Managing Prisoner Enrolments

The Ministry recommends the following in response to inquiries about the correct process for managing prisoners’ enrolment with their general practice: Q1: What happens to a patient’s enrolment when the practice is advised the patient is in prison?

A: The Provider must un-enrol the patient once it is made aware that the person has been imprisoned.

Once the usual Provider is made aware that their patient has been imprisoned, that patient is no longer eligible to be on the register and "must be removed" from the Enrolment Register (Clause 3.3 Enrolment Requirements V4.0). The prisoner receives funded health care in prison via the Department of Corrections. The three yearly period for CBF funding is irrelevant here. The issue is that public-funded health care should not be paid twice for the same person for the same care. Further, the usual Provider will not be providing healthcare services to this person while they're in prison. The majority of sentences are within the three year limit for enrolment however, so in the interests of the patient’s ongoing care the Ministry advises that the patient should be retained on the practice register as an unfunded (registered) patient (see question 4 below).

Q2: What is the situation if the GP doesn’t know the patient is in prison?

A: In this case the patient would stay enrolled.

Q3: What happens if the patient has a short sentence or is on remand?

A: When a Provider is informed that their patient is in prison (either by the patient or the prison health services provider), information is not always available on how long that person will be there. If it's a short prison stay, it’s possible that the person could be removed and then put back on the register within a single funding period (currently 3 months).

Q4: Who looks after the patient’s health care when they are released from prison?

A: The prisoner would need to enrol at a general practice after release. However a practice can retain someone on the register as a "Registered Patient" (not Enrolled). Any recalls for regular health tests and health screening etc will still occur, but the practice will not receive capitation funding for that person.

Q5: What happens if a person is out on bail and not in custody?

A: They can remain enrolled with their GP until they are sentenced.

Thanks Alastair McLean Project Manager Primary Care Service Commissioning Ministry of Health DDI: (04) 816 3312 Mobile: 021 514 940 Fax: (04) 816 2493 http://www.health.govt.nz