HRDC/PLN Newsletter – The steep cost of medical co-pays in prison puts health at risk

April 19, 2017

Prison Legal News, a monthly print publication that covers criminal justice issues, is a project of the Human Rights Defense Center, a 501(c)(3) non-profit organization.
The steep cost of medical co-pays in prison puts health at risk
If your doctor charged a $500 co-pay for every visit, how bad would your health have to get before you made an appointment? You would be right to think such a high cost exploitative, and your neighbors would be right to fear that it would discourage you from getting the care you need for preventable problems. That’s not just a hypothetical story; it’s the hidden reality of prison life, adjusted for the wage differential between incarcerated people and people on the outside.
In most states, people incarcerated in prisons and jails pay medical co-pays for physician visits, medications, dental treatment, and other health services. These fees are meant to partially reimburse the states and counties for the high cost of medical care for the populations they serve, which are among the most at-risk for both chronic and infectious diseases. Fees are also meant to deter people from unnecessary doctor’s visits. Unfortunately, high fees may be doing more harm than good: deterring sick people from getting the care they really do need.
A $2-5 medical co-pay in prison or jail may not seem expensive on its face. But when we consider the relative cost of these co-pays to incarcerated people who typically earn 14 to 62 cents per hour, it’s clear how they can be cost-prohibitive. To compare the cost of medical co-pays in prisons and jails to what people pay on the outside (relative to the wages available to each population), I first calculated how many hours of work it would take a low-paid incarcerated person in each state to pay for one co-pay. Then, I translated this hourly cost into the wages earned by a minimum wage, “free world” worker in the same state.
Does Solitary Confinement Make Inmates More Likely To Reoffend?
As a teenager, Adam Brulotte relished the attention he received from getting into fights at parties. When he was 18 years old, he was arrested for burglary and aggravated assault after punching a man and breaking his jaw in seven places.

Brulotte arrived in Maine State Prison in 2012 to serve a two year sentence for violating his probation.

There, he was sent to solitary confinement for starting a riot on his cell block. During the approximately four months he spent in isolation, Brulotte cut himself, flooded his cell with toilet water and pushed feces under his door. Each incident earned him more time in solitary confinement.

Once he was released, Brulotte tried to find a sense of normalcy. He started dating, got a job at a local convenience store but soon ended up back in jail for driving without a license, an assault and failing to pay court fines.

“It leaves a scar on you that you won’t forget and you can’t heal … you get flashbacks and anxiety,” he said of solitary.

How many people die each year in the American prison system?
Each year, hundreds die in the nation’s prisons and jails.
Drugs, suicide, homicide, and more natural causes, like age or heart disease, are often to blame for the fatalities, but exactly how many pass away while in custody each year is not completely clear. The Bureau of Justice Statistics, the federal agency tasked with keeping track of nationwide data for the Department of Justice, has used its Deaths in Custody Reporting Program to compile a report on mortality at local jails and state prisons, but the numbers gathered are neither comprehensive nor recorded and reported in real time. Last year, the Huffington Post underwent an extensive effort to determine the number of deaths in local jails, finding that a complete record was prohibitively difficult to obtain and highlighting the importance of keeping such statistics for very-short term facilities.
The most recent BJS report on mortality in local jails was released in December 2016, covering the period from 2000-2014 for 2,870 reporting jail jurisdictions, included a similarly striking case to be made for focusing on deaths occurring in the first few days after an arrest and before a conviction. The most recent numbers from 2014 indicate that nearly three-quarters of inmates passed away before they had been convicted of a crime; forty percent of deaths happened within a week of arrest.

Trump’s America: For-Profit Prisons, Immigrant Detention and Shady Political Donations
The Trump administration recently awarded a $110 million contract to the GEO Group, one of the country’s largest private prison contractors, to develop and operate a new detention facility in Texas.
Despite the fact that last summer the Obama administration announced a phase-out of private prisons, the industry was granted a lifeline during the 2016 election when Trump publicly backed private prisons and expressed his support for the detention and deportation of millions of undocumented immigrants. During the campaign, GEO Group (formerly Corrections Corporation of America) donated $225,000 to a pro-Trump super PAC. Following the election, the Trump administration quickly reversed Obama’s policy and proceeded to grant GEO Group the lucrative contract.
In response, last year the Campaign Legal Center (CLC) filed a complaint with the Federal Election Commission, claiming that the GEO Group donation violated the contractor contribution ban. More recently, on March 1, CLC submitted a FOIA (Freedom of Information Act) request with the Bureau of Prisons and Office of Inspector General at the Department of Justice (DOJ) to find out why the DOJ made the decision to reverse the Obama order.
For-profit prisons and immigrant detention centers are far from new, nor is their political spending. According to a report from Free Speech For People:
Between 2000 to 2012, GEO and CoreCivic (along with another small company) have spent more than $32 million on campaign contributions and lobbying for the federal level alone. In 2014, CoreCivic and GEO spent well over $3 million lobbying Congress and more than $500,000 on federal campaign contributions.
New Analysis: Crime, Violence, and Murder Remain Near Historic Lows
Crime rates have dropped dramatically and remain near historic lows, despite localized increases in some places, according to a new report from the Brennan Center for Justice at NYU School of Law analyzing data from the last quarter-century.
In Crime Trends: 1990-2016, a team of economics and policy researchers analyzed data from the Federal Bureau of Investigation and directly from police departments in the nation’s 30 largest cities. Several key findings:
  • Overall Crime Rate: Since its peak in 1991, crime has fallen by more than half, from 5,856 crimes per 100,000 people to 2,857 crimes. Crime in 2016 remains near historic lows. Though the murder rate has increased in some cities, there is no evidence that the hard-won public safety gains of the last two-and-a-half decades are being reversed.
  • Violent Crime: Since its peak in 1991, violent crime has fallen by approximately half, going from 716 violent crimes per 100,000 people to 366 crimes. Like rates of overall crime and murder, the violent crime rate has risen and fallen without disrupting the long-term trend downward. For example, there were small increases in 2005 and 2006, and then numbers resumed a downward trend. Researchers project the 2016 violent crime rate will increase 6.3 percent nationally and 2.4 percent in the nation’s 30 largest cities, remaining near historic lows.
  • Murder: From 1991 to 2016, the murder rate fell by roughly half, from 9.8 killings per 100,000 to 5.3. The national murder rate rose in 2015 and 2016, but this was caused by spikes in a few locations. For example, murder rates in the 30 largest cities increased by 13.2 percent in 2015, with half of that increase attributed to Baltimore, Chicago, and Washington, D.C. The murder rate went up an estimated 14 percent in 2016, with Chicago causing almost half of that increase. Additionally, with murder at historic lows, modest increases may appear large in percentage terms.
  • City-Level Analysis: The report provides detailed data on overall crime, violence, and murder for the 30 largest cities in America from 1990 to 2016. Numbers show that crime trends vary from city to city.
“Our analysis shows that crime has been going down the last quarter-century and remains near historic lows,” said Ames Grawert, a counsel in the Brennan Center’s Justice Program and an author of the analysis. “There are some local spikes that are concerning, but the numbers simply don’t back any claims of a national crime wave.”

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From the PLN in Print Archives
In a decision sure to reverberate throughout the nation’s criminal courts, in March 2017 the U.S. Supreme Court reversed the conviction of a Colorado defendant charged with sexual battery due to a juror’s racially discriminatory comments during deliberations. According to Justice Anthony Kennedy, “Racial bias implicates unique historical, constitutional, and institutional concerns.”

In a majority opinion joined by five of the eight justices currently on the Court, Justice Kennedy wrote, “An effort to address the most grave and serious statements of racial bias is not an effort to perfect the jury but to ensure that our legal system remains capable of coming ever closer to the promise of equal treatment under the law that is so central to a functioning democracy.”

Jurors are normally inoculated from having their decisions scrutinized and overturned pursuant to Federal Rule of Evidence 606(b), which sets forth a broad no-impeachment policy, with only limited exceptions, to provide finality to jury verdicts.

However, many jurisdictions have recognized exceptions for juror comments that exhibit racial bias during deliberations, and three federal Courts of Appeal have held there is a constitutional exception based on evidence of racial bias.

Miguel Angel Peña-Rodriguez was charged in Colorado state court with the sexual assault of two teenage sisters. A jury was empanelled and the jurors were asked whether they could be fair and impartial. All responded affirmatively. Peña-Rodriguez was found guilty of unlawful sexual contact and harassment, sentenced to probation and required to register as a sex offender.

According to the Supreme Court, two jurors disclosed that “during deliberations, another juror had expressed anti-Hispanic bias toward petitioner and petitioner’s alibi witness…. According to the two jurors, [that juror] “told the other jurors that he ‘believed the defendant was guilty because, in [his] experience as an ex-law enforcement officer, Mexican men had a bravado that caused them to believe they could do whatever they wanted with women.'” The unnamed juror also reportedly said, “I think he did it because he’s Mexican and Mexican men take whatever they want.”

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Hawaii: Union Says Suspensions Shouldn’t Stop Prison Guard Promotions
by Ian Lind
This little item left me sputtering and trying to keep my coffee from spewing across the computer keyboard.
It seems the United Public Workers, the union which represents some 13,000 state and county blue collar workers, including about 1,200 prison guards, believes the Department of Public Safety is violating the state constitution and state law by refusing to promote prison guards into supervisory positions if they have been suspended from their jobs within the previous two years.
Of all things, the union says refusing to promote prison guards with recent suspensions violates the “merit principle.”
That’s the idea that people should be hired and promoted in public sector jobs based on merit, on their ability to perform the job, rather than because of their political clout or family connections.
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New ‘Hire American’ order should not include prisoners
Yesterday, President Trump signed an executive order enforcing his administration’s worthy concept to “Buy American and Hire American.”
Unfortunately, while the program is well-intended, there exists a hidden flaw within the confines of the announcement. That issue was not addressed in today’s executive order.
When the government buys apparel for the military (or other federal institutions under the guidelines of the Berry Amendment), instead of giving first dibs to private domestic contractors, it allows the federal prison system to grab the business. That’s right, our prisons get priority to bid on uniform manufacturing!
The group creating this issue is a division of the Federal Bureau of Prisons (BOP), operating under a work program called the Federal Prison Industries (also known as UNICOR). They profess to do all things good for prisoners, but their efforts (and growing business model) retain the power and the ability to put legitimate U.S. apparel makers out of business.
How can that be? Is our own government unintentionally forcing hard-working American firms to shut down? Well, yes, it’s quite true, because these independent contractors lose orders to UNICOR due to a requirement that the U.S. military “mandatory source” their apparel from the prisons, before going to the private sector.

Was an Attack on Tennessee Correction Officers Truly “Unprovoked?”
On April 8, 2017, three correction officers were injured at the Turney Center Industrial Complex (TCIX) in Only, TN allegedly by 16 inmates with possible “security threat group,” or gang, affiliations.
One of the officers was reportedly taken hostage by the inmates for approximately three hours.
All three were hospitalized and are now “recovering at home,” according to the Tennessee Department of Correction (TDOC).
The agency has said that the attack on the correction officers was “unprovoked.”
On Sunday, The Post & Email received an unsolicited email from an apparent observer to the TCIX incident who wrote, “As you know, there was, what TDOC is calling an “unprovoked incident” in Unit 3 at that prison last Sunday, April 8, 2017 that resulted in three officers being hospitalized. Attached is a letter that he sent out while the entire prison was on lock-down and no phone calls were allowed. As you will note, the story that TDOC told the media is far from what everyone, including those that were not even near Unit 3, are saying.”

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