Health Care Within the Prison Walls – and Without

Date: October, 2017

Graceann Palmarella 

(Above left) Bruce Herdman, PhD, MBA, Chief of Medical Operations at Philadelphia Prison System with Jennifer Pinto-Martin, PhD, MPH, Executive Director, Center for Public Health Initiatives, and Heather Klusaritz, PhD, MSW, Director of Community Engagement, Center for Public Health Initiatives and Co-Director, National Center for Integrated Behavioral Health.

(Above right) A crowded and engaged audience in the John Morgan Reunion Auditorium.

The Center for Public Health Initiatives (CPHI), the Leonard Davis Institute of Health Economics (LDI), and the National Center for Integrated Behavioral Health (NCIBH) were recently joined by over 150 attendees to hear from Bruce Herdman, PhD, MBA, Chief of Medical Operations at Philadelphia Prison System. Audience members came from both schools and departments within Penn as well as outside government and community organizations.

The audience was captured as Dr. Herdman discussed the living conditions in the prison, the medical care and disease prevalence, and disparities across the system. The top convictions of inmates include drug charges (31%), robbery (12%), and aggravated assault (10%). Of the charged inmates, there are tremendous disparities; over 85% are people of color (66% African American and 19% are Hispanic), a statistic certainly not representative of the City of Philadelphia. Herdman recalled that African Americans are 8X more likely to be arrested for marijuana compared to whites.

(Above) Captured and engaged audience members including Jennifer Pinto-Martin, PhD, MPH, CPHI Executive Director, Sara Solomon, MPH, RD, CPHI Deputy Director, and Chyke Doubeni, MD, FRCS, MPH, Co-Director, National Center for Integrated Behavioral Health.

Dr. Herdman provided important statistics, including 30% of those incarcerated are homeless and 80% are from Medically Underserved Areas (MUAs). In fact, most inmates receive better care in the prison system than they do outside. Additionally, 17% of those treated are seriously mentally ill and 36% of inmates are on the behavioral health caseload. The average length of stay in prison is 102 days, but inmates with Serious Mental Illness (SMI) stay approximately 28 days longer than Non-SMI, on average.

In our first seminar of this series with with Jeffrey Hom on "Opioids in Philadelphia: The Obstacles and Opportunities in Addressing a Public Health Crisis", we heard how large an issue the opioid epidemic is. Bruce Herdman weighed in on this issue from the standpoint of the Philadelphia Prison Systems. Of the heroine overdoses last year, 27% had just come out of the prison system where they were being treated for their addiction. In order to combat this issue and this epidemic, Narcan is now being handed out to prevent overdoses. They expect that 5,000 kits will be given out this year.

Dr. Herdman and his team have been working hard to deliver innovative care to those they serve and to ensure continuity of care after release. He shared that this is his favorite job that he has had because he is working with those in most need. Many audience members stayed after the talk to find out how they can get more involved with this work. 

Check out the CPHI Data Brief on "Reducing Incarceration in Philadelphia."

Bruce Herdman's slides from the event can be found here.

If you were not able to join us for this event, or if you'd like to view the talk again, the video footage can be found here.

Bruce Herdman is the Chief of Medical Operations at Philadelphia Prison System. Dr. Herdman's career in health care administration in Philadelphia includes service as Executive Director of the Mayor's Commission on Health, Senior Vice President for Psychiatric Services at Pennsylvania Hospital, Vice President for Risk Arrangements and Ancillary Services at Independence Blue Cross and Senior Vice President of Provider Network Management at Keystone Mercy Health Plan. Dr. Herdman served on the boards of two hospital foundations and on the board of the Carrier Clinic.

In 2006 Dr. Herdman joined the Philadelphia Department of Prisons in the newly created position of Chief of Medical Operations. He is responsible for the delivery and quality of the medical, behavioral health and dental services provided to over 7,000 inmates at the Prison and in the community.

This event was co-sponsored by the Leonard Davis Institute of Health Economics (LDI) and the National Center for Integrated Behavioral Health (NCIBH).