Legislative audit finds continuing deficiencies in prison health care; committee opens bill to address improvements

The Legislative Auditor General presented a second in‑depth follow‑up audit of correctional health services that identified significant progress in administrative processes but continuing clinical and compliance gaps at the Utah State Correctional Facility. "In 2021 and 2023, our office made a total of 25 recommendations… 18 recommendations are still in process and only 7 have been implemented," said Brian Dean, legislative deputy auditor general. The audit team said a physician consultant who reviewed a 50‑chart sample concluded that 50 percent of reviewed cases had inadequate or inappropriate care (the audit noted the figure rose from 17 percent in the 2021 sample, and the auditors flagged poor or missing documentation as a contributing factor). The auditors found that 46 percent of the sample lacked access to timely care, that 14 percent lacked adequate follow‑up, and that 19 percent contained vague monitoring orders. The audit highlighted diabetes care issues at the Salt Lake facility, citing delays between insulin administration and meal delivery that can exceed the 30‑minute standard. It also raised concerns about EMTs administering controlled substances and insulin without sufficient documented supervision and incomplete performance evaluations for staff. Auditors documented repeated instances of protected health information and medications improperly discarded in medical trash at both Salt Lake and Gunnison facilities, including at least one packet containing a controlled substance that had not been destroyed properly. They found unlocked biohazard sharps bins and gaps in barcode scanning and pill‑line documentation that allowed staff to skip controlled‑substance barcode scanning in order to save time. The report described improvements in policies and the creation of standard operating procedures and said CHS had updated metrics, though it recommended that the department update metrics reported to the Legislature and improve communication about fund use. Auditors recommended another in‑depth follow‑up in 24 months; the committee voted to open a committee bill file to address correctional health care services. Department leaders attending the meeting, including DHHS Executive Director Tracy Gruber and Dr. Stacy Bank, told the committee they agree with the recommendations, emphasized progress made, and said CHS and UDC are working closely to implement changes. The department asked for continued legislative engagement and noted that recruiting, training and operational coordination are ongoing challenges.