Fewer than a quarter of federal prisons have maintained adequate medical staffs in recent years despite a nearly $200 million increase in funding for medical care, according to a report from the Justice Department's Office of the Inspector General. Prisons have a hard time competing for medical staff, given the low salaries and poor working conditions, and though the investigators focused on federal institutions, the problems they identified also exist in state facilities. Money spent on medical care in the 97 institutions run by the Federal Bureau of Prisons grew from $905 million in 2010 to $1.1 billion in 2014. That increase, however, did little to solve the shortages in medical staff. Just 24 federal institutions were staffed at or above the level set by bureau policy, investigators note. Staffing at 12 institutions reached a "crisis level" in 2014, investigators said.