- The Washington Times - Monday, February 23, 2004

The U.S. Marshals Service has failed to provide basic and emergency medical treatment to the 40,000 federal prisoners it has in custody, a report said yesterday.

Justice Department Inspector General Glenn A. Fine said his office also found that the Marshals Service did not obtain the lowest medical rates allowed by federal legislation, paying $7 million annually in excess fees for outside medical care.

“We recognize the serious challenges facing the U.S. Marshals Service as it deals with significant increases in prisoner population,” Mr. Fine said. “However, our review found that the [service] needs to improve its management of prisoner medical care.”

U.S. Marshal Benigno Reyna said in a letter to Mr. Fine that the number of prisoners his agency handles annually has increased by 53 percent since 1999, adding that although he agreed that prisoner health care is a high priority, “increases in workload make this problematic” unless Congress approves requested staff increases.

Mr. Reyna said the service was developing a national managed care plan that will resolve many of the issues raised by the inspector general.

The 103-page report noted that the Marshals Service currently provides medical care to about 40,000 federal prisoners at local jails, contract facilities and at U.S. Bureau of Prisons detention centers. It said the prisoners remain in the service’s custody throughout the trial process, which can run from several days to several years.

Last year, the report said, the service spent $43 million on outside medical services for prisoners, including $36 million for health care and $7 million in related guard costs. In addition, to the costs, the report cited what it called associated risks: the possibility of escape; death or injury to a bystander, a law-enforcement official or the prisoner; and exposure of the general public to possibly infectious diseases.

Mr. Fine said investigators found the service often ignored essential internal controls and procedures at its district offices that were designed to ensure that basic and emergency health care was administered properly and that necessary outside medical care was efficiently and safely provided.

Marshals Service district offices are located in Arizona, California, Florida, Illinois, Kansas, New Mexico, New York, Pennsylvania, South Carolina, Texas and Washington, D.C.

The report said the service did not adequately track and monitor communicable diseases among its prisoners, such as tuberculosis, hepatitis and HIV/AIDS; and failed to properly manage contract guards who transported prisoners to and from health care facilities, meaning it could not effectively control risks to the public when prisoners were transported to off-site facilities.

The report also said the service failed to ensure that federal prisoners housed in local detention facilities received proper health care, and it did not follow financial-control procedures established to guarantee that outside medical payments were legitimate, necessary, accurate or at the lowest cost.

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