[Congressional Record (Bound Edition), Volume 146 (2000), Part 6]
[Extensions of Remarks]
[Page 7776]
[From the U.S. Government Publishing Office, www.gpo.gov]



            BILL TO ESTABLISH OFFICE OF CORRECTIONAL HEALTH

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                          HON. TED STRICKLAND

                                of ohio

                    in the house of representatives

                         Thursday, May 11, 2000

  Mr. STRICKLAND. Mr. Speaker, today I am introducing legislation which 
would establish an Office of Correctional Health within the Department 
of Health and Human Services.
  According to the Department of Justice (DOJ), the United States is 
second only to Russia among industrialized nations in incarceration 
rates with nearly 2 million people in jail or prison. The fuel that 
feeds this prison population explosion is comprised of several 
components. Mandatory minimum and ``three-strikes'' sentencing laws 
have resulted in longer sentences and more frequent incarcerations. A 
look at the changing demographics in American prisons and jails sheds 
light on the challenges correction facilities face at the beginning of 
the 21st century.
  According to DOJ, 57 percent of state prisoners and 45 percent of 
federal prisoners surveyed in 1997 said they had used drugs in the 
month before their offense. A whopping 83 percent of state prisoners 
and 73 percent of federal prisoners had used drugs at some time in the 
past. It is estimated that about three-quarters of all inmates can be 
characterized as being involving in alcohol or drug abuse in the time 
leading to their arrest.
  In the first comprehensive report on mental illness in correctional 
facilities, the Bureau of Justice Statistics (BJS) found that seven 
percent of federal inmates and 16 percent of those in state prisons or 
local jails or on probation said they either had a mental condition or 
had stayed over night in a mental hospital unit or treatment program. 
The highest rate of mental illness was among white females in state 
prisons at 29 percent. For white females age 24 or younger this level 
rose to almost 40 percent. When compared to other inmates, mentally ill 
inmates and probationers reported higher rates of prior physical and 
sexual abuse. According to BJS, nearly 6 in 10 mentally ill offenders 
reported they were under the influence of alcohol and drugs at the time 
of their current offense. Many people do not know that the Los Angeles 
City jail is now the largest mental institution in the United States, 
holding 3,300 seriously mentally ill inmates on any given night.
  The increased incarceration rate of women also presents new health 
care challenges to correctional facilities. According to BJS, in 1998 
an estimated 950,000 women were under custody, care or control of 
correctional agencies. Nearly 6 in 10 women in state prisons had 
experienced physical or sexual abuse in the past. This statistic, 
coupled with the reality that 7 in 10 women under correctional sanction 
have minor children, points to the acute need for counseling services. 
Women inmates utilize health care services at higher rates than men. 
Because of their need for reproductive health care, including sexually 
transmitted diseases, and the possibility of pregnancy either upon 
entry into the correction system or during, women's special health care 
needs must be addressed in a comprehensive fashion.
  The health care needs of inmates have expanded as the incarcerated 
population has aged. As inmates grow old in prison they succumb to the 
same ailments which afflict the elderly in the outside world--diabetes, 
heart disease and stroke. These geriatric health care needs represent 
another challenge to correctional agencies in providing adequate care.
  In 1996, the Centers for Disease Control and Prevention's National 
Center for HIV, STD, and TB Prevention formed an ad hoc working group, 
the Cross Centers Correctional Work Group made up of health 
professionals from across CDC. The purpose of the group is to focus 
attention on the complex health needs of incarcerated men, women, and 
youth in the United States. I commend the work of this group and the 
fine efforts of CDC in addressing the very complex health issues 
associated with correctional facilities.
  According to CDC, in 1994 AIDS diagnoses were almost six times more 
prevalent among the incarcerated population than among the general U.S. 
population. Further, inmates coming into correctional facilities are 
increasingly at risk for HIV infection through risk behaviors such as 
needle sharing and unprotected sex. Also, tuberculosis (TB) is another 
important public health issue in prisons and jails according to CDC. TB 
infection rates are substantially higher among inmates because 
conditions associated with TB (poverty, drug use, HIV infection, etc.) 
are more common in the incarcerated population than the general U.S. 
population.
  Rates of infectious disease are known to be higher among inmates than 
in the general population and because most inmates are released after 
they've served their time, without treatment, these infected inmates 
threaten the public health of the community upon release.
  All of these alarming statistics contribute to the need for the 
establishment of an Office of Correctional Health with HHS. Such an 
office would coordinate all correctional health programs within HHS; 
provide technical support to State and local correctional agencies on 
correctional health; cooperate with other Federal agencies carrying out 
correctional health programs to ensure coordination; provide outreach 
to State directors of correctional health and providers; and facilitate 
the exchange of information regarding correctional health activities.
  Mr. Speaker, with a growing diverse and medically complex population 
in America's prisons and jails, we must ensure that inmates are 
provided the health care they need, that staff members operate in a 
safe working environment, and as a result, public safety is enhanced.

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