North Carolina prisons telehealth Initiative runaway success
Glenn Mack is Chief Information Officer, both for the North Carolina Departments of Public Safety and Adult Correction. It is a big job, and a weighty one; mistakes are not just financially costly but might endanger the lives, both of employees and the public.
The Department of Public Safety (DPS) comprises approximately 6,000 staff, along with around 10,000 North Carolina National Guard soldiers and airmen. DPS employees help ensure North Carolina is a safe place to live, work and visit, through effective law enforcement, juvenile justice programs, emergency response and recovery and homeland security preparedness.
The Department of Adult Correction (DAC) operates the state’s 54 prison facilities and its probation and parole system. It employs approximately 20,000 people across North Carolina, and its mission is to protect the public by collaboratively focusing on rehabilitation, protection, innovation, accountability and professionalism. DAC became a standalone entity in 2023, having previously been part of DPS.
Whatever work is being done across both departments, Glenn and his team are invariably involved.
“The business units have come to recognise that before any new project or initiatives begin someone from IT needs to be there from the start, which is why we are involved in just about everything,” he says.
In the DPS, Glenn and his team are currently involved in a number IT projects for the areas his team oversees, including case-record management for one of its law enforcement programmes, video surveillance for the State Capitol Police and some exciting solutions for Juvenile Justice. But it is DAC that has recently dominated most of their time.
“DAC has many new agency initiatives that have had supportive funding to deploy, whereas our work for DPS has mostly been project-based and maintenance for the past year. But we are always ready to be called into action in the event of something major, like an extreme weather event or serious public disorder. We typically get called in when there are new directives or initiatives to assist with,” Glenn continues.
Prisons telehealth initiative took off in the pandemic
In early 2018, the DAC began work on introducing telehealth provision across its facilities. Although the initiative pre-dated COVID-19, the pandemic acted as a catalyst.
“The need for it was there before the pandemic,” says Glenn, “because we needed to minimise the costs associated with providing healthcare to our offenders and to help address the Correction Officer staff shortages.”
He adds: “It was timely the pandemic occurred right when we were ready to launch.”
Telehealth has certainly worked on the cost-saving front, having saved the state US$20m to date.
The kind of health issues prisoners present with is similar to the civilian world – cancers, heart problems and arthritis – but there are also physical injuries, from the inevitable altercations.
“What's interesting about the US is that the only people who by law are required to receive healthcare are offenders, whether they’re in a federal, state or local prison system. We were spending an exorbitant amount of money on healthcare. It takes a lot of staff-support resources to take an offender out of prison, to the doctor or hospital, and then back.”
But it is not just the cost savings that make the new system so welcome, because the decreased movement of offenders attending healthcare appointments outside of prison has increased safety, both for prison staff and the public.
It is also much better for prisoners' welfare, says Glenn.
“It helps maintain their dignity because they're not visible in public in shackles and handcuffs,” he explains. “Plus, they don’t lose pay from the jobs they do in the facilities, as hospital and doctor rides might take four or five hours each way. Now, they're simply escorted into the telehealth room.”
But with 54 prisons to run, setting up the telehealth service was no easy feat, says Glenn. He explains that purchasing and implementing all the equipment and medical peripherals was the first step.
Dr Gary Junker, PhD, HSP-P Deputy Secretary for Comprehensive Health Services stated: “We are extremely pleased with our telehealth expansion over the past several years. What started as primarily telepsychiatry, the telehealth network expanded during the pandemic and has continued to grow since that time.
“Our telehealth team in collaboration with Information Technology, and supported by dedicated staff at each correctional facility, has managed to improve the quality of healthcare while conserving valuable staff resources. The future will see additional telehealth connections with both internal providers and external healthcare partners.”
Trusted partners are Cisco and Presidio
The trusted vendor partners involved in the telehealth project are the multinational digital communications technology conglomerate, Cisco, whose HQ is in North Carolina, and also Presidio, which specialises in designing, implementing and managing digital platforms.
At the heart of the telehealth solution is Cisco Webex, the enterprise video conferencing solution. Webex offers a suite of collaboration tools designed to facilitate remote work and virtual communication.
Its headline features include high-quality video and audio, real-time content sharing, virtual backgrounds, and AI-driven features such as noise cancellation and meeting transcriptions.
It also offers end-to-end encryption and compliance certifications, and is accessible via desktop, web browsers and mobile apps, making it versatile for different environments – like correctional institutions.
“We started laying out the infrastructure years ago with our VoIP, and this transitioned into Webex,” Glenn explains.
“Some of the biggest challenges – outside of carving out the funding, purchasing and implementing all the technology – was that we have all these locations across the state, which means the solution providers have to traverse the statewide network,” he adds.
“We worked with Cisco to find optimal configurations, both onsite and the necessary quality of service (QoS) over the State’s network to the remote healthcare providers. Finally, we had to replicate this 54 times, so every prison had the same provision.”
Glenn adds: “Both Cisco and Presidio have come to really understand our business, our requirements and the critical safety of life mission in the work we do.”
He adds: “We would not have had the success we’ve experienced without them. Their people work with us in a way that makes us feel like we are all on one team striving for a common goal. They are committed to our success.”
Hope University: An Innovative Offender Education Programme
As well as telehealth, Glenn and his team have worked hard on providing an offender education programme it calls Hope University, whose purpose is to provide educational and job-skill opportunities for incarcerated offenders.
In terms of delivery of Hope University Glenn says there is “tremendous collaboration between our technology staff and the staff in education services”.
Dr Brooke Wheeler, Superintendent for Education Services states: “Hope University is a wonderful tool for incarcerated people in NC to learn new information and skills.
“As we know, education is one of the most effective interventions to prevent recidivism, and we believe in providing educational opportunities to our population at no charge and in all settings. With thousands of courses available, all offenders can find something they are interested in to be productive and work toward reentry success. We continue to work with our valued IT team toward improving and expanding opportunities in Hope University to provide as much educational content as possible, with the goal of all residents participating.”
Glenn further adds: “With Hope University, Cisco is also our primary trusted partner for the technology side of things, and we also have partnered with many of the State’s local community colleges, universities and third-party education providers.”
In terms of the future for him and his colleagues, Glenn says that, with the US and statewide election coming up, there could be leadership changes on the horizon, and that this “always creates delays with implementing new solutions as the funding and directives change”.
On the technology front, he says his team will “continue to increase our cyber protection posture, grow our telehealth service offerings, modernise our offender management solutions, and continue the deployment of our educational services for Hope University”.
He adds: “We will also look ahead, to explore new innovative solutions to increase safety, operational efficiencies and to reduce costs. Oh, and of course finding ways to leverage AI.”
Glenn says the challenges posed by his role are many and varied, but that the biggest issue is “protecting lives across the two departments, every moment of every day with limited personnel resources”.
“It’s difficult attracting new talent due to the present compensation models for State employees,” he explains, adding: “The government doesn't pay what the private sector pays. Although this area of the country is a hotbed for technology talent, we can't compete.”
He adds that another difficulty is that, with his team under the purview of the NC Department of Information Technology, “there are often competing priorities in seeking to support the two departments, which can cause delays and cost overruns”.
There are no shortcuts to meeting such challenges, he points out. “You just need a personal commitment to public service, dedication and a lot of overtime.”
It is certainly a challenging role, but also hugely rewarding, says Glenn.
“I get to work with some amazingly talented and committed individuals including my leadership team, plus the technology we’re implementing and supporting is making a difference not only to our 20,000 or so staff but also to the citizens of North Carolina.”
He continues: “The thing that goes to the heart of what we do is building relationships, both within the internal business units and with vendor partners,” says Mack. “It is this that leads to increased success, and it also builds trust.”
This approach feeds into Glenn’s personal credo, which is to “build relationships, treat people with kindness and always choose to use the telephone over an email”.
In terms of looking to the future, in the world at large, we have all seen how much influence AI is having, and it is no different in the adult correction space.
“There’s definitely strong interest by leadership to leverage AI,” says Glenn. “We currently use it for facial recognition solutions, application development coding, and application quality assurance testing. We are also working to create an AI infrastructure to help modernise our offender management solution.”
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