Florida

Correctional Medical Authority (CMA)

Budget

$1,513,751 (2022)

Staffing

10 staff members; 7-member volunteer board; local healthcare providers contracted for inspections

State Prison Profile

Florida has 58 state prison facilities subject to CMA oversight and incarcerates approximately 99,000 people in state prisons. The state prison system is run by the Florida Department of Corrections (FDC).

Authority

Title XLVII, Chapter 945, Sections 602-6036

  • Structure: The CMA is an administrative agency independently housed within the Department of Health with volunteer board members appointed by Governor subject to Senate confirmation. Board members are required to represent a range of medical professions. (945-602)
  • Authorized Activities: The CMA is broadly empowered to make recommendations on the delivery of healthcare in Florida prisons, including establishing minimum standards for prison physical and mental health care. The CMA is required to conduct at least triannual surveys of mental and physical health care at all FDOC facilities and report its findings, including any need for immediate action to address life-threating conditions, to the Secretary of Corrections. CMA authority is limited to medical care. (945-603, 6031, 6034)
  • Access: CMA access to FDOC facilities and records is not specified in Florida statutes.

Activities

CMA works to ensure that standards of mental and physical health care are met in Florida prisons by advising on plans and policies for healthcare delivery, inspecting FDOC facilities, and monitoring facility progress on corrective actions when standards are not met. 

  • Inspections: CMA works with independent contractors (generally licensed healthcare workers) to conduct on-site inspections, called “surveys,” of healthcare services at each FDOC facility every three years. From 2004 to 2020, CMA had trouble maintaining the triannual inspection schedule due to staffing and budget constraints. 
  • Corrective Action Plans: When facilities fail to meet medical care standards, they submit a Corrective Action Plan to CMA, which monitors their progress towards compliance.
  • Health Services Plan: CMA advises the FDOC Secretary on the development of the prison health services plan, from standards of care to cost containment and projected medical needs.
  • Policy Review: CMA reviews proposed amendments to Florida’s prison healthcare system prior to FDOC implementation. 

Reports

Annual Reports, Corrective Action Plan Reports, Survey Reports. Publicly available here.

  • Annual Reports include information about the status of elderly people who are incarcerated in Florida facilities. 

Organizational History

Impetus for the creation of the CMA began with a prison-conditions lawsuit (Costello v. Wainwright) filed in 1972, which led to the Florida prison healthcare system being placed under direct federal supervision. After 14 years of court supervision, the Florida Legislature created the CMA to oversee prison medical conditions, allowing the court to relinquish supervision of physical health care in 1990 and mental health care in 1993. The CMA’s authority and responsibilities were expanded in the 1990s. In 2004, the Legislature moved to dismantle the CMA but were unable to because CMA was monitoring a legal settlement; CMA staff was instead cut by 50%, from 12 staff members to 6. In 2011 the Legislature again voted to eliminate the CMA. That bill was vetoed by the Governor, but the CMA lost funding and disbanded until funding was restored and the agency was reestablished under the Executive Office of the Governor the next year. In 2020, the CMA was transferred back to the Department of Health, its original administrative location, and its budget was increased sufficiently to allow for the staff to increase from 6 to its current size of 10.

Special Note

CMA is the only healthcare-specific prison oversight body in the United States.