 $181,478 $1,993 $173,449 $11,671 $487,021 $6,160

September 2014 $201,834 $21,223 $184,472 $6,024 $178,685 $4,137 $488,308 $42,938

October 2014 $198,882 $4,197 $186,542 $1,321 $182,187 $1,945 $484,705 $7,814

November 2014 $196,323 $2,896 $183,447 $2,947 $193,596 $2,028 $490,808 $5,657

December 2014 $199,504 $3,673 $185,265 $416 $192,385 $4,048 $495,655 $1,011

January 2015 $199,201 $2,143 $178,448 $5,535 $195,566 $8,137 $492,323 $16,552

February 2015 $207,685 $35,898 $179,357 $55,340 $192,839 $72,902 $488,081 $61,292

March 2015 $202,383 $4,847 $181,629 $1,413 $193,596 $2,237 $485,052 $22,708

April 2015 $193,294 $17,929 $189,658 $16,626 $193,899 $7,688 $477,477 $30,749

May 2015 $195,872 $23,359 $182,485 $8,945 $187,417 $1,310 $491,090 $595

June 2015 $196,475 $28,870 $176,782 $2,953 $188,749 $2,777 $487,324 $954

July 2015 $201,928 $21,575 $176,479 $2,361 $182,993 $12,801 $483,688 $34,277

August 2015 $185,242 $36,129 $176,660 $9,232 $190,249 $32,571 $495,649 $48,327

September 2015 $198,595 $551 $169,056 $551 $188,749 $551 $491,262 $551

October 2015 $199,959 $2,991 $170,874 $6,519 $191,324 $33,884 $500,200 $14,554

November 2015 $195,566 $5,916 $175,721 $4,120 $196,929 $7,417 $490,354 $31,283

December 2015 $195,372 $5,484 $169,889 $6,646 $189,709 $5,635 $494,093 $16,729

January 2016 $197,384 $7,081 $169,056 $15,114 $196,020 $1,860 $493,535 $7,614

February 2016 $200,868 $54 $169,965 $969 $192,991 $144 $493,838 $390

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MONTH

WHCC WWC WHF WSP

On-Site

Cost

Off-Site

Cost

On-Site

Cost

Off-Site

Cost

On-Site

Cost

Off-Site

Cost

On-Site

Cost

Off-Site

Cost

March 2016 $195,566 $6,707 $170,419 $2,917 $190,718 $6,442 $487,627 $20,058

April 2016 $205,715 $7,126 $164,209 $398 $191,476 $18,911 $494,747 $22,949

May 2016 $199,959 $11,615 $169,662 $1,069 $194,960 $318 $490,959 $19,349

June 2016 $197,838 $1,868 $168,753 $5,689 $195,717 $2,545 $491,111 $12,981

FY2015 $2,400,307 $156,664 $2,191,798 $108,203 $2,247,182 $129,083 $5,862,591 $232,854

FY2016 $2,373,992 $107,097 $2,050,743 $55,583 $2,301,835 $123,078 $5,907,062 $229,061

Subtotal $4,774,299 $263,761 $4,242,541 $163,786 $4,549,016 $252,161 $11,769,652 $461,915

Total $5,038,060 $4,406,327 $4,801,177 $12,231,568

Table A1. (cont.)

MONTH

WMCI Total On-

Site Cost

Total Off-

Site Cost Total Cost On-Site

Cost

Off-Site

Cost

July 2014 $464,904 $90,320 $1,514,840 $150,952 $1,665,792

August 2014 $462,178 $49,879 $1,514,840 $72,017 $1,586,856

September 2014 $461,541 $79,210 $1,514,840 $153,532 $1,668,371

October 2014 $462,523 $28,209 $1,514,840 $43,486 $1,558,326

November 2014 $450,665 $137,202 $1,514,840 $150,730 $1,665,570

December 2014 $442,030 $8,664 $1,514,840 $17,812 $1,532,651

January 2015 $449,301 $81,738 $1,514,840 $114,104 $1,628,944

February 2015 $446,878 $44,504 $1,514,840 $269,936 $1,784,775

March 2015 $452,180 $10,465 $1,514,840 $41,671 $1,556,510

April 2015 $460,511 $46,169 $1,514,840 $119,161 $1,634,000

May 2015 $457,975 $30,700 $1,514,840 $64,909 $1,579,748

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MONTH

WMCI Total On-

Site Cost

Total Off-

Site Cost Total Cost On-Site

Cost

Off-Site

Cost

June 2015 $465,510 $46,527 $1,514,840 $82,081 $1,596,921

July 2015 $469,752 $89,587 $1,514,840 $160,601 $1,675,440

August 2015 $467,040 $80,707 $1,514,840 $206,966 $1,721,805

September 2015 $467,177 $2,970 $1,514,840 $5,174 $1,520,013

October 2015 $452,483 $68,512 $1,514,840 $126,460 $1,641,300

November 2015 $456,270 $106,881 $1,514,840 $155,617 $1,670,456

December 2015 $465,778 $40,246 $1,514,840 $74,739 $1,589,579

January 2016 $458,845 $38,109 $1,514,840 $69,778 $1,584,618

February 2016 $457,179 $77,448 $1,514,840 $79,005 $1,593,844

March 2016 $470,509 $92,861 $1,514,840 $128,986 $1,643,825

April 2016 $458,693 $73,545 $1,514,840 $122,929 $1,637,768

May 2016 $459,299 $39,039 $1,514,840 $71,389 $1,586,229

June 2016 $461,420 $180,704 $1,514,840 $203,786 $1,718,625

FY2015 $5,476,196 $653,586 $18,178,074 $1,280,390 $19,458,464

FY2016 $5,544,443 $890,610 $18,178,074 $1,405,429 $19,583,503

Subtotal $11,020,639 $1,544,196 $36,356,148 $2,685,819 $39,041,967

Total $12,564,835 $39,041,967

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Attachment B

Source: Wyoming Department of Corrections.

“The contract specifically states:

A. The Parties hereby acknowledge and agree that the risk share parameters (and resultant

financial implications to the Parties – collectively “Risk Share Arrangement”) have been

established for the mutual benefit of the parties in order to contain costs associated with this

Contract.

B. The intent within this section is to define Contractor’s responsibilities and cost limitations

for off-site services as outlined below. Pursuant to the terms of this Contract and consistent with

Constitutional, community, and NCCHC Standards, Contractor hereby agrees to arrange for,

ensure the provision of and initially pay for all medical, dental, vision, mental health, and any

special needs care, as well as the necessary transition services for any and all WDOC Inmates at

WMCI, WSP, WWC, WHF, WHCC. Said services shall include medically necessary discharge

planning and any referral(s) for inmates in WDOC Facilities, including those housed in specialty

therapeutic programs such as the Intensive Treatment Units (ITU) at WMCI and WWC.

C. Once an inmate has been taken into the custody of the WDOC (from the time of intake into

the WDOC facilities) Contractor shall be financially responsible for the cost of all medical

treatment regardless of the nature of the illness or injury or whether or not the illness or injury

occurred prior or subsequent to the individual’s incarceration at the WDOC (once the inmate has

been determined to be medically stabilized), subject to the limitations on financial responsibility

for Off-site Services as set forth below. An inmate shall be considered medically stabilized

when the medical condition no longer requires immediate emergency medical care or outside

hospitalization so that the inmate can be reasonably housed inside a WDOC facility. The

WDOC shall notify the Contractor’s on-site staff of all remotely booked inmates within twenty-

four (24) hours of said booking (as applicable).

D. For purposes of this Contract, off-site services shall be defined to include services that are

rendered outside of the five (5) WDOC facilities (WMCI, WSP, WWC, WHF, and WHCC),

including but not limited to the following (the list below is not intended to be all inclusive):

i. Inpatient hospitalization;

ii. Off-site surgical services, devices, implants, prosthetics;

iii. Physician fees associated with inpatient or outpatient care;

iv. Office visits (excluding post-op services included in the surgical fees and

bundles);

v. Ambulatory surgery including professional fees, technical fees, and facility

charges;

vi. Emergency care including ground ambulance transfers, air transfers, or other

emergency transport services;

vii. Diagnostic and Therapeutic radiology (offsite);

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viii. Ultrasound;

ix. Renal dialysis requiring hospital level of care;

x. Chronic Renal dialysis (when services are not possible on site due to any reason

other than staffing variance) or contractor required maintenance;

xi. Chemotherapy infusions when ordered off-site by medical specialist;

xii. Specialty Physician office visits (i.e., OB, Cardiac, Oncology, etc.);

xiii. Laboratory and pathological capabilities (related to and generated during off-site

specialty services); and,

xiv. Physical Therapy and Rehabilitative Medicine.

xv. The Parties hereby acknowledge and agree the costs for all Off-site Services

(provided to the WDOC inmates) will be the shared financial responsibility of the Parties.

Specifically, the WDOC and Contractor shall each be financially responsible for fifty

percent (50%) of the total costs spent on Off-site Services.

xvi. Contractor shall be responsible for the initial payment of all invoices associated

with the provision of Off-site Services. On a monthly basis, the Contractor will bill the

WDOC for fifty percent (50%) of any and all costs paid for Off-site Services related to

dates of services occurring within the Contract Term. Such billings will be in addition to

the twenty-four (24) equal monthly payments identified in Section 4.A. of this Contract

and will be due and payable within forty-five (45) days of receipt.

xvii. Contractor shall provide monthly, documentation (via electronic format) to

support claims paid by the Contractor for Off-site Services.

xviii. The Parties recognize that Contractor cannot control the timeliness of the

submission of claims and/or invoices from non-contracted third party providers. In

addition, there may be instances in which the Contractor has denied a claim, but the

provider has appealed the denial and the claim is still in the appellate process, therefore

such monthly billings will continue beyond the Contract Term until all claims for Off-site

Services related to dates of services occurring within the Contract Term have been

received and paid by the Contractor.”

c. Services are coordinated in the facilities in the following manner. If an inmate needs

medical attention, he fills out a Health Services Request form, which is then forwarded to the

medical department at the facility where the inmate is housed. Those requests are reviewed daily

and triaged by medical staff. An inmate is given an appointment, which is coordinated between

the medical department and security. Facilities have specific Nurse Sick Call times which in

effect act as a medical clinic. Multiple inmates may be called to the medical department at one

time and wait to be seen. If determined necessary, the inmate will see a physician or physician’s

assistant or be scheduled in the future to be seen.

Follow up appointments are scheduled when necessary, inmate patients are advised of the care

plan, any restrictions impacting the inmate of which security should be aware are relayed and the

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inmate returns to his/her housing area. This process can be repeated as many times as the inmate

believes s/he needs medical attention.

In an emergency, the nurses respond to the location of the emergency, administer care at that

location and have the inmate transported to the infirmary or if needed, an ambulance is

summoned.

In the event treatment is needed outside the facility, the nurse’s work with the outside provider to

schedule the appointment. The medical department works closely with security that transports

the inmates to the outside appointments. Outside treatment is sought when the contracted

medical providers believe it is necessary for the illness or injury presenting.

When an inmate is in the hospital, WDOC security staff provide 24/7 security in the inmate’s

room. Daily contact occurs between the medical staff and the hospital and medical staff at the

WDOC institution from which the inmate was taken. When able, the inmate is returned to a

WDOC facility. Depending on the condition and medical needs of the inmate upon release from

the hospital, s/he may not be returned from the facility they left, but may be taken to the

Wyoming Medium Correctional Institutions (WMCI) in Torrington, which has the ability to

provide more acute care.

d. The two larger facilities, WMCI and the Wyoming State Penitentiary (WSP) in Rawlins,

have a full-time dedicated physician at each facility, and have nursing staff on duty 24/7. The

three smaller facilities have nursing staff on duty sixteen hours a day and have a physician

contracted for specific hours each week. The process for seeking medical attention remains the

same at every facility.

Seeking mental health and dental services is handled in much the same way as the medical

process. The inmate requests to be seen, an appointment is made and follow-up is scheduled as

needed. Emergencies are responded to immediately.”

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Attachment C

Table C1. Census of the Wyoming State Penitentiary Inmates by Age and Minimum Sentence, September 2016.

Age

Category

Years to Minimum

0-5 6-10 11-15 16-20 21-25 26-30 > 30 Life Life w/o

Parole Death

Past Proj.

Min Unknown Total

18-20 10 1 0 0 0 0 0 1 0 0 2 0 14

21-25 71 4 3 0 1 1 1 4 1 0 26 1 113

26-30 100 8 0 1 4 1 0 4 5 0 26 1 150

31-35 66 7 8 1 0 1 3 1 3 0 9 0 99

36-40 35 11 3 4 4 1 0 8 8 0 16 0 90

41-45 37 7 3 2 0 0 0 12 0 0 11 0 72

46-50 14 6 3 2 0 1 1 11 0 0 7 0 45

51-55 18 4 6 3 2 0 1 14 2 0 6 0 56

56-60 12 3 1 2 1 0 0 10 0 0 3 0 32

61-65 3 0 1 0 1 0 0 6 1 0 5 0 17

66-70 2 1 0 0 0 0 0 4 0 0 4 0 11

71-75 0 0 1 0 0 0 0 1 0 1 1 0 4

76 or older 0 0 0 0 0 0 0 1 0 0 0 0 1

Total 368 52 29 15 13 5 6 77 20 1 116 2 704

Source: Legislative Research adaptation of Wyoming Department of Corrections data.

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Table C2. Census of the Wyoming Medium Correctional Institution Inmates by Age and Minimum Sentence, September

2016.

Age

Category

Years to Minimum

0-5 6-10 11-15 16-20 21-25 26-30 > 30 Life Life w/o

Parole

Past Proj.

Min. Unknown Total

18-20 17 1 0 1 0 0 0 0 0 0 0 19

21-25 42 3 0 0 0 1 1 1 0 19 1 68

26-30 53 3 1 0 0 0 0 1 0 28 0 86

31-35 43 6 1 3 1 0 2 1 2 25 2 86

36-40 40 5 6 2 1 1 1 6 2 18 0 82

41-45 16 9 1 3 1 0 1 4 2 14 0 51

46-50 13 10 2 4 2 0 1 6 0 13 0 51

51-55 22 5 2 0 3 0 0 10 4 8 1 55

56-60 14 10 0 1 2 1 0 12 3 4 0 47

61-65 8 2 3 2 1 1 0 2 0 3 0 22

66-70 1 2 2 0 0 1 0 8 2 4 0 20

71-75 5 0 0 0 1 0 0 4 0 3 0 13

76 or

older 2 1 0 1 0 0 0 2 0 2 0 8

Unknown 1 0 0 0 0 0 0 0 0 0 0 1

Total 277 57 18 17 12 5 6 57 15 141 4 609

Source: Legislative Research adaptation of Wyoming Department of Corrections data.

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Table C3. Census of the Wyoming Honor Conservation Camp and Boot Camp Inmates

by Age and Minimum Sentence, September 2016.

Age Category Years to Minimum

0-5 6-10 Past Proj. Min. Unknown Total

18-20 8 0 0 0 8

21-25 37 0 4 0 41

26-30 16 0 6 2 24

31-35 36 0 10 0 46

36-40 30 1 6 1 38

41-45 16 2 5 0 23

46-50 17 0 4 0 21

51-55 25 2 4 0 31

56-60 21 0 3 0 24

61-65 8 0 3 0 11

66-70 4 0 1 0 5

71-75 3 0 0 0 3

Unknown 1 0 0 0 1

Total 222 5 46 3 276

Source: Legislative Research adaptation of Wyoming Department of Corrections data.

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Table C4. Census of the Wyoming Honor Farm Inmates

by Age and Minimum Sentence, September 2016.

Age

Category

Years to Minimum

0-5 Past Proj. Min. Unknown Total

21-25 8 7 0 15

26-30 22 5 1 28

31-35 27 9 0 36

36-40 32 12 0 44

41-45 28 9 1 38

46-50 35 5 0 40

51-55 11 0 0 11

56-60 19 2 0 21

61-65 6 2 0 8

66-70 3 0 0 3

71-75 3 0 0 3

Total 194 51 2 247

Source: Legislative Research adaptation of Wyoming Department of Corrections data.

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Table C5. Census of the Wyoming Women’s Center Inmates by Age and Minimum Sentence,

September 2016.

Age

Category

Years to Minimum

0-5 6-10 11-15 16-20 26-30 Life Past Proj. Min. Unknown Total

18-20 3 1 0 0 0 0 0 0 4

21-25 17 0 1 0 0 0 2 0 20

26-30 35 2 1 0 0 1 10 0 49

31-35 26 0 1 0 1 0 7 1 36

36-40 36 1 0 0 0 2 11 0 50

41-45 17 0 0 1 0 0 7 0 25

46-50 12 0 0 0 0 2 1 0 15

51-55 8 1 1 1 0 2 3 0 16

56-60 9 0 0 0 0 1 0 0 10

61-65 1 1 0 0 0 0 0 0 2

66-70 2 0 0 0 0 0 0 0 2

Total 166 6 4 2 1 8 41 1 229

Source: Legislative Research adaptation of Wyoming Department of Corrections data.

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