New York State
Department of Correctional Services
Glenn S. Goord, Commissioner
Office of Public Information
For immediate release:
Noon on Thursday, May 4, 2000
New York's aggressive prison TB care lauded by the Institute of Medicine
The Department of Correctional Services' successful efforts to manage tuberculosis care among staff and inmates was highlighted today in a report issued by the prestigious Institute of Medicine of the National Academy of Sciences in Washington, D.C.
The Institute, established in 1970 as an adviser to the federal government, today released a 200-page report entitled "Ending Neglect: The elimination of Tuberculosis in the United States." The report, funded by the U.S. Centers for Disease Control and Prevention in Atlanta, recommends among other things that screening programs be established that target high-risk communities in the United States - including mandatory skin tests for all inmates in correctional facilities.
Commissioner Glenn S. Goord said, "My highest priority is the safety of the staff and inmates in our 70 facilities across the state. That responsibility includes a commitment to their physical health. This report once again confirms that the policies of Governor George Pataki continue to increase the safety and health measures available to the work force and the offenders within our system, making ours the best system in the nation."
The report specifically recommends that "Tuberculin testing be required of all inmates of correctional facilities and completion of an approved course of treatment, when indicated, will be required, with a referral to the appropriate public health agency for all inmates released before completion of treatment."
In discussing TB in a custodial setting, the report focuses on New York to note that it "took the situation in 1991 as a challenge and has shown significant progress." The report notes that while 25 percent of inmates continue to enter the New York state prison system having been exposed to the TB bacterium:
- The incidence of TB disease has dropped from 225 cases per 100,000 inmates in 1991 to 40 in 1998.
- While there were 39 cases of prison multi-drug-resistant TB in 1991, there was only one in 1998.
- The rate of TB infection among staff dropped from 1.7 percent in 1993 to 0.03 percent in 1998.
- The rate of TB infection among inmates declined from 2.4 to 1.2 percent over the same period.
The Institute noted that stark turnaround was directly attributable to a "Departmental commitment (that) included staff dedicated to dealing with infectious diseases for all staff and inmates; mandatory PPD skin testing for everyone in the system, inmates and staff; mandatory evaluation of all suspect cases; liberal use of respiratory isolation including all cases while sputum testing awaits results; directly-observed therapy with all anti-tuberculosis medications, and mandatory treatment of latent infection. During the decade, three-quarters of a million PPD tests have been given."
The report also commended the Department's balancing of rights in the handling of the few inmates who refuse to be tested for TB by either PPD or X-ray. The Department does not use force to compel inmates to be tested. Instead, inmates who refuse to be tested are confined to their cells and let out for one hour of daily exercise or when medical or legal visits are required. Between 20-50 of the 72,481 inmates housed today in New York's 70 facilities are confined for refusing such tests. In most cases, the confinement continues for a few weeks to a month until the inmate decides to submit to testing.
The report noted that New York's overall TB policy has been upheld by federal courts that have ruled the policy does not violate an inmate's constitutional rights. The policy is also consistent with earlier judicial decisions that require prison systems to take steps to prevent the spread of controllable diseases.
(Editor's Note: Institute of Medicine of the National Academy of Sciences press contacts for this report are: Media Relations Officer Neil Tickner and Media Relations Assistant Mark Chesnek, both of whom can be reached at  334-2138.)