Audit of the Massachusetts Department of Correction (DOC)

This is a Massachusetts State Auditor performance audit of the Department of Correction covering July 1, 2016 through June 30, 2018.

“This report details the audit objectives, scope, methodology, findings, and recommendations for the audit period, July 1, 2016 through June 30, 2018.”

Auditors looked at whether incarcerated people had proper access to healthcare, including sick-call requests, healthcare planning before release, and certain women’s healthcare services.

“In this performance audit, we examined inmate access to healthcare, including sick call requests, reentry healthcare services, and women’s specific healthcare services related to pregnancy and annual preventive examinations.”

Late or undocumented medical responses can allow health problems to get worse and can expose the state to legal risk.

“Without timely treatment for physical and mental health issues, an inmate’s condition could worsen.”

For ordinary residents, this report is about whether the state prison system follows basic health and release-planning rules for people in its custody, which affects public safety, government accountability, and healthcare continuity after release.

“DOC is responsible for providing reentry services to all inmates to ensure successful transition from the inmate population into the community.”

The audit found two main problems: sick-call standards were not consistently followed, and DOC did not always keep proof that important reentry healthcare steps happened.

“DOC did not always maintain documentation to support the following: that Individual Reentry Plans were reviewed with the inmates, signed by the inmates, and provided to the inmates before release; that physical and mental health appointments for post-release services were scheduled with external medical providers when necessary; and that DOC obtained signed Authorizations for Release of Medical Records from inmates.”

The auditor recommended stronger controls, monitoring, training, job aids, and review of whether reentry staff should focus only on reentry work.

“DOC should ensure that there are internal controls and monitoring in place to ensure compliance with DOC policies and procedures.”

The findings are significant because the audit identified repeated documentation and timing problems in core prison healthcare processes, even though DOC is responsible for thousands of inmates across Massachusetts facilities.

“As of June 2018, DOC was responsible for 8,741 inmates housed in 16 correctional facilities (see Appendix A) across the Commonwealth and had approximately 4,600 employees.”

A Sick Call Request Form is the form an incarcerated person uses to ask for medical, dental, or mental health care; an Individual Reentry Plan is a release plan covering issues like healthcare, housing, Medicaid, employment, and community resources.

“To request access to healthcare, an inmate completes an SCRF, selecting a type of service requested (medical, dental, or mental health); stating the nature of the problem or request; and adding his/her name, inmate commitment number, and signature, as well as the date.”