Looking out for prisoners’ health
The state corrections system is lauded for its program to prevent the spread of disease
An accreditation team that recently visited three Hawaii prisons was impressed with the system's efforts to prevent illness and diseases, said Dr. Kay Bauman, prison medical director.
National Commission on Correctional Health Care members toured the Oahu, Women's and Maui community correctional centers.
"The one compliment they continued to give us was our attention to prevention," Bauman said. "They found that to be unusual in a prison setting. It is not something corrections does really well in a lot of places, yet it is cost-effective."
"I like the population I work with. Most patients are everyday people when we get them off drugs. They can be a neighbor, a cousin, the kid next door."
Dr. Kay Bauman / Medical director, state prisons
Bauman retired July 1 after six years in the Department of Public Safety but is continuing half time through the end of the year until a successor is named.
With 95 percent or more inmates eventually returning to the community, she said, "We want them to go back and work and contribute." They have a better chance of doing that if they are healthy, she said.
Bauman recalled an inmate who weighed more than 450 pounds and decided to do something about his health while incarcerated.
He lost more than 200 pounds, his diabetes vanished, his joints and back felt better and his blood pressure and cholesterol went down, she said. He was extremely proud of his accomplishment, she said.
"Cheerleading is the fun part of my job," said Bauman, who encourages inmates to tackle health problems.
"I try to give them some education about health issues for their personal needs, whether it's diabetes or hypertension or breast cancer screening or cancer screening in general, or immunizations and annual flu shots."
Hawaii has the highest chronic hepatitis B rate and the highest rate of liver cancer per capita in the country, and inmates are among the state's highest-risk groups, she said.
So the public safety medical unit and state Health Department have collaborated on an aggressive screening program for all types of hepatitis in the prisons. Every inmate has a hepatitis B shot, and some also have hepatitis A shots, Bauman said.
The medical team keeps track of all inmates with hepatitis C and has "amazingly good results" with the treatment program, which is difficult, Bauman said.
She said the system also has made great strides in cancer screening, including Pap tests and colon cancer screening, "which often is tucked in back for prison health."
The prisons do "not just an average job, but an excellent job" of managing patients for diabetes, hypertension and cancer, she said. "We absolutely meet public standards."
She keeps a cancer registry and has about 35 to 40 patients under observation or active treatment for cancer at any time, she said.
At least 300 prisoners have diabetes in the eight Hawaii facilities and two mainland facilities, she said. "With hypertension and other cardiac diseases, there are almost twice as many."
Bauman oversees health care for the 1,859 male inmates at Saguaro Correctional Facility in Arizona and about 200 women at the Otter Creek facility in Kentucky as well as the Hawaii prisons.
Prevention and treatment of infectious diseases, such as methicillin-resistant Staphylococcus aureus, hepatitis and sexually transmitted diseases like chlamydia are major health care challenges in any institutional system, she said.
"Luckily, even though Hawaii has one of the two highest rates of tuberculosis of 50 states," she said, the prison system has had only three active cases in six years.
"I like the population I work with," Bauman said. "Most patients are everyday people when we get them off drugs. They can be a neighbor, a cousin, the kid next door."
Since most inmates are battling addiction, Bauman would like to see more bed space for the program, she said. "It would be wonderful if they could be in a continuous addiction program from the time they get in to the time they leave."
She has also been "beating the drum for six months" to ban smoking at all isle prisons. "It's such a huge risk for our patients, a huge risk for everybody."
Kulani, Maui Community Correctional Center, the Women's Correctional Center and part of the Hawaii Community Correctional Center have chosen to be nonsmoking, she said. "To their amazement, they've had way less problems than they predicted."