Auditors find gaps in prison behavioral‑health care; committee advances correctional health amendments
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Summary
Legislative auditors presented 20 recommendations after finding inconsistent suicide observation, missed follow‑up care and medication management gaps in prison psychiatric units; the committee passed a correctional health amendments bill to implement standards and system changes.
The Legislative Auditor General presented two audits of correctional behavioral‑health services identifying systemic problems in psychiatric infirmaries and custody oversight.
Auditors said staff inconsistently applied observation policies for suicidal inmates, documented multiple instances where inmates classified as acutely suicidal were placed on lower levels of observation contrary to policy, and found 26 cases in which such classification led to attempts between checks. They also found incomplete medication management (20% of sampled charts), insufficient follow‑up (40% lacked adequate follow‑up), delayed care (54% not timely), and poor documentation in nearly half of reviewed charts.
The audit recommended CHS and UDC standardize policies, improve triage and follow‑up tracking, ensure NCCHC behavioral‑health certification, and strengthen supervision and training. Auditors engaged a board‑certified forensic psychiatrist who flagged inadequate medication oversight and recommended structured processes for involuntary medication and continuity of care.
UDC and CHS leaders (Rebecca Brown, Amy Griffiths, Dr. Stacy Bank, and Dr. Mark Wisner) acknowledged the findings and described corrective steps including joint policy review committees, supervisory audits of q‑15 checks, environmental hazard assessments, expanded clinical oversight, a part‑time board‑certified forensic psychiatrist at 0.8 FTE, CAMS implementation and expanded training. They reported no completed suicides in over a year while noting remaining gaps.
Representative Lisonbee presented a committee bill to require an EMR to support Medicaid billing under the 1115 waiver, create a non‑lapsing contingency fund for high‑cost correctional health expenses, develop a substance use disorder treatment plan including medication‑assisted treatment as medically necessary, require NCCHC behavioral health and SUD accreditation, and allow designated mental‑health examiners to inform parole and assisted outpatient treatment conditions. The committee voted to recommend the bill with a favorable recommendation.
Both auditors and agency witnesses said implementing the recommendations will require coordinated policy, monitoring and possibly additional resources; committee members indicated intent to monitor implementation and consider further appropriations during the 2026 session if required.