Running Header: THE MAINE STATE PRISON HAS THE ABILITY TO CUT COSTS 1

The Maine State Prison has the ability to cut healthcare costs by using Medical Diets as part of a medical treatments

Kaplan University

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Taking prescription medication has become an everyday part of life for many people. Nearly 70 percent of Americans take at least one prescription drug. More than half take two, yet every medicine comes with side effects or risks associated with their use. (mayoclinic, June 19, 2013) What if people were informed that health could be improved immensely and medications could be decreased or even ended through a few simple diet changes? What if simple food and life style changes could save your health and your wallet? That is the logic and practice we must incorporate into our homes and local facilities supported by our tax dollars such as The Maine State prison. Many inmates located at The Maine State Prison have a medical need for a special diet. By accommodating these special diets, The Maine State Prison would be able to reduce their short term as well as long term prisoner healthcare costs. The Maine Department of Corrections ( DOC) has the highest per-prisoner healthcare cost in the nation in 2001 averaging 7,761 per inmate per year (Prison Healthcare cost, 2013)Inmates health, the public's safety, and taxpayers total corrections bills are all affected by how individual Sates manage prison health care services. So how is ones diet related to healthcare and its costs?
A meal at an average prison/jail costs between $1.46 and 1.69$ depending on how many inmates the facilities holds. That means the average cost to feed a inmate for one day is $5.10 , almost $5.00 dollars less than an average lunch on the street. The average 19-to 50-year-old American man spends about $9.55 a day on a moderate food plan, according to October 2011 estimates from the U.S. Department of Agriculture. (The Price of Prisons – Maine, 2012) That's pennies compared to what is being paid out for prisoner healthcare expenses. Expenses that could be greatly reduced by paying more mind to what inmates are putting into there bodies. THE MAINE STATE PRISON HAS THE ABILITY TO CUT HEALTHCARE COSTS 3

All inmates are entitled to medical care and attention as needed to treat both short-term conditions as well as long-term illnesses. The medical care provided must be "adequate." (Rights of Inmates, 2012) That said, giving a brittle diabetic a “regular” meal that would also be severed to a non-diabetic will spike there blood glucose level every time. That same inmate then comes to the treatment clinic for blood sugar testing, and then receives insulin coverage to bring his/her blood glucose back to a normal level. This routine is repeated at every meal. Along with insulin coverage many inmates also take an oral tablet to control blood sugars 1-2 times daily. This treatment is not adequate; it is equivalent to putting a band aide on a broken leg. A 2009 study by Consumer Reports found that diabetic patients spend an average of $6,000 per year on costs for treating their disease. This figure includes medications costs, blood glucose monitoring and other related supplies. It does not include any long term medical complications that often arise from the disease (Care and Counseling, 2012). Those who suffer from Diabetes have many other complications related to unstable blood glucose levels. These complications require more invasive treatment. On average, diabetic individuals have 2.6 additional, and potentially life threatening illnesses. Most common are high blood pressure, fluid and electrolyte disorders, chronic pulmonary disease, anemia and kidney failure (Care and counseling, 2012). Diabetes is just one of the many medical conditions that inmates at the Maine State Prison suffer from. Heart disease is another common healthcare condition. Each year in Maine more than one out of four (26%) of people die from heart disease or stroke (The Burden of Cardiovascular Disease in Maine 2012). Diet plays a crucial role in the development and prevention of cardiovascular disease. Comparisons between a diet low in saturated fats, with plenty of fresh fruit and vegetables, and the THE MAINE STATE PRISON HAS THE ABILITY TO CUT HEALTHCARE COSTS 4 typical diet of someone not making healthy choices show that there is a 73 percent reduction in the risk of new major cardiac events when choosing the healthy diet (World Heart Federation 2014). Another disease common in the inmate population is hepatitis C (HCV). The percentage of inmates infected with Hepatitis C is significantly higher than that of the general population due to the epidemiology of the disease. On average 13 to 54 percent of inmates suffer from hepatitis C. Recent Centers for Disease Control and Prevention (CDC) recommendations are that all incoming inmates be screened for HCV and those infected be evaluated for the presence of liver damage and the need for treatment (William Cassidy, M.D, 2013). People who suffer from a liver disease such had Hepatitis C benefit best from eating a specific diet. Proteins play a role in helping your body repair tissue. As well as prevent fatty buildup and damage to the liver cells. In people with severely damaged livers, proteins do not process properly. Waste products can build up in the body affecting the brain as well as cause other system disruptions (William Cassidy, M.D , 2013)

In cases of a badly damaged liver a medical “special diet” is a necessity. A proper diet consisting of cutting down on protein, increasing your intake of carbohydrates, and limiting your salt intake can greatly improve liver health in a person with hepatitis C. A balanced disease specific diet can lead to better liver functioning and decrease the risk of cirrhosis of the liver. As well as help the immune system stay strong, giving it the ability to fight off illness. Studies have shown that people infected with hepatitis C have higher rates of diabetes than those who are not infected. A good diet can help reduce body fat and also help control blood sugar. In turn lowering risk for diabetes (George F. Longstreth, MD , 2014).

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The list of medical conditions that can be treated by using a special diet as a crucial and beneficial part of a patients treatment plan is a long one. As of January 25, 2013 the Goverment updated the list of these qualitifing diets, there are currently 37 eligibal medical conditions that require a special medical diet allowace in prisons (Rights of Inmates, 2012). However, in order for this form of treatment to be beneficial the prison needs to actively and consistantly be using these medical diets in the inmates treatment plans.
Are these changes really necessary or is the budget working just fine how it is? The Maine Department of Corrections in 2010 had $124.8 million in prison expenses. The state of Maine also had $8.1 million in prison-related costs outside the department’s budget. The total cost of Maine’s prisons to incarcerate an average daily population of 2,362 was $132.9 million. That means that 6.1 percent of costs were costs outside the corrections budget. American tax payers contributed money out of their personal hard earned pay checks that are meant to be used to provide food and shelter for their love ones. Not to pay those 132.9 million dollars (The Price of Prisons – Maine 2012). There isn’t a real question here; these changes are detrimental to our states budget.
Healthy eating is a cornerstone of healthy living. This is something taught at a young age. Inmates at the Maine State Prison eat what they are served regardless of their desire to maintain a healthy life style. The foods consumed directly affect blood sugar levels, blood pressure, GERD, they directly affect almost all medical conditions any given person has. As well as habitual poor diet choices can be the direct cause of someone acquiring a unnecessary medical condition. Practicing the use of “Medical Special Diets” not only at home but in our Prison populations will decrease costs of current and future medical care. Decreasing the medical costs of the prison as a whole. In turn decreasing the amount of money taken out of weekly paychecks . Everyone has bills, not THE MAINE STATE PRISON HAS THE ABILITY TO CUT HEALTHCARE COSTS 6 t to mention their own healthcare expensive, so why pay unnecessary money out to cover an inmates medications and surgery when this can be avoided by a simple change in diet. The problem is big, but he answer it's self is simple.

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References

Care and Counseling ( February 6,2012) Retrieved from : http://smartretailingrx.com/patient-care-counseling/the-full-value-of-a-diabetes-patient/

Clements, K (December 16, 2011). Effective Writing Series. Retrieved from: http://www.screencast.com/users/KUWC/folders/Effective%20Writing%20Podcasts%20%282011%29/media/4ac4b8aa-eb9a-4340-8bb8-5fb23656115a George F. Longstreth, MD (2014) Diet- Liver Disease. Retrieved from: http://www.nlm.nih.gov/medlineplus/ency/article/002441.htm

Mayoclinic (June 19,2013) Retrieved from: http://newsnetwork.mayoclinic.org/discussion/nearly-7-in-10-americans-take-prescription-drugs-mayo-clinic-olmsted-medical-center-find/

Prison Healthcare cost (2013) Retrieved from; http ://www.pressherald.com/2013/10/29

Rights of Inmates (2012) Retrieved from : http://civilrights.findlaw.com/other-constitutional-rights/rights-of-inmates.html#sthash.H1M5qJ5W.dpuf

The American Heart Association (2014) Retrieved from : http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/The-American-Heart-Associations-Diet-and-Lifestyle-Recommendations_UCM_305855_Article.jsp

The Price of Prisons – Maine (2012). Retrieved from: http://www.vera.org/filesprice-of-prisons-maine-fact-sheet.pdf

The The Prison Index (2003), page 29. (Graph: Peter Wagner, 2003) Burden of Cardiovascular Disease in Maine (2012) Retrievedhttp://www.prisonpolicy.org/prisonindex/toc.html

Cardiovascular Health Program, Maine Center for Disease Control and Prevention; 2012. Retrieved from: http://www.cardiohaelth.org

World Heart Federation (2014). Retrieved from: http://www.world-heart-federation.org/cardiovascular-health/cardiovascular-disease-risk-factors/diet/

William Cassidy, M.D (2013). Hepatitis C Infection in Prisons. Retrieved from : http://hcvadvocate.org/hcsp/articles/cassidy-1.html

Reflection
Writing has never been my strong suit. Even in grade school I had a vivid imagination and could come up with fun exciting short stories, however I never seemed to put them down on paper correctly. Growing up I have always been confident in math and science, but if someone mentions a writing class I want to turn and run far away.
In the past I have taken writing classes and learned some, but not enough to feel confident in my writing. As I read over my final project I realized that although it is far from perfect and I have a lot to work on, I felt proud of it. I personally saw a huge improvement in myself when comparing it to my work in unit one. I must admit that it felt really good. In nursing I have to do a lot of charting, as well as write a lot of professional emails and memos. I honestly believe that this class has improved my skills to a notable degree where as I don't look completely clueless when trying to write in a professional environment. Just today at work I had to write an email to the regional medical director regarding a patient. I found myself thinking “ remember my audience, remember who i'm writing to”. The old me would of just sent a quick email and went on with my day without any thought. Although I am a working progress, I truly feel I am improving and that is what is going to give me the confidence to do more, learn more and be more as I advance in my nursing career.