STICKING TOGETHER: A

COHESIVE CORRECTIONAL
HEALTH DELIVERY SYSTEM

Kimberly M. Pearson, MHA, MBA, RN, CCHP

Deputy Agency Director
Correctional Health Services
 A COHESIVE
CORRECTIONAL HEALTH CARE DELIVERY SYSTEM
CORRECTIONAL HEALTH CARE LEADERSHIP INSTITUTE / SUMMER 2017
 FACULTY DISCLOSURE
I DO NOT HAVE ANY RELEVANT FINANCIAL RELATIONSHIPS WITH
ANY COMMERCIAL INTERESTS.
 LEARNING OBJECTIVES

 Identify the correctional healthcare model currently being

utilized in their jail system.
 List the advantages to merging medical and mental health
programs.
 Identify the potential successes that might be realized by
merging medical and mental health programs.
ORANGE COUNTY, CALIFORNIA
 5 ADULT FACILITIES
AVERAGE DAILY CENSUS 6100
ICE CONTRACT CAPACITY: 958
HEALTH CARE STAFF: 350
Number of Mental Health cases open on the last day of this month
1,573
Number of Mental Health cases that were opened during this month
457
Number of inmates, on the last day of the month, receiving
psychotropic medication for a 752
Mental Health disorder

Number of inmates assigned to Mental Health bed on the last day of 122
this month

Number of inmates seen at sick call (medical, mental health, wound

care) 8,465
Number of physician/nurse practitioner encounters during this month
(excluding dental) 7,949
Number of off-site medical appointments
Inmates Requiring Mental Health during
Attention: this month

236
Number of dental encounters during this month
1,480
WHAT’S YOUR FACILITY MODEL?
 THE OLD ORANGE COUNTY MODEL
PRIOR TO 2011

Health Care Agency – Correctional Medical Services

Health Care Agency – Correctional Mental Health

Health Care Agency – Behavioral Health Services

 THE NEW ORANGE COUNTY MODEL
POST 2011

Health Care Agency – Correctional Health Services

Medical and Mental Health Services for all incarcerated

adults in the Orange County Jail system
Correctional Health Services Behavioral Health Services

MENTAL HEALTH SERVICES DISTINGUISHED BY

IN-CUSTODY VERSUS OUT-OF-CUSTODY
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TITLE AND CONTENT LAYOUT WITH LIST

THE TRANSITION
BUT WE CAN’T…THAT WILL NEVER WORK
 Staff
Reactions
 Staff
Reactions
 Staff
Arguing
 Staff
Arguing
Director of
Nursing
Reaction
Reality
Management
motto for
sanity
WHY?
UNIFIED MANAGEMENT PHILOSOPHY & PRACTICES
COMBINING POLICY AND PROCEDURE MANUALS
CROSS TRAINING OF NURSING STAFF
Specific medical training
for mental health nurses

Specific mental health training

for medical nurses
REDUCTION OF INMATE MOVEMENT
Improved Safety
IMPROVED EFFICIENCY

“Go back to your

cell and put in
another inmate
message slip /
sick call slip”
MORE PRODUCTIVE MEETINGS
MERGING OF THE MEDICAL RECORD
MANAGEMENT OF PHARMACEUTICAL COSTS
 Extensive review of pharmaceutical formulary

Combining medical and mental health formulary

for increased accountability and management

Training of mental health prescribers regarding

medication costs

Initiation of stronger non-formulary request forms

to be reviewed by medical director
 Pharmacy Expenditures vs. ADC
8000

7000 7039
6805
6265
6000 6055 6028
5721

5000

4.264
4000
3.492
3000
2.456 2.569
2.422
2000 1.877

1000

0
10/11 11/12 12/13 13/14 14/15 15/16

$ Millions ADC
OVERALL BUDGET MANAGEMENT
IMPROVED STAFF MORALE…EVENTUALLY
SO WHERE ARE WE NOW?
IMPROVED STAFF MORALE…EVENTUALLY
 KIM PEARSON, MHA, MBA, RN, CCHP
DEPUTY AGENCY DIRECTOR – CORRECTIONAL HEALTH SERVICES
COUNTY OF ORANGE HEALTH CARE AGENCY, SANTA ANA, CA
KPEARSON@OCHCA.COM
714-834-5404