United States Marshals Service's Prisoner Medical Care

Report No. 04-14
February 2004
Office of the Inspector General


Table of Contents

  EXECUTIVE SUMMARY

INTRODUCTION
In-House Medical Care
Outside Medical Care
Management of Prisoner Medical Care
Prior Reports
  1. INTERNAL CONTROLS OVER OUTSIDE MEDICAL CARE COORDINATED BY DISTRICTS WERE INCONSISTENT AND IN SOME CASES NEARLY NON-EXISTENT
    Background
    Recording of Financial Transactions in the Financial Management System (FMS)
    Prisoner Tracking System
    Prisoner Case Files
    Federal Acquisition Regulations
    Office of Program Review
    Recommendations
  1. THE USMS IS INCURRING MILLIONS IN UNNECESSARY COSTS FOR OUTSIDE MEDICAL CARE
    Medicare Versus Medicaid
    Approval of Non-Emergency Outside Medical Care
    Prisoner Insurance
    National Health Care Contract
    Recommendations
  1. INTERNAL CONTROLS OVER IN-HOUSE MEDICAL CARE AT JAILS AND EMERGENCY CARE PRODEDURES IN USMS CELLBLCOKS NEED STRENGTHENING
    Background
    Cellblock Medical Care And Emergency Procedures
    Cellblock Equipment
    Local Jailhouse Medical Care
    Nassau County Correction Center
    Conditions of Confinement Reviews
    Conclusion
    Recommendations
  1. TRACKING AND MONITORING OF COMMUNICABLE DISEASES
    Initial Screening for TB
    Documenting TB Results
    Timeliness of TB Testing
    Tracking Active TB Cases
    Hepatitis and HIV/AIDS
    Conclusion
    Recommendations
  1. SECURE TRANSPORT OF FEDERAL PRISONERS TO AND FROM HEALTH CARE FACILITIES JEOPARADIZED BY ILL-MANAGED CONTRACT GUARD OPERATIONS
    Contract Personnel Records
    Training
    Contract Monitoring
    Conclusion
    Recommendation
 

APPENDIX I AUDIT OBJECTIVES, SCOPE, AND METHODOLOGY

APPENDIX II SCHEDULE OF DOLLAR-RELATED FINDINGS

APPENDIX III GLOSSARY OF TERMS AND ACRONYMS

APPENDIX IV STATEMENT ON COMPLIANCE WITH LAWS AND REGULATIONS

APPENDIX V USMS POLICIES AND PROCEDURES FOR TRANSPORTING FEDERAL PRISONERS

APPENDIX VI USMS CONTRACT GUARD POLICY

APPENDIX VII USMS POLICIES AND PROCEDURES FOR OUTSIDE MEDICAL SERVICES

APPENDIX VIII USMS POLICIES AND PROCEDURES FOR CELLBLOCK OPERATIONS

APPENDIX IX RE-PRICING CONTRACT WITH HEALTHNET, INC.

APPENDIX X PROPOSED NATIONAL MANAGED CARE CONTRACT

APPENDIX XI STATISTICAL SAMPLING MODEL

APPENDIX XII AUDITEE RESPONSE

APPENDIX XIII ANALYSIS AND SUMMARY OF ACTIONS NECESSARY TO CLOSE REPORT