Running health care within departments of corrections is a complex and daunting task. Extraordinary numbers of prisoners have severe mental illness or chronic medical diseases. When prisoners enter the system, they have many co-morbidities, and conditions that are not stable and have not been well-managed. Location, pay levels, patient population, and working conditions can undermine recruitment and retention of health care professionals. Custody staff, clinical staff, and administrators commonly approach corrections with differing training, approaches, and priorities, and little exposure to the others’. The vast numbers of prisoners and staff, alone, introduce complexity.

With the current budget climate and court rulings, many prison systems and jails are implementing or revising their health care or mental health care systems. Collaboration Specialists professionals serve in Special Masterships overseeing the design and operation of these systems. Using conflict management principles, we work with staff from all affected departments to determine which existing practices are most effective. We lead conversations to improve interdisciplinary understanding and to find out obstacles and staff’s solutions to them. We coordinate negotiations between corrections and prisoner representatives so durable, constitutional decisions are made and implemented as painlessly as possible.


Coleman v. Brown, requiring outpatient, intermediate and acute mental health services for more than 30,000 prisoners with qualifying diagnoses in California’s prisons

Ruiz v. Estelle, requiring a full medical and mental health system for Texas’ 120,000 prisoners


▪  Information systems that support day-to-day
    management and quality improvement efforts, and
    track a wide variety of services
▪  Interdisciplinary quality improvement teams
▪  Systems for interdisciplinary information-sharing
    on discipline and clinical conditions that affect
    custody decisionmaking
▪  Systems for interdisciplinary coordination in
    placing patients in appropriate levels of care
▪  Systems for tracking and responding to medication
▪  Systems for ensuring medication continuity across
    a variety of changes in location and level of care
▪  Systems with interdisciplinary responsibility for
    preventing suicide and analyzing systems
    breakdowns relatedto suicidal behavior and to
    emergency response