Are Prison-Healthcare Consent Decrees Implemented? A Difference-in-Differences Study of Consent Decree Impacts on Budgets and Hiring

• In Event: State Prisons & Legal Change

Abstract

There is a debate in law and society and criminal legal studies about whether litigation causes social change, including changes to prisons. One limitation courts face in policy implementation is their lack of power over the purse—they can rarely compel increased spending on services (Rosenberg, 2008). But courts could effect changes by placing pressure on political branches to respond to prison conditions. Prison administrators, while ostensibly resistant to reform, might welcome intervention as an approach to obtain funding for prison improvements, including healthcare. This paper tests this idea by taking an econometric approach to investigate courts’ ability to influence spending through consent decrees. Nearly all prison healthcare consent decrees contain policy goals that necessitate increased spending on medical services or staffing (Baer & Bepko, 2007; Faria, 2014). In implementation studies, cost is established as a clear outcome measure to assess whether a policy is enacted (Proctor et al., 2011). Are healthcare-related prison consent decrees implemented, as measured by changes in healthcare hiring and spending? To answer this, I compare spending and hiring in jurisdictions with consent decrees to jurisdictions without them. I use a staggered difference-indifferences approach to analyze how consent decrees are associated with healthcare-related hiring and spending.

Author

• Bryant Jackson-Green, University of California, Irvine