A questionnaire designed by the American Academy of Pediatrics was circulated to facility directors to determine the level of compliance with American Correctional Association standards and identify common problems among the centers. The health delivery system suffers from lack of coordination in both staffing and level of care, has disorganized screening and overuse of off-site services for nonemergency health needs, lacks health training for facility staff, and has marginal recordkeeping. Recommendations are to fund a medical director, accountable physicians, and onsite paraprofessional medical staff and to coordinate existing resources with public health. Medical services for juveniles in the centers should be upgraded as soon as possible to be comparable to those prov ided by the State for adult inmates. 11-item bibliography.