Medical Update

THIS BLOG WAS WRITTEN IN JANUARY, 2015.

 

            Virginia DOC recently settled the pending class-action lawsuit brought on behalf of the 1200 female inmates at Fluvanna Correctional Center. The lawsuit alleged that the women were receiving inadequate medical care. A court appointed monitor will be named to reform health care services at the facility and VDOC has agreed to revise department policies regarding health care.

            At the same time, the department faces a $45 million shortfall in inmate healthcare through next year. DOC had contracted with Corizon (a “for-profit” prison medical provider) to manage medical care in 17 facilities, but Corizon withdrew mid-contract because it found it could not meet its profit goal and fulfill its contract obligations. Another “for-profit” medical corporation – Armor – has temporarily taken over medical care in those 17 prisons which has led to a further $14.4 million shortfall in the DOC medical budget this year.

            Finally, DOC acknowledged that there are 23 active hepatitis C patients who can benefit from the newest drug treatment protocol (that number will go to 50 next year) however, only $750,000 was budgeted – each 12 week treatment costs $84,000 per person – creating another budget deficit.

            “DOC” could be an acronym for “draining our state coffers.” What a continuing waste of money … and lives. Isn’t it time for change?

 

 

Trial Date

This blog was written in November, 2014. 

            Less than 30 days from now a Federal Court will hear a suit brought by 5 female offenders at Virginia’s Fluvanna Correctional Center for Women. The class action lawsuit, filed in 2012, seeks injunctory relief from VDOC for its mismanagement of medical care for those behind bars. Be ready Virginia; VDOC will lose this case and the budget woes already affecting the Commonwealth will only worsen. Look no further than the bloated, arrogant, mismanaged bureaucracy that is VDOC when you ask “why.”

            At a time when the voters of the Commonwealth were quick to elect any politician who said they were “tough on crime,” DOC realized it had a problem. Everything has a cost and that’s especially true in prison. You want to lock up virtually anyone for anything (after all, a majority of those behind bars are there for non-violent crimes) there is a cost. And a major cost associated with longer sentences, with mass incarceration policies, is the cost to provide medical care. The Commonwealth knew they had a burgeoning problem years ago.

            What was their solution? Outsourcing. VDOC concluded that it was cheaper to contract out offender medical care than provide staff doctors. So the state entered into a sweetheart (for the for-profit corporations anyway!) contract first with Armor, later with Corizon, both “players” in the booming prison-industrial complex that has seen U.S. corrections expenditures go from $6 billion in 1980 to $80 billion today. The state agreed to pay these companies $76 million per contract year to provide medical care and case management for the incarcerated. That sounds like a lot of money (and it is) except those companies had their own staffing costs. They also had a population they were servicing that was less healthy than the general population, with diabetes and mental disorders rampant. Keeping costs down became the benchmark. Forget Hippocrates; their mantra was, “every buck saved is a buck for our bottom line.”

            Then, VDOC gave almost no thought or care to the “work” these private contractors did as long as the department was not responsible. Trouble is, VDOC – and the Commonwealth – can’t shirk their obligation to provide medical care to those in its custody. That’s the law. Funny, isn’t it? All those “law and order” types suddenly became very “shades of grey” when it comes to government doing what they are legally obligated to do.

            That provides background to the suit – government ineptitude followed by sweetheart contracts with no oversight. But, to the women involved, it is more personal. To the patients – and their families – who were ignored and mistreated, their poor care, the 3 or 4 deaths each year resulting from negligent health care at Fluvanna, it was personal. You break the law, you go to prison. You shouldn’t end up dying because of bad medical care, which the state is required to provide when they take away your freedom.

            My first year here I befriended a bright, young redheaded kid. He had gone drag racing one night with three other cars. These were county roads in Augusta County. And these 18 to 20 year-olds were going way too fast, being reckless. Then it happened. He lost control and his car went airborne. His girlfriend lay dying in his car. The charge was vehicular manslaughter; the sentence was four years. I make no judgment on the leniency – or severity – of his time. Parents lost a daughter. Four years or forty, that will never be made whole.

            They sent him here and late in ’09 he began having severe stomach pains. He ran a fever. He passed blood. Medical refused to see him. “You’re on the sick call list,” he was told. His mother called and complained and Medical gave him an appointment. Stomach virus was the diagnosis “Take Mylanta.” That night his fever spiked. The floor officer rushed him down to medical and he was immediately taken to the hospital with a ruptured appendix.

            That story isn’t an aberration; that story is day-to-day medical care inside. “Care” is not the right word. Every year men and women die behind bars from medical neglect. That is criminal and should not be tolerated. That is the basis of these five women’s lawsuit.

            How has the government reacted to the suit? They have stonewalled. This past summer the court was so incensed by DOC’s refusal to comply with discovery that it awarded the Plaintiffs over $16,000 in attorney fees. Ironic isn’t it, the purveyors of the law, those charged with administering the law, ignore the law. Who pays? The taxpayers.

            The late Ben Bradlee of the Washington Post cited Walter Lippmann in a lecture he gave in 1997 at the University of California. Lippmann, Mr. Bradlee noted, believed that “In a democracy, the truth emerges. Sometimes it takes years … sometimes it seems to take forever, but it does emerge.”

            Mr. Bradlee, the Executive editor of the Post from 1968 to 1991 knew a little something about the truth and the attempts over and over again by government to spin it and shape it and distort it. But, at the end, the truth will emerge.

            For far too many years the Commonwealth of Virginia’s politicians, supported and greased by companies like Corizon and Armor have told voters you are safer with more people behind bars. These politicians have lied about the true costs the people of Virginia incur with these reckless policies built on greed. But the truth will emerge … and it may start on December 1^st in a Federal courthouse when the Department of Correction’s medical contracts are exposed for what they are.

The State of Corrections

Want to know how important re-entry really is to the decision-makers in Richmond? Look at VDOC’s new visitation system. As I wrote before, DOC installed a “centralized” visitation approval system last December. Before that, a person who wanted to visit an inmate came to the facility, picture ID in hand. They’d fill out a one page form, have their ID scanned into the NCIC (National Crime Information Center) database – to verify no felonies or outstanding warrants – and they were admitted. The “new” system requires an electronic application to be submitted with approval “within 30 days” for instate residents and 90 days for out of state. No problem, right?

            Well, for starters the state isn’t meeting the 30 day standard. “That’s a minimum,” the visitation clerk tells folks on the phone – when they actually bother to answer the phone. You say, “That’s not what the policy says, nor is that what your department spokesman – Larry Traylor – told the press.” Well, that’s the way it is. So visitation numbers are down, way down. And frustration is up. Visits, connections to family and friends in the real world matter – or so they tell in re-entry all the while making it more difficult to maintain those relationships.

            I’ve learned DOC does a good job talking about breaking the cycle of recidivism but in reality, recidivism keeps them getting $1 billion + every year. Visitors are treated poorly when they come here. There is no recognition by a sizable percentage of the staff that “these folks are the public. They pay taxes to keep this place open and me in a job.” Instead, visitors are subjected to disrespectable comments about their clothing: “inappropriate” (meanwhile, most of the officers need to “size up” their uniforms – obesity is a major problem in the officer ranks). There is no correlation between working in corrections and dealing with the public.

            Prisons hide behind the veil of “keeping the public safe.” With over fifty percent of the inmates “nonviolent” the talk of public safety and public protection, are handy myths perpetuated to generate funding. The fact is, most corrections officers at this level – medium security re-entry – are female or men over fifty. And, most lack physical fitness or aptitude to confront and restrain any serious problem (it’s not that way in higher levels where beefy, corn-fed young officers patrol the corridors under the watchful eyes of gun-toting officers on catwalks).

            Visitors – tax paying citizens – will tell you it is embarrassing and humiliating to visit someone who’s incarcerated here. It shouldn’t be. VADOC must be accountable and responsive to the public. VADOC employees should be held to a level of trust and respect for the public. And, programs (such as the new visitation policy) should be evaluated for their effectiveness in breaking patterns of recidivism. Employees of DOC need to be accountable for the $1.2 billion in state money they spend and professionalism should matter.

            Then there’s the medical care. I have repeatedly noted in this blog how Virginia outsources inmate medical care and how poorly that care is provided. It’s about to get worse. VADOC recently signed a contract with Corizon (a for-profit health care firm specializing in prison health) to provide inmate health care.

            Who is Corizon? It is a company accused of abuse in many of the states it operates in. 660 suits for malpractice have been filed against it in the last 5 years. Maryland DOC terminated its Corizon prison contract over abuse allegations. Just last month, Idaho DOC did the same. Maine legislators investigated Corizon and issued a stinging report over inmate medical care neglect.

            Why then would Virginia contract with such a disreputable company? Someone needs to ask Harold Clarke, Virginia’s DOC Director about the contract’s financing including rebates back to the state. It’s ironic, Harold Clarke, after being named Director of DOC, gave a flowery speech talking about his faith playing a pivotal role in how he will direct VADOC. I posed the question to him then – and reiterate now – what kind of director would Jesus be? Does the Corizon contract pass your “faith” test, Mr. Clarke?

            And then there’s good-ole JPay. JPay is the company responsible for money order receipts and credit to an inmate’s account. If you have a banking relationship on the “outside” and have access to certified checks or cashier’s checks, you mail the check to the institution and within twenty-four hours it’s posted to your inmate trust account. But, if you are one of the thousands of poor families in the state who lack access to a bank, you use money orders. DOC doesn’t process money order deposits for inmates anymore – too labor intensive and time-consuming (isn’t that everything associated with incarceration). So DOC outsourced it to JPay. All money orders now go to Florida where JPay processes them – at a fee of course.

            What used to take forty-eight hours onsite, now takes 22 days. And, it’s still labor-intensive. JPay was supposed to be given electronic access to CORIS – the inmate record system (our “7” digit inmate numbers). VADOC hasn’t done that – lack of IT resources” – so JPay processes the money order, then sends it to the institution to be hand-keyed into an inmate’s account.

            That’s right, VADOC is now paying a third party fee for money orders that it still has to process. And I’m the one locked up for stealing other people’s money!

            Virginia’s Corrections Department is a bloated, poorly managed, antiquated bureaucracy that only gives lip service to its mission – the safety of the public and the successful restoration of rehabilitated offenders back to society. It’s time for Virginia to take a serious look at this failed system misnamed corrections.