Regarding conditions of confinement, the Commission concluded that violence remains a serious problem in America's prisons and jails. Recommendations focus on changing the conditions in correctional facilities that fuel violence, such as overcrowding, inmate idleness, inadequate risk classification of inmates, and the use of force in managing inmates. Regarding inmate medical care, the Commission found high rates of disease and illness among prisoners, coupled with inadequate funding for their health care. Among its recommendations are partnering with health providers from the community; commitment to treating mentally ill inmates; screening, testing, and treating for infectious diseases; and extending Medicare and Medicaid to eligible prisoners. Regarding inmate segregation, the Commission concluded that the increasing use of high-security segregation is counterproductive. It recommends that segregation be a measure of last resort, that segregated prisoners have regular human contact, that adverse physical conditions of segregation be eliminated, and that mentally ill inmates in segregation be housed in secure therapeutic units. Regarding labor and leadership, the Commission concluded that better safety inside prisons and jails depends on changing the institutional culture, which in turn depends on upgrading corrections professions at all levels. Recommendations pertain to recruitment, training, and retention. Regarding oversight and accountability, the Commission found that most correctional facilities are not exposed to external monitoring and public scrutiny. It recommends independent, nongovernmental oversight of correctional facilities and the development of effective internal complaint systems. Regarding knowledge and data, the Commission recommends uniform nationwide reporting on safety and abuse in correctional facilities. Lists of commission witnesses and works cited