As in the free world, health care for prisoners is an expensive and staff-intensive operation. As such, efforts are continuously underway to provide the required care in the most cost-efficient manner possible.

Providing quality health care to prisoners is an important MDOC responsibility. The state is liable for meeting standards in health care set by state and federal law and by court decisions. To fail meeting those standards would unnecessarily expose Michigan's taxpayers to expensive litigation on top of health-care costs.

The department works on making sure the delivery of health care is as cost-effective as possible by providing good medical care through a variety of methods including Telemedicine, health-care co-pays and managed care.

The savings come through the managed care provider's ability to successfully negotiate a number of large cost-effective contracts; through lower-cost contracts with community hospitals possible through use of a system that requires pre-authorization of hospital and specialty services based on national criteria; and use of special high security sections within community hospitals in which prisoners are treated separately from the general public and guarded by state corrections officers.

The Hadix v Johnson federal court case covered health-care, custody and physical-plant issues at several prisons in the Jackson area. The improved quality of the MDOC's mental health care helped the department to resolve the mental health issues under a class action lawsuit brought by prisoners in 1984. The department has had an interagency agreement with the Department of Community Health (DCH) for several years to provide mental-health services to seriously mentally-ill prisoners.

The level of medical, dental and psychological care provided by the Bureau of Health Care Services has also led the department to the final negotiation stage for resolution of health care issues in the Hadix case.

The system's prison hospital – the Duane L. Waters Hospital in Jackson – maintains its accreditation through the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The Joint Commission accredits health-care organizations according to performance-based standards and is an indicator of quality.

Medical, dental and mental health services are provided to prisoners using a standard of care imposed by court decisions, legislation, accepted correctional and health-care standards, as well as department policies and procedures. Ensuring adequate health care for prisoners also protects communities to which offenders return after incarceration and improves their opportunity to become productive members of society.

Primary health care is provided by nurses, physicians, dentists and other staff at clinics located in each prison. Chronic disease management, dental care, vision care, health screening specialty care clinics and emergency care are provided on site. Health promotion, disease prevention and health education are key components of the department's overall health-care plan. Care is provided only by qualified health-care professionals who must be licensed by the state of Michigan.

Units at the Lakeland Correctional Facility are designed and staffed to meet the needs of elderly prisoners and special-needs prisoners, including those with diabetes. In-patient units at the Huron Valley Correctional Facility and Marquette Branch Prison are available for prisoners who need 24-hour nursing care.

In-patient, short-term care is provided at local hospitals, at the Duane L. Waters Hospital and at a department-operated secure unit at Foote Hospital in Jackson. The 84-bed Waters hospital is situated within the secure perimeter of Charles E. Egeler Correctional Facility and is accredited by JCAHO. In addition to medical, surgical, long-term and psychiatric care, numerous specialists provide specialty care to prisoners at out-patient clinics located inside the secure perimeter at the hospital and at other prison sites.

Prisoners requiring care not available at Duane L. Waters Hospital may be hospitalized in the secure unit in Foote Hospital in Jackson or wherever their health-care needs can most expeditiously and cost-effectively be met.

Mental health services are provided through the department's psychological services staff as well as through a contract with the Department of Community Health (DCH). MDOC psychological staff provide reception testing, sex-offender treatment, assaultive-offender treatment, crisis intervention, suicide evaluation and follow-up of mentally-ill prisoners discharged from the acute care continuum provided by the DCH staff. Care provided by DCH includes in-patient care in an acute-care JCAHO-accredited psychiatric hospital – the Huron Valley Center in Ypsilanti – as well as residential treatment programs and by out-patient mental health teams located throughout the prison system.