Abstract
State correctional systems are experiencing a dramatic increase in inmate populations and health care services costs. Like the community at large, these systems are experimenting with various cost control programs. An approach gaining in popularity is the use of an inmate user fee for medical services. This study used an observational study design and a telephone survey to gather data to learn the scope and complexity of inmate user fee programs from 50 state departments of corrections (DOC), the District of Columbia, and the Federal Bureau of Prisons. The results suggest a growing trend among prison systems to charge inmates fees for defined health care services. Inmate user fees programs appear to reduce utilization and do generate modest revenues; however, the positive or negative impact of these programs on the quality of inmate health care and the ability to sustain a long term DOC fiscal viability have yet to be established.
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