Crisis in Correctional Care: Pressing for Prison Reform

As prison populations continue to increase and budgets get tighter, reforming the system will become ever more important. Sandy Hausman produced this series for WVTF Radio as a 2013 National Health Journalism Fellow. 

The other parts in the series can be found here:

Diabetes and Death in Virginia Prisons

Crisis in Correctional Care: Inmates Allege Medical Neglect

Crisis in Correctional Care: Mental Illness

Crisis in Correctional Care: Elderly Inmates

Health care in American prisons has never been great. In fact, before 1976, inmates were not legally entitled to care. Now, however, the courts have said prisons must provide adequate medical services. State legislators know that, and ten years ago they were given a detailed report of serious problems with healthcare behind bars in Virginia (Click here for audio).  

But Hope Amezquita with Virgnia’s ACLU says they did nothing, and her colleague, lawyer Gabe Eber, says voters probably didn’t care.

"A lot of people would say, ‘I don’t have a right to healthcare. I don’t have insurance. I can’t get my cavities filled. Why should this murderer or this thief or this sex offender get free healthcare when I’m not? That’s probably one of the reasons there hasn’t been more outrage.”

But under the Affordable Care Act, more Americans will have coverage, and voters may begin to see it as a moral right. They may also tire of spending a billion dollars a year on corrections. “Lawmakers now realize that you can build new prisons, or you can build college classrooms, but you can’t do both," said Eber.

Marc Mauer heads the Sentencing Project in Washington, DC - a non-profit that does research and lobbies for alternatives to prisons. “And I think there’s also growing recognition that it doesn’t do much good to just sound tough on crime, we need to be smart on crime.  We need to be looking at policies and programs that can actually provide safety, not just sound good in election campaigning.”

Four Northern Virginia legislators - Senator Adam Ebbin and Delegates Patrick Hope, Charniele Herring and Tom Rust - have been pressing for prison reform, and the Department of Corrections has a new program that allows inmates to earn their way out of solitary.

The state claims it’s cut the number of inmates in administrative segregation by 58% since it began using the Step-Down program two years ago. It also reports a 56% reduction in prison incidents and 23 percent fewer inmate grievances, so that trend seems likely to continue.
Virginia’s parole board has rarely made use of the geriatric provision that allows early release of elderly inmates. Often, model prisoners are told no, because they committed a serious crime, essentially ignoring the idea that prisoners can be rehabilitated. By law, inmates are only considered for geriatric parole if they apply, but Delegate Hope says few do. “A lot of inmates are so disgusted with the whole parole board process. They get rejected so much. People that are in their 60’s and 70’s, they’re not violent offenders. They’re no threat. I think we should consider them for release.”

The legislature could change the law - bringing cases of elderly inmates to the board automatically, and if a new governor appoints a more lenient board, more prisoners over 60 could be released.  Lawmakers might also want to follow the U.S. Attorney General’s lead in doing away with mandatory sentences for drug-related crimes.   

Former Virginia Beach businessman Steven Colosi, who’s been behind bars for more than a decade, says excessively long sentences have made it impossible for some inmates to go home. “What’s happening is in many cases they’re keeping us in here so long that they’re losing any ability re-connect to family or community. You know your family passes away, and some of these guys have nowhere to go.”

The state may also face up to a serious medical problem spread by IV drug use, tattooing and sex in state prisons - a viral liver disease that can kill. “Hepatitis-C is a huge problem in prisons. It’s very expensive to treat. So there’s a real hesitancy of correctional systems to start treatment. It takes months + and a lot of systems have put restrictions on accessibility of hepatitis-C treatments," said Eber.

Unlike neighboring Maryland, Virginia doesn’t even screen for hepatitis-C, and public health officials warn that as infected prisoners leave state correctional centers, they could bring an epidemic of this disease into the community.

One other area to watch is privatization. Some observers, like Gabe Eber, Staff Counsel to the ACLU’S National Prison Project, say government alone should administer prisons and the health care they provide: “By adding a private, for-profit corporation in there, you’re changing the nature of the punishment. You’re giving this corporation considerable power over prisoners who are in the custody of the state, and when you put a profit motive into the provision of health care, it may not necessarily be in the interest of the taxpayers or of equal importance the prisoners.”

But the business of caring for prisoners appears to be a profitable one, and companies pay to play. Corizon, Virginia’s largest provider of medical services to prisons, paid lobbyists here more than $21,000 this year, and its CEO gave $500 to the campaign of Republican Ken Cucinelli.

Another provider, The GEO Group spent nearly $15,000 on lobbyists, and one of their top competitors, Armor Correctional Health Services, contributed $25,000 to the campaign of Democrat Terry McAuliffe.

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Audio file