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The Effect of Accreditation of Healthcare in Jails on Healthcare Processes and Inmate Health Outcomes

Marcella Alsan (Harvard Kennedy School) and Crystal Yang (Harvard Law School)

PROJECT SUMMARY

Jails admit nearly 11 million individuals each year, including a high number of inmates with mental illnesses, infectious diseases, and chronic diseases. Since the Supreme Court’s 1976 landmark decision in Estelle v. Gamble, federal and state correctional systems (including prisons, jails, and juvenile detention facilities) have been constitutionally mandated to provide “reasonably adequate” health care to the incarcerated population. Yet, unlike health care systems that provide services to the nonincarcerated population, there is no legally mandated accreditation system for the health care provided in U.S. correctional systems, including jails. As a result, the delivery of health services can vary widely from one jail to another.

In this study, we will randomize the offer of health care accreditation via the National Commission on Correctional Health Care (NCCHC) to medium-sized jails. NCCHC, the organization that pioneered standards for jail health care services, operates a voluntary accreditation program based on a set of consensus-driven standards that provide a framework for the care inmates receive. The process of preparation, verification, and maintenance of accreditation may improve health care processes, inmate health outcomes, and satisfaction and retention among correctional staff, and potentially reduce recidivism, litigation, and health care costs for jails. To test these hypotheses, we will randomly assign 20 out of 40 medium-sized jails to obtain accreditation and the other 20 to a control group.

principal investigators

Marcella Alsan

Professor of Public Policy
Harvard Kennedy School

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Crystal Yang

Professor of Law
Harvard Law School

 

PARTNER

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fUNDER

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PROJECT TEAM