Can Juvenile Justice Detention Facilities Meet the Call of the American Academy of Pediatrics and National Commission on Correctional Health Care? A National Analysis of Current Practices

Abstract

OBJECTIVE. Despite the recommendation of the American Academy of Pediatrics, just 53 of the ∼3500 juvenile justice residential facilities in the United States have received voluntary accreditation for facility health care from the National Commission on Correctional Health Care. This suggests either that facilities do not meet the standards of care or do not seek accreditation. This study describes whether and under what conditions juvenile detention facilities (a narrowly defined subset of all facility types) adhere to some of the standards outlined by the National Commission on Correctional Health Care and promoted by the American Academy of Pediatrics. METHODS. Data from 2 national censuses of juvenile justice residential facilities (n = 726) were used to describe detention facility performance in terms of 10 types of service provision, ranging from health screening to communicable-disease testing. Multivariate models predicting high levels of service provision were estimated. RESULTS. Juvenile detention centers partially meet some of the minimum standards. Most services can be garnered at some level; however, they tend to be provided on an ad hoc basis for portions of the population rather than systematically for the whole population. Detention centers most likely to provide a higher tier of services tend to be those that have longer average lengths of stay, are larger, and are government owned. There are also geographic and racial differences in quality and scope of health services. CONCLUSIONS. Juvenile facilities have been provided a single set of standards for a diverse system with tremendous variation across and within facility types. Detention centers are just one specialized type. Very few detention centers meet a minimum standard of care, which suggests that standards are simply not being met (hence the low levels of accreditation). The findings of this study call into question whether detention facilities with little in the way of health care infrastructure can benefit from National Commission on Correctional Health Care standards as they are currently packaged, regardless of whether accreditation is the ultimate goal.