Minimum Standards for Medical Care of Youth Incarcerated Across the United States.

Abstract

The study sought to identify strengths and gaps in state standards for medical care in juvenile confinement facilities across the United States to support the development of uniform legislated standards at state and federal levels. The study focus is timely, given Medicaid policy changes that came into effect in January 2025, which allow states to seek federal reimbursement for health and reentry services for incarcerated youth. To address existing literature gaps, we collated and examined current state standards for access to medical care in juvenile confinement facilities as outlined in state laws, administrative code, and policies. We conducted an iterative thematic analysis to group states into tiers based on the scope of access to medical care required. State standards for access to medical care in juvenile confinement facilities varied widely. Most states do not require a comprehensive or community standard of care, including preventive care and treatment. Even where more robust standards exist, they are generally found in policy or administrative code rather than in state law. Current standards for access to medical care in state juvenile confinement facilities are insufficient to address the urgent and unmet health needs of incarcerated youth. There is a need for strengthened standards enshrined in state and federal law, which are more durable than policy or administrative code, along with legislated monitoring and oversight frameworks. These measures are crucial to ensuring that incarcerated youth receive at least the same standard of care as their peers in the community.