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

July 2025

Published in the journal Pediatrics, “Minimum Standards for Medical Care of Youth Incarcerated Across the United States” examines the strengths and weaknesses of state standards for medical care provided to incarcerated youth across the country. In the absence of federal standards for this type of care, critical outcomes – such as overall health and rates of recidivism for the 27,587 youths held in juvenile correctional facilities – hinge on the quality of care prescribed at the state level.

The study found wide variation in these standards, and even the most robust standards of care generally exist in state policy or administrative codes rather than being codified in state law. For example, Massachusetts does not establish a high medical care standard at the legislative, administrative, or policy level; its requirement that medical care meets or exceeds the community standard is only seen in the Department of Youth Services’ (DYS) health care contracting requests. Further, none of the 14 states designated as having “comprehensive” or “community-level” standards of care have such requirements written into law. Other states fall even shorter, with 19 states requiring only “basic” or “as necessary” care for young people.

The article recommends that all states update their standards of care--in legislation to ensure durability--for incarcerated youth to meet or exceed the level of care available in the community, and it suggests referencing the most current pediatric guidelines, including the AAP’s Bright Futures Guidelines, as a resource. It further proposes that the standards should include monitoring mechanisms, oversight frameworks and enforcement procedures to improve access to and quality of health care. Finally, the article calls for these standards and oversight structures to be codified at the federal level.

Recognizing that Massachusetts should have a stronger standard of care in legislation, CfJJ strongly supports “An Act relative to health care quality for children and youth” that would codify DYS’s current practice of meeting or exceeding the pediatric community standard of care.