by Richard Forbus, MBA-HCM, CCHP
Last week, I had the opportunity to attend the Western State Sheriff’s Association conference in Reno, Nevada. Sheriffs and correctional leaders from across the western and midwestern states gathered to discuss the pressing issues facing their facilities—particularly in health care. At the NCCHC booth, we had insightful conversations about the challenges correctional facilities are navigating and the solutions they’re seeking.
The Ongoing Impact of the Opioid Crisis
The opioid epidemic remains a major concern for jails in the western region, with fentanyl continuing to drive the crisis. Its widespread availability and low cost increase the risk of overdoses and adverse events, particularly in intake areas where new arrivals may be under the influence or experiencing withdrawal. The impact extends beyond those in custody—staff safety is also a growing concern, as they manage these high-risk situations daily.
One crucial step in addressing this crisis is expanding access to medication-assisted treatment (MAT). Many conference attendees expressed interest in how to build or enhance MAT programs in their facilities, underscoring the growing recognition of its importance in correctional health care. Right after the conference, NCCHC released the new Jail Guidelines for the Medical Treatment of Substance Use Disorders 2025. I’m proud to share it with you here.
Mental Health Challenges
Mental health remains a critical issue in correctional settings. Many individuals entering jails arrive in crisis—off their prescribed medications, exhibiting violent tendencies, or engaging in self-harm. This not only poses risks to health care and custody staff but also jeopardizes the safety of other incarcerated individuals. Addressing these needs effectively requires a well-trained, well-supported workforce and access to appropriate mental health services.
Facilities accredited by NCCHC tend to have better systems in place to manage these challenges. A recent study from researchers at Harvard found that NCCHC-accredited jails had significantly lower mortality rates compared to non-accredited facilities. This research highlights the critical role that structured, high-quality health care programs play in saving lives and improving patient outcomes in custody.
The Growing Strain on Staffing
Staffing shortages continue to be one of the biggest challenges across the correctional system. Both health care and custody staff are feeling the strain, directly affecting the ability of facilities to provide essential medical services and maintain security. The stress of understaffing also takes a toll on employee mental health and well-being, further exacerbating retention issues.
Rising Medical Acuity in Jails
Nearly everyone I spoke with at the conference reported an increase in the medical complexity of individuals entering custody. Chronic conditions, untreated illnesses, and the cumulative effects of substance use and mental health disorders are placing greater demands on correctional health services. These factors, combined with staffing shortages and security concerns, create a perfect storm that increases the risk of critical incidents.
Finding Solutions Through Collaboration
While these challenges can feel overwhelming, the WSSA conference reinforced an important point—no facility is alone in this struggle. Sheriffs and administrators across the country are actively seeking solutions and collaborating on best practices. Whether managing a small rural jail or a large metropolitan facility, the need for an effective, collaborative, and well-supported correctional health care system has never been greater.
How NCCHC Can Help
As the national leader in correctional health care, NCCHC is here to support facilities in navigating these challenges. Whether you need technical assistance, accreditation guidance, or educational resources, we’re ready to help. The new Harvard study confirms that NCCHC accreditation not only ensures compliance with best practices but also directly contributes to better health outcomes and fewer in-custody deaths—an essential factor for facilities looking to improve care and mitigate risks.
If your facility is considering implementing a jail-based MAT program, exploring accreditation, or simply looking for guidance on improving correctional health care, we’re here to help. If you’d like to meet to discuss the issues you’re seeing in your facility and community, pick a time and let’s talk.
Next, my travels take me to NCCHC’s Spring Conference on Correctional Health Care, where I look forward to connecting with many of you.
Thank you for the work you do, and please stay safe out there!
Richard Forbus, MBA-HCM, is NCCHC’s vice president of program development.
