Lawyers are back in federal district court over care at the state’s medical prison for women. They complain that underqualified nurses are diagnosing conditions and prescribing treatment, that care is often delayed and communication is lacking. Sandy Hausman has details.
The latest complaint from the Legal Aid Justice Center was filed on behalf of a woman who claims she couldn’t get consistent treatment for a dangerous condition called pulmonary hypertension.
“She depends on a life-saving medication that has to be administered every two days," says Shannon Ellis, an attorney with the Legal Aid Justice Center. "She's been hospitalized at UVA and at VCU multiple times because of failures to have her medication available, failures to have the pump necessary to administer it, administration of the medication in incorrect amounts so that she has symptoms of toxicity.”
Earlier this year Legal Aid asked a judge to make Virginia’s Department of Corrections live up to its promise of improving healthcare for all inmates at Fluvanna. Among other things, the state pledged to hire 78 more nurses, but Ellie says the prison should do more.
“The judge’s order did not specify what level of qualifications the nurses needed to have, and a historic problem at Fluvanna and at prisons across Virginia is very underqualified medical professionals.”
A registered nurse, for example, has a bachelor’s degree, while a nurse-practitioner has a master’s. Most of those hired to work in state prisons, however, are licensed practical nurses with about a year of training, and they’re not supposed to diagnose disease or prescribe treatment.
Inmates also complain about some of the doctors on staff. Margaret Breslau, who heads the Coalition for Justice in Blacksburg, has heard their stories.
"A woman, after trying to get on sick call for ever and ever and ever finally gets to see an OB/GYN, and they discover a mass the size of an eggplant. She has had pain. She’s had bleeding. The doctor tells her – and she has the paperwork on this -- to eat more vegetables."
After an ultrasound, the doctor told Shebri Dillon she would need an operation.
“She told me that I was definitely going to have to have surgery, that they were going to have to remove this thing.”
But a second scan, this time an MRI, showed nothing, so the mother of four is left wondering what’s causing her pain. She’s worried, because this is not the first time she’s had problems with prison care.
“I had a tooth pulled, and I kept telling them, ‘It still hurts. I think it’s infected. They still didn’t have me on the appointment list. It’s starting to smell. It is killing me, so I got a bunch of Q-tips and a bunch of salt from the chow hall, and I dug out the infection with the Q-tips and packed it with salt from the chow hall.”
She calls that Civil War medicine and says plenty of inmates are resorting to home remedies when they’re unable to get professional care at the prison. The Department of Corrections refused to comment and would not allow us to interview Dillon in person – deeming it a security risk for a radio reporter to visit Fluvanna with a recording device.
Back at the Legal Aid Justice Center, attorney Shannon Ellis adds that Fluvanna is not the only place providing inadequate care.
“At Goochland Women’s Prison, which is about 20 miles down the road from Fluvanna. the same practices that led to our lawsuit against Fluvanna are going on, for example, LPNs conducting sick call. Having these underqualified nurses making diagnostic decisions is something the Department of Corrections is clearly aware is an unacceptable practice.”
And there are plenty of worrisome stories from men’s prisons – this despite the fact that Virginia spends nearly 20% of its billion dollar budget for corrections on healthcare.
PART TWO: MORE SIGNS OF A FLAWED SYSTEM?
Despite lawsuits over prison medicine and state promises to do better, Virginia may still be facing a healthcare crisis behind bars. A federal court says the state is not providing adequate care at the Fluvanna Correctional Center for Women, and critics say there are problems elsewhere in the system as Sandy Hausman reports.
Despite lawsuits over prison medicine and state promises to do better, Virginia may still be facing a healthcare crisis behind bars.
The Virginia Department of Corrections is this state’s most expensive agency – costing taxpayers well over a billion dollars a year, and 17% of that money goes to providing medical services for inmates. Even so, prison rights advocates say care is inadequate.
Shannon Ellis is with the Legal Aid Justice Center – representing prisoners in an on-going legal fight to make things better at Fluvanna. She’s encouraged by the appointment of a new director – a doctor who has practiced at the Mayo Clinic and the University of Virginia.
“We are very happy that the department has hired Dr. Paul Targonski as the new medical director of the prison, and we have a lot of confidence in his skill and his desire to improve conditions at the prison, however he’s working within a system that remains poorly funded and has a culture and history of not providing good care.”
One reason – most care is provided by licensed practical nurses with just one year of training. Another, Ellis says, is too few prison guards.
“Correctional officer availability has a direct impact on prisoners’ ability to access medical services. You need the correctional officers to walk them over to the medical building. You need the correctional officers to drive to the outside hospital to get the specialist care, and if you’re short on correctional officers you’re going to be delaying that care.”
Delays are a problem throughout the system according to Margaret Breslau, director of the Coalition for Justice in Blacksburg. She corresponds with 200-300 prisoners a month on average, and many have complaints about medical care.
“Around Thanksgiving, an inmate was in the chow hall, and he was stabbed in the head and bleeding. Gets sent to the nurse. She puts medical glue on his head to stop the bleeding, and then he never got any other follow-up. He’s got dizziness. He’s got headaches. Another inmate had all of his teeth extracted in May of 2018. In January, I still haven’t been called in to be fit for dentures.”
Dental care is also lacking at Fluvanna, according to inmate Shebri Dillon.
“There’s a mass of people in the compound who are toothless and have been waiting years for teeth.”
Critics also worry about uneven supplies of prescription drugs. The department of corrections is now facing suit by a woman who’s been hospitalized repeatedly, because Fluvanna can’t seem to get her medication right. Again, inmate Shebri Dillon.
“It is a fear, and inherent fear with all the women here, that if you get sick it could possibly be fatal.”
To complicate matters, the prison system discourages inmates from getting prompt attention by charging a $5 co-pay. That might not seem like a big deal, a reason to delay medical attention, but prison reform advocate Margaret Breslau says hourly earnings for inmates are low.
“If you’re lucky enough to have a job in a prison, 49 cents is the high end, 29 cents is the minimum. That doesn’t get you very far.”
And, finally, she says, conditions in prison are, themselves, unhealthy. Hundreds of people crammed into small cells with limited access to fresh air, fresh food and sunlight.
“You have black mold. You have poor ventilation. You hear about water being brown. We hear about toilets being broken, water rationing for showers, a lot of them don’t have air conditioning.”
This spring, a monitor appointed by the federal district court in Charlottesville is expected to report on efforts to improve conditions at Fluvanna.