Although the epidemiology of mental disorders in the prison system has been investigated, delivery of health services to prison inmates has not received similar scrutiny. The article describes the process by which a state prison commission developed their assessment of health care delivery. In addition, the article presents a model for defining such a mission, selecting standards against which to test prison health services, choosing a testable focus, refining a valid and reliable methodology, and piloting the result. Any evaluative effort must first recognize the unique constraints on administrative and clinical colleagues in the prison settings. Difficult patients with compound problems and substantial motivation to overuse or misuse the correctional health system can strain an institution with significant security responsibilities. Use of a community standard for assessing correctional health care grounds the process in a language and culture that is accessible to all practitioners and permits collegial, reliable exchanges of information. Notes, references