Springfield Medical Center

[John Young <jya@pipeline.com>]

Alia,

Thanks for the update on CJ. Please keep us informed. More on
CJ's music and how to get it, and help promote it, would be
welcomed. It sounds wonderfully rude and vulgar, all right!

Below is a 1994 thumbnail description of the U.S. Medical Center 
for Federal Prisoners in Springfield, Missouri, taken from a long, 
critical report on prisoner health care with more on the Springfield
facility available at:

   http://jya.com/hehs-94-36.txt (81K)

Bureau of Prisons Health Care: Inmates' Access to Health Care Is Limited
by Lack of Clinical Staff (Letter Report, 02/10/94, GAO/HEHS-94-36).

[Excerpt]

SPRINGFIELD MEDICAL REFERRAL CENTER

   MISSION OF REFERRAL CENTER

The U.S. Medical Center for Federal Prisoners in Springfield,
Missouri, is one of the Bureau of Prisons' six referral centers that
treat male medical, surgical, and mental health patients.

   LOCATION AND CONDITION OF FACILITY

The Springfield Medical Referral Center is an administrative
facility, meaning it is equipped to house inmates of all security
levels.  It was built about 1933.  Inmates live in six connected
buildings, each of two or three stories.  The medical facilities are
concentrated in four of the six buildings.  The acute and chronic
care medical and surgical patients are housed in units that resemble
typical hospital rooms, except that several rooms in each unit have
locked doors.  These locked cells are used for patients who are (1)
dangerous to staff or other inmates, (2) participating in the federal
witness protection program, or (3) waiting for their custody status
to be determined.  The mental health patients are housed in units
that resemble typical prison cell blocks with one-man cells.

Springfield also has a unit that can contain up to 37 inmates in
individual locked cells for disciplinary or protective reasons.

   NUMBER OF INMATES AND PATIENTS SERVED

Springfield serves approximately 1,120 inmates, including 439
patients who require medical or surgical care and 294 who need
psychiatric care.  The medical and surgical care is provided to about
46 acute care patients, 54 patients receiving renal dialysis, and 393
other chronic or recovering patients.  The mental health population
includes 177 treatment patients and 117 forensic inmates who are
being evaluated for their mental ability to stand trial.

   NUMBER AND TYPE OF MEDICAL BEDS

The Joint Commission on Accreditation of Healthcare Organizations
rates Springfield as a 46-bed acute care and 177-bed mental health
hospital.

   NUMBER AND TYPE OF STAFF POSITIONS AUTHORIZED 
   AND FILLED

In July 1993, Springfield had 279 authorized health care positions,
including 5 psychiatrists, 15 medical/surgical physicians, an
optometrist, 12 physician assistants, 127 nurses, 9 pharmacists, 12
psychologists, 6 quality assurance staff, 10 medical records staff,
and 82 other health care staff.  At that time, 18 positions were
vacant, including 3 medical physicians, a surgeon, a psychiatrist, a
physician assistant, 10 nurses, 1 medical records staff, and 1 other
health care staff.  The following specialists were working at
Springfield:  3 general practitioners, 4 psychiatrists, 2 internists, 
2 neurologists, 1 physiatrist, 1 anesthesiologist, 1 orthopedic 
surgeon, and 1 chief of health programs.

Physicians and physician assistants are available 24 hours a day.
However, physicians generally work from 7:30 a.m.  to 4:00 p.m.
During the evening and night shifts and on weekends, one physician,
one psychiatrist, and one psychologist are on call.  Physician
assistants are available in the facility 16 hours a day.  Nurses are
responsible for medical care between 10:00 p.m.  and 6:00 a.m.
Nursing service is provided 24 hours a day.

   STAFF ORGANIZATION

The Associate Warden for Medical Services supervises most of
Springfield's health care staff, including nurses and technicians.
The Clinical Director is responsible for the internal medicine
physicians, psychiatrists, surgeons, dentists, physician assistants,
the quality assurance coordinator, utilization manager, and
infection-control practitioners.  The Associate Warden for Mental
Health Services is responsible for the psychologists and social
workers who work with the mental health patients.