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30,000 Inmates, 40 Doctors: Health Care Remains A Concern At Virginia Prisons

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There are 40 doctors for the 30,000 inmates housed in Virginia prisons.
Alan Meiss: http://www.flickr.com/photos/25357031@N00/2952399609/
There are 40 doctors for the 30,000 inmates housed in Virginia prisons.

The United States has more people in prisons and jails than any other country in the world — 2.2 million inmates, and correctional centers are so crowded that a court in California ruled it was impossible to provide adequate medical care. That state is now under orders to release 9,600 inmates.

In Virginia, the issue isn't how many inmates the commonwealth has, but rather how they are cared for. A lawsuit over prison care is pending, and this year the General Assembly may consider more funding or reforms in how prison's provide medical and mental health care to inmates.

Shocking stories from Commonwealth prisons

Virginia's Department of Corrections prohibits recording of interviews at many of its prisons, but inmates who were recently released paint a picture of neglect and indifference. At the Indian Creek Correctional Center in Chesapeake, 47-year-old Steven Jowers recalls what happened to his friend Fly.

"I watched him lose like 50 pounds in like three months, and he died like a month later of pancreatic cancer. Stage four. They never went and tested him. They never did anything. Three weeks later, a friend of mine, Gary Graves, went to medical and said, 'I'm having chest pains,' and they gave him two Advil and told him to sign up for sick call. Well at 5:30 in the morning, when they woke everybody up for count, he was dead. He had a heart attack during the night," says Jowers.

Similar stories also come from the state's main prison for women. Abigail Turner, a lawyer for the Legal Aid Justice Center, has filed suit on behalf of several inmates, including Jeanna Wright. Turner says Wright complained to the prison nurse about intense abdominal pain and rectal bleeding for a full year before having a thorough exam.

"She was finally referred to the University of Virginia. There she was diagnosed with stage four abdominal cancer, and she died in April of 2012," she says.

Virginia gets about 2,000 complaints annually relating to health care, but the Department of Corrections cites the need for medical privacy in refusing to discuss individual cases.

Ten years ago, the state's chapter of the American Civil Liberties Union issued a report on prison medicine, complaining of deliberate neglect, unnecessary deaths, botched surgeries, and policies that put cost above the health and welfare of patients. Since then, ACLU attorney Hope Amezquita has seen no improvement.

"It seems to have gotten worse! We don't know a lot, and what we do know is not good," she says.

No incentive to treat

Amezquita says crowding is a problem, and she points to one other potential issue — care at many facilities is provided by a private company, Nashville-based Corizon, which has contracts for 500 prisons in 29 states including Virginia, Maryland, and the District of Columbia.

"It doesn't take a rocket scientist to know that their mission is to make money. It may be cynical of me to say this, but you can t make more money unless you cut services and treatment and staff," she says.

Corizon refused a request for an interview, but on its website the company claims to keep expenses down through economies of scale, emphasis on preventive medicine and efficiencies it has developed as a firm focused solely on correctional care.

The company says it saves prisons and jails an average of 15 percent on medical services and has an excellent record of fighting lawsuits, with 91 percent of inmates who sue getting no compensation.

Staffing varies from state to state and prison to prison, but Virginia has 40 doctors to care for 30,000 prisoners. It depends day to day on about 700 nurses, some of whom hold licensed practical degrees which require as little as one year of training.

Psychiatric care a long-term concern

When it comes to inmates' mental health, the state has 14 psychiatrists to care for those 30,000 inmates. Marc Mauer, executive director of the Sentencing Project, a non-profit advocacy group in D.C., says most correctional centers are unprepared to deal with a psychiatric tsunami.

"About one of every six people in prison has a history of mental illness. Often times it's dealt with through medication without a lot of individualized attention," he says.

Advocates say there are also problems in county and city jails. Harvey Yoder, a clergyman and family counselor who often visits the Harrisonburg Regional Jail, objects to the treatment of patients deemed suicidal.

"A person is stripped of their clothing and given a paper gown to wear, and the cell itself has nothing in it, no mattress or anything. There's a grate in the floor that has to be used for a commode. It's just abominable," he says.

Yoder says prisoners who pose a physical threat to themselves or others can also be put in a restraining chair, with their arms, legs and torsos strapped down for hours. We made repeated calls to the county sheriff to talk about that, but he did not respond.

Four Northern Virginia lawmakers have led the charge to improve mental healthcare in prisons. Senator Adam Ebbin and Delegates Patrick Hope, Charnielle Herring and Tom Rust have urged the Department of Corrections, for example, to stop putting inmates in isolation. Hope, who represents Arlington, says it's in the best interests of the inmates and everyone else.

"About 90 percent of all the prisoners in Virginia will one day get free, and when you put someone in isolation for long periods of time, they become seriously mentally ill, and I worry about their next victim, I worry about their next crime," he says.

Change possible, but not guaranteed

One other factor may soon force Virginia and other states to make changes. It costs about $25,000 a year to keep a single person in prison here, and the price tag more than doubles after age 60. Stephen Colosi, an inmate at the Buckingham Correctional Center, took time to crunch the numbers and shared them with us from a pay phone in the prison.

"There's 1,100 inmates in here right now that are over 60, and if you multiply that times 68,000, that's $74 million. Now for $2,300 a year you can put an ankle bracelet on a man and monitor his whereabouts 24/7. So for $72 million savings, you could hire a lot of teachers, police officers and youth counselors for these kids," he says.

More than 1,000 inmates in Virginia have been eligible for parole under the geriatric provision of the law. Elderly prisoners who've served part of their sentence can be released early if they're not deemed a danger to society, but only 40 have been freed since 2001.

Under a new governor with a new parole board, more elderly inmates could be released. What seems unlikely to change is the role of private, for-profit healthcare companies. Over the last decade, they've spent more than $165,000 on campaign contributions and lobbyists in Virginia.

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