Data source: SENTRY Admissions and Release Status (ARS) data.
When an inmate requires extensive care and cannot be maintained in the general population of the prison, he or she is usually transferred to one of several Federal Medical Centers. Inmates travel to the FMC by bus or air via the U.S. Marshals Service or by chartered aircraft. The latter is the method most commonly used for transfers of maximum-security inmates with psychiatric problems.
Every time an inmate’s designation is changed (that is, when he or she moves from one location to another), prison staff create an entry in the ARS portion of SENTRY. Some movements occur from one unit to another within a prison; others occur from one facility to another. For this demonstration, it became apparent almost immediately that transfers of psychiatric patients to FMCs were declining, as telemedicine improved the psychiatric care being provided in the prisons. Psychiatric transfers were therefore the focus of this analysis.
Bureau programmers supplied the research team with a file listing all inmates who had spent any time at demonstration or comparison prisons during the year preceding the demonstration and during the demonstration itself, and their ARS records for these periods. From these a chronology of events was created for each inmate, and transfers of inmates from a prison to an FMC were identified. ARS coding allowed identification of those transfers to FMCs for psychiatric care. The ARS coding also permitted distinction among transport modes.
Psychiatric Transfers Averted: Costs
Data source: Airbills and escort costs from prison financial records.
There are several cost elements for transfers to FMCs.
Air charter. At the demonstration prisons, air charter bills and security escort costs were collected for each psychiatric transfer to an FMC. Each flight was round-trip because the plane and crew needed to return. If two inmates were being transferred on the same flight for psychiatric care, the cost was distributed evenly between the two cases; thus a flight with two inmates had half the cost per inmate as a flight with one inmate. Some inmates remain at the FMC for a long time and others return to their initial prison or are relocated to another facility. These returns or relocations happen in a variety of less costly ways (commonly by bus) and are not included in the costs of transfers.
Security/escort. Each flight, in addition to the aircrew, includes an array of guards and a physician assistant. Actual costs for all of these participants were included where records existed; for transfers lacking data, an average based on the existing data was used.
Other. Finally, because a transfer also involves considerable review and approval by prison officials, these costs for transfers were included, as were costs for external encounters (see above), in the calculation of unit costs.