Dr. Lloyd Novick’s Role in Improving Prison Healthcare

Posted on October 31, 2025 by Mohamed Al-Ibrahim Leave a comment

This entry is part 2 of 2 in the series Public Health Trailblazers

Dr. Lloyd Novick, One Remembrance.

The Attica prison riot in New York started on September 9, 1971, and when it ended four days later, it marked the bloodiest prison riot in our country’s history with 33 inmates and 10 correctional officers killed. The prisoners revolted seeking better living conditions and improved medical care. This event was preceded several months earlier by minor riots at New York City jails which began at the Manhattan House of Detention for Men. The original building of this facility in lower Manhattan was built in 1838 in Egyptian Revival architectural style and was appropriately known as the Tombs.

The Tombs 1838

The Tombs 1941-2023

Source: Wikipedia

Up to that time, healthcare services in prisons and jails in the United States were delivered and controlled by correctional administrators. As a result of these events, healthcare services of New York City’s jails were put under the jurisdiction of its health department. Dr. Lloyd Novick, as Deputy Commissioner of the NYC Department of Health, was given the hastily minted title of Executive Medical Director for Correctional Health. Overnight, he was responsible for nine city facilities, several prison wards in hospitals such as Bellevue and Elmhurst, as well as several federal and county facilities managed by the NYC Department of Corrections. A total of almost 10,000 incarcerated individuals.

The task was to improve medical care for this population. It started by focusing on basic needs to begin appropriate planning. A newly developed assessment tool was put in place and used for all admissions to NYC prisons and jails. A detailed analysis was made of the health status of 1492 consecutive admissions as a first step in planning and for staff training. This simple but crucial study was effective in providing a profile of the health status of the prison population and justifying the increase of expenditures required for improved services. Within months, the scope of services was planned and implemented including:

1. Structured medical assessment at intake.

2. Dispensing of medication became a nursing function.

3. A mental health service with staff and referral criteria was formed.

4. Dental health services became available at each facility.

5. A specialty referral system was developed.

6. Access to laboratory and imaging procedures was put in place.

Lloyd’s vision attracted many physicians and other health professionals like me to extend their moonlighting hours to assist the staffing needs of NYC jails and prisons. Studies and publications followed, and these became the guiding light for progressive national efforts to improve care for prisoners. Activists in New York, Baltimore, and elsewhere rallied in replicating the New York City model. Standards for healthcare services in jails and prisons followed. A few years later, I joined a group of Johns Hopkins University activists to design health services for Baltimore’s City Jail. This came about as a result of litigation because of poor conditions in this facility. In 1981, the Baltimore City Jail became the largest facility in the country accredited by the American Medical Association. We simply used the Lloyd Novick process and a little of his free advice. Academic and other healthcare facilities became interested in the Montefiore Hospital/Rikers Island contractual model brokered by Lloyd and which was emulated in many parts of the country.

Lloyd dealt with end-stage kidney disease bravely and privately, and with his wife Carole’s help, chose home dialysis. He was a big man, and as he lost muscle strength, they found help from a community nurse originally from Kenya. In her conversations with Lloyd, she learned about and became interested in prison healthcare. When Lloyd passed, Carole gifted her a copy of Lloyd’s book, Health Problems in the Prison Setting, A Clinical and Administrative Approach. And so, it goes on…

About the Author

Mohamed Al-Ibrahim: Mohamed S. Al-Ibrahim, MB ChB, FACP, Colonel (Retired) USMC, is Senior Physician Investigator at Pharmaron Clinical Pharmacology Center since 2017. From 2006-2017 he was Chief Medical Officer and President of SNBL Clinical Pharmacology Center Inc. He also served as Chief Medical Officer, University of Maryland Mid-Town Medical Center (2004 to 2006) and Executive Chief of Staff at Department of Veterans Affairs, Maryland Health Care System (1994 to 2004). Prior to this, he served as Chief, Division of General Internal Medicine and Geriatrics, University of Maryland School of Medicine (1983 to 1994). Dr. Al-Ibrahim is Board Certified in Internal Medicine, Infectious Disease and Geriatrics. He received MB ChB from Baghdad College of Medicine in and MB from Oxford University Board. He is Adjunct Professor of Medicine, University of Maryland School of Medicine.