Oregon Department of Corrections outlines moves to improve health care after Department of Justice investigation

SALEM, Ore. (KTVZ) -- The Oregon Department of Corrections said Tuesday it "has taken major steps to improve health care services for adults in custody following a thorough investigation conducted by the Department of Justice, at DOC Director Michael Reese's request."

Here's the full announcement - we'll have more from a Tuesday afternoon media briefing on KTVZ News this evening:

In February, DOC's two top Health Services leaders were terminated following whistleblower allegations. The director responded quickly by bringing in an expert-led consulting firm to conduct a comprehensive assessment of the health care system and assigned the incoming Health Services Assistant Director to act on its findings.

Efforts have since focused on evaluating systems, strengthening staffing, and making operational improvements. 

The largest area of reform has focused on AIC access to off-site specialty care. Improvements in this area include an overhaul to the Therapeutic Levels of Care (TLC) system and scheduling process – removing delays in accessing care. Changes include: 

• Allowing for use of individual provider’s clinical judgment regarding outside referrals for all levels of care.  

• Modifications to allow for a range of clinical requests to be referred by providers without needing TLC approval. 

• Ensuring TLC meetings are not canceled.  

• Centralized scheduling for offsite care under one clinical structure. Additional schedulers and transport staff have been hired to help address the backlog of needed outside medical trips.  

Earlier this year, DOC hired the Falcon Group, a national consulting firm specializing in correctional health care. Falcon conducted a comprehensive review of DOC’s health care delivery system, including policies, practices, and the overall quality of care.

Falcon arrived at 67 findings and key observations reflecting convergence among sources of information and stakeholders that were unprecedented in Falcon’s experience. The key findings in “State of Oregon Department of Corrections Healthcare Delivery System Assessment,” included Falcon noting that DOC impressed them as authentically committed to studying and improving health care for AICs.

The report also noted that Pharmacy Services and Dental Services both emerged as best practice models, and that Behavioral Health Services has many best-practice approaches.  

The Falcon team has also provided a series of recommendations as part of their report, ranging from no-cost process changes to full replacement of a prison. DOC will take the next 120 days to review the report and determine recommendations to move forward. DOC will then create an implementation plan based on recommendations in Falcon’s report. 

Other areas of focus have included hiring for critical positions and pushing through the final stages of electronic health records implementation.  

DOC is in the beginning stages of developing a Continuous Quality Improvement (CQI) office for Health Services. This team will use data-driven processes to identify gaps, implement best practices, and ensure compliance with medical standards and regulatory requirements. 

From Director Michael Reese: “As part of our commitment to improving the quality, accessibility, and efficacy of care for adults in custody, this report will serve as a strategic guide for prioritizing actions within the implementation plan being developed by our incoming Health Services Assistant Director. We are committed to ensuring that the implementation plan will be completed within 120 days, and we value Falcon’s willingness to assist in prioritizing and refining the report’s recommendations.”