ONLY IN THE 1970'S HAS THE JUDICIAL SYSTEM MOVED BEYOND THE 'HANDS-OFF' DOCTRINE WITH RESPECT TO THE INADEQUATE MEDICAL CARE SERVICES AND CONDITIONS AFFECTING THE HEALTH OF INMATES. THERE IS NOW GENERAL MEDICAL AND LEGAL AGREEMENT THAT MINIMALLY ACCEPTABLE STANDARDS FOR PRISON AND JAIL HEALTH SERVICES ARE SIMILAR TO STANDARDS FOR HEALTH SERVICES IN THE COMMUNITY. ADMINISTRATIVE AND PUBLIC POLICY ISSUES WHICH MUST BE CONFRONTED IF ACHIEVEMENT OF RECOGNIZED STANDARDS IS TO OCCUR INCLUDE ACCOUNTABILITY, INTEGRATION OF SERVICES, MEDICAL EVALUATIONS UPON ADMISSION TO PRISON, CONTINUITY OF CARE, EMERGENCY CARE, RELATIONSHIPS WITH OTHER MEDICAL FACILITIES, ENVIRONMENT, EPIDEMIOLOGY, AND BUDGETING. CORRECTIONAL INSTITUTIONS ARE HIGHLY COMPLEX SYSTEMS FROM A HEALTH CARE VIEWPOINT. ACCOUNTABILITY FOR MEDICAL CARE DECISIONS WITHIN MAJOR INSTITUTIONS MUST BE VESTED IN APPROPRIATELY QUALIFIED, LICENSED PERSONNEL. THERE SHOULD BE A PHYSICIAN WHO IS RESPONSIBLE FOR THE MEDICAL STAFF SELECTION, EVALUATION, AND COORDINATION OF HEALTH CARE SERVICES. IN ADDITION, ONE OF THE MOST FREQUENT DEFICIENCIES IN THE HEALTH SERVICES OF CORRECTIONAL INSTITUTIONS IS THE FAILURE TO INTEGRATE THE FUNCTIONS OF VARIOUS HEALTH CARE PERSONNEL. FOR EXAMPLE, SPECIALISTS IN PSYCHIATRY AND MEDICINE MAY BE PRESCRIBING MEDICATIONS FOR PATIENTS, WHILE BOTH ARE UNAWARE OF POTENTIALLY DANGEROUS DRUG INTERACTIONS THAT MAY BE OCCURRING. IT IS SUGGESTED THAT ANY PERSON WHO IS CONFINED TO A CORRECTIONAL INSTITUTION BE GIVEN AN ADEQUATE MEDICAL EVALUATION UPON ARRIVAL. APPROPRIATE ATTENTION SHOULD ALSO BE DIRECTED TOWARD CONTINUITY OF CARE OF THOSE REQUIRING CHRONIC MEDICAL CARE, SUCH AS DIABETICS. EMERGENCY CARE PLANS INCLUDING THOSE FOR MEDICAL DISASTERS SUCH AS FIRES SHOULD BE DEVELOPED. ARRANGEMENTS SHOULD BE MADE WITH LOCAL HOSPITALS OFFERING SPECIALIZED SERVICES. ENVIRONMENTAL CONDITIONS AFFECTING HEALTH SHOULD BE ANALYZED, AND CHANGES EFFECTED WHEN DEEMED MEDICALLY NECESSARY. FINALLY, IF CORRECTIONAL INSTITUTIONS ARE TO ACHIEVE AGREED UPON STANDARDS, FISCAL SUPPORT AT LEAST APPROACHING PER CAPITA NATIONAL EXPENDITURES FOR HEALTH SERVICES MUST BE AVAILABLE. MANY PRISON SYSTEMS ALLOCATE FAR LESS THAN THIS FIGURE. FOOTNOTES ARE PROVIDED.