Inside the Central Prison Healthcare Complex: A Growing Challenge
The Central Prison Healthcare Complex in Raleigh is a hub of activity. Inmates from across North Carolina seek various medical services here, including general health check-ups, dental procedures, and even surgeries. While some visit for routine care, others may stay for months for extensive treatments.
During a recent tour, the urgent care unit was surprisingly quiet. Hospital director Chad Lovett noted that this calm wouldn’t last.
In another part of the facility, ten inmates received dialysis for kidney issues, while others underwent dental procedures and psychiatric care. The complex also houses a 60-bed unit for long-term medical attention. Opened in 2011 at a cost of approximately $154 million, the facility has 398 beds, with over half designated for mental health care.
As the prison population ages, the healthcare demands have surged, leading to rising costs. “Our healthcare budget keeps climbing,” said Arthur Campbell, the chief medical officer. “As inmates age, their healthcare needs intensify.”
North Carolina must provide medical care to over 32,000 inmates. However, costs are skyrocketing. In the fiscal year 2024-25, prison healthcare spending reached $444.7 million—a 65% increase over the past decade. Often, these expenses exceed the department’s budget, which is a serious concern.
“Healthcare is non-negotiable,” noted Secretary Leslie Cooley Dismukes. “Unlike food or uniforms, we can’t cut healthcare services.”
In January 2025, the department faced an $82.5 million budget shortfall, which included large sums for pharmacy, general healthcare, mental health, and dental needs. With rising prescription costs—like a $900,000 annual medication for one hemophilia patient—financing medical care is becoming increasingly problematic.
An aging inmate population drives many of these challenges. Research shows incarceration can worsen health and accelerate aging. In North Carolina, the number of inmates aged 70 and older has tripled in the last decade, adding pressure for more specialized, expensive care.
For every inmate over 50, healthcare costs are four to five times higher compared to younger prisoners—averaging an additional $27,748 per person each year. In 2025, as admissions rose, the number of inmates with significant medical needs, including higher rates of chronic conditions, also increased.
Staffing issues further complicate the situation. Currently, 74% of registered nurse positions at correctional facilities are vacant. The low starting salary of $58,898 makes recruitment difficult, as many nurses can find better-paying jobs nearby. This lack of staff leads to strained resources and necessitates reliance on costly outside medical facilities.
To tackle these issues, the department is focused on expanding internal medical services. In 2025, about 88% of the 2.7 million clinical encounters were conducted within the prison system. The Central Prison Healthcare Complex performed nearly 460 surgeries last year, showing a 48% increase from 2024.
However, all of this hinges on staffing. The department aims to create more medical facilities in strategic locations, which would help meet the growing needs of the aging population.
The challenge is clear: managing the healthcare needs of inmates amid rising costs, staffing shortages, and aging demographics. As Campbell succinctly stated, “Everything relies on resources and staffing.”
For further details about the implications of these healthcare challenges in North Carolina prisons, you can visit the North Carolina Department of Adult Correction’s Health Services Division.
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