The Real Cost of Prisons Weblog

But the alleged substandard practices of Prison Health Services, a Tennessee contractor exposed in articles by The New York Times and published in the Times Union, aren't limited to a single company and aren't merely a byproduct of privatization. They go on in many prisons in New York where health care is rendered by the state itself and health complaints of inmates are treated suspiciously, late and, often, not at all.
Consider the case of Andre Davidson. His mother and three children received a $900,000 settlement in 1999 after Davidson, 29, died at Green Haven Correctional Facility in Dutchess County from a series of worsening, and untreated, asthma attacks.
In 2001, Ibn Kenyatta won a $1 million settlement after his grossly distended bladder was ignored by Fishkill prison staff until his kidneys failed and he was rendered permanently unable to urinate.
And the state was held 100 percent liable the same year in the death at Cayuga prison of James Wooten, who knew he was lapsing into congestive heart failure and had desperately sought help. His young son was awarded $338,000.
As with Prison Health Services, state prison administrators have been sharply criticized by the Commission of Correction, a three-member board that investigates jail and prison deaths. But because it works for and is appointed by the man at the top of state government, George Pataki, the commission has not been nearly as strident in speaking out about care in state prisons as it has in county jails.
The Times series told of people who died unnecessarily from allegedly shoddy and indifferent care -- from a nuclear scientist denied his Parkinson's medicine at the Schenectady jail to a 35-year-old woman who was given Bengay during 10 agonizing days of chest pains at the Dutchess County jail. The commission's chair called Prison Health, which was contracted to provide health care in those facilities, "reckless and unprincipled in its corporate pursuits, irrespective of patient care," the Times reported.
Ironically, the commission has repeatedly found many of the same failures of care at state prisons, linking the deaths of inmates to poorly kept medical records, poorly dispensed medications, inadequate staff and tragically belated care. Twice in 2001, mentally ill inmates starved to death after obvious physical and psychological signs of distress were ignored, it found. And as at Rikers, state prison officials have been chastened at least two dozen times in recent years for lapses in mental health care that preceded suicides. Inmates, the commission reported, were abruptly dropped from care, denied medication or treated as if they were feigning illness.
But, contrary to its conclusions concerning Prison Health Services, the commission has shown little inclination to blame the system that produced those failures. Nor has it insisted that action be taken when prison officials have either disputed its findings or failed to discipline staff faulted by the commission.
The problem is first that the commission has no power to enforce its delicately labeled "recommendations." But secondly, it has an inherent conflict of interest as gubernatorial appointees, which neutralizes the reporting power it does have. Commission reports are often used in lawsuits filed by the families of dead inmates; as a result, the commission's findings in recent years have become increasingly cryptic and restrained. That is, except when criticizing -- rightfully, it would seem -- entities such as Prison Health Services.
A separate but related issue is the failure of state law to subject prison health care to the same scrutiny afforded other hospitals and clinics in the state, which are regulated by the state Health Department. Not so prisons. A pending bill would change that.
State-rendered prison health care may not be riddled with the type of "shocking incompetence and outright misconduct" that, according to the Times, the commission says it found in jails under contract with Prison Health. But there is little doubt that serious problems exist in inmate health care, as judges and their appointees have found.
At Green Haven prison, eight inmates died from 1992 to 2000 after receiving inadequate care -- even as the prison, the target of a class-action lawsuit over health care, was under the scrutiny of a court-appointed monitor. One inmate died of untreated meningitis, another of a staph infection ignored for six months. Significantly, most of those deaths were not even reviewed by the commission, which focuses almost exclusively on suicides. But for the lawsuit, they would likely have gone unnoticed, as many deaths do.
The need for commission independence and enforcement power is urgent. An estimated 10,000 inmates suffer from Hepatitis C; another 6,000 are infected with HIV. Complaints about substandard care are legion. When inmates are released sicker than when they went in, community systems are stressed and families suffer. Moreover, prisons have a moral obligation to care for people at their literal mercy when they get sick.

At a hearing on prison health care last year, Sister Antonia Maguire, a prison chaplain for 30 years, said she'd seen cancer patients wait months for care and HIV-positive inmates go without medicine.
"To be aware of such situations and to say nothing would make me a part of them," she said. "I cannot live with that on my conscience."
Would that the Commission of Correction had such fortitude.

Mary Beth Pfeiffer, who has reported extensively on state prisons, recently spent a year as a Soros Justice Media Fellow. Her e-mail address is marybethpf@aol.com.

All Times Union materials copyright 1996-2005