Prisons are criticized for health care

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Keri Blakinger’s “Inside Out” is a partnership between NBC News and The Marshall Project, a nonprofit newsroom covering the US criminal justice system. The column draws on Blakinger’s unique perspective as an investigative and formerly incarcerated journalist.

When the coronavirus hit the Federal Bureau of Prisons last year, the top official responsible for overseeing health care and safety in more than 120 prisons was Nicole English, a career correctional officer with a degree from graduate studies in public administration and no practice. health care experience. When she changed roles during the height of the pandemic, her replacement, Michael Smith, also had no formal medical training.

I would seriously question his understanding of science, but he was a nice guy, said Bill Axford, union president at Rochester Medical Prison, Minnesota, where Smith previously worked as an assistant principal.

Axford said that when he expressed concerns that radon, an odorless radioactive gas that can cause lung cancer, could pose a danger to parts of the prison, Smith initially dismissed the potential threat. . He was saying things like, Radons not real, Axford said. Axford said that after sending Smith an email from an expert on the dangers of radon, Smith agreed to take the threat seriously. On another occasion, Axford said, Smith said he believed sunscreen, not the sun, caused skin cancer.

Another union official, who declined to be named for fear of reprisal, claimed the Oxfords account.

Union leaders, prison health workers and inmate rights advocates said it was troubling officials in the health services division of federal prison systems during the Covid-19 crisis were unlicensed medical. Nearly 50,000 federal prisoners tested positive for Covid-19 last week, and at least 258 have died. The Prisons Bureau was criticized last year by politicians and union leaders for pressuring guards to come to work sick, failing to follow its own pandemic plan and purchase masks Counterfeit N-95.

That’s why our agency is down, said Joe Rojas, a union leader who works at the Coleman prison complex in Florida. You have people who are not qualified and you have a medical pandemic, but the management has no medical training.

Neither Smith nor English responded to requests for comment. Agency spokeswoman Randilee Giamusso defended the Bureau of Prisons’ response to the coronavirus as swift and effective, but declined to comment on Smith’s or Englishman’s qualifications beyond sharing their published biographies.

Instead, she wrote in an email that in their roles as deputy directors in charge of the health services division, English and Smith oversaw a range of highly trained subject matter experts who can help define policies and making decisions. These include the agency’s medical director, who is the final health care authority for the office, Giamusso said.

But as some critics have noted, the head of the health services division is the one who signs some of the most important medical policies and standards, including Covid-19 protocols and home containment guidelines.

Concerns about medical care and the qualifications of those responsible for it, from administrative leaders to staff who treat patients, are not unique to the federal system. From California to Alabama, reports and public records show that prisons routinely hire underqualified and even disgraced medical staff.

The nonprofit National Commission on Correctional Health Care has requested since 1999 that medical staff in prisons and prisons have the same credentials as those working outside, in settings such as hospitals. But states often allow prison medical staff to work under restricted licenses due to past disciplinary issues and critics say this is part of why prisons were so ill-equipped to deal with the coronavirus.

For people who are indoors, it’s not always clear what the credentials of the person caring for them are, said Andrea Armstrong, a law professor at Loyola University in New Orleans who has studied the medical care in prison. They generally feel that they are finding people who cannot find employment anywhere else.

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Outside of prison, most patients can avoid bad doctors by researching and choosing another doctor, but those behind bars cannot.

When I was locked up in New York ten years ago, our verification process was reduced to rumors and fear. Don’t go to that doctor, he’s fumbling with people, a friend of mine warned me. This nurse only gives you medicine if she likes you, said another. There were stories of women having had their bad teeth removed or taking the wrong medicine, or a woman who was so constipated that she became septic and died. We generally weren’t sure if the rumors were true, but we knew they could be and we made our healthcare decisions accordingly.

Sometimes this meant that we were refusing medical care or simply not seeking it. During the pandemic, prisoners from New York to Texas to California told me they were hiding signs of illness or refusing treatment because they did not trust prison officials or medical staff. This suspicion is one of the reasons some incarcerated people are still hesitant to get vaccinated, The Marshall Project reported. Just over 46% of American prisoners received at least one injection, compared to over 66% of adults in the general population.

I actually refused the shot because I was so scared to get it here, a federal prisoner told me in June. She asked to be identified only by her first name Jenny for fear of reprisal, and said that during her time behind bars, she had an untreated hernia in her chest and had stopped taking medications that seemed necessary, including antihypertensives and antidepressants. . I have a feeling we have medical staff who don’t know how to do their job properly.

Ultimately, Jenny agreed to be vaccinated only because she had read articles about judges who had refused compassionate release to some prisoners who refused injections.

Armstrong, the law professor, said states often allow medical professionals who are not licensed to work in hospitals and private practices to work in institutional settings like prisons.

Recently, a BuzzFeed News investigation found that 10 of 12 Louisiana prison doctors, including six medical directors, had a history of license restrictions or suspensions for everything from fraud to child pornography convictions. The report came weeks after a federal judge ruled that medical care at the state’s largest prison was constitutionally inadequate. A prison spokesperson did not respond to a request for comment, but previously told BuzzFeed that hiring practices meet state medical board standards.

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In Georgia, the state paid more than $ 3 million to settle lawsuits involving two doctors, including a Dr Yvon Nazaire who was hired as a medical director while still on probation in another state. Once he moved to Georgia, he was accused of mismanaging the medical treatment of nine deceased women, and a woman who found herself in a vegetative state after Nazaire and other prison officials ignored her medical distress and accused her of faking her symptoms, her family said. in a lawsuit. He did not respond to requests for comment this week, but the Atlanta Journal-Constitution previously reported that Nazaire was fired in 2015 and allowed his medical license to expire before the state could sanction him. At the time, the newspaper also reported that he had defended the quality of his care. A Georgia prison spokesperson asked questions of a contractor who manages medical staff, who did not respond to a request for comment.

Investigations and court records show a history of equally troubling hiring decisions in prisons in California, Florida, Illinois, Kansas, Mississippi, Oklahoma and Texas. Some states have said they have looked at doctors on a case-by-case basis and provided adequate care, according to the Associated Press and The Appeal. A few states said they couldn’t find enough doctors otherwise, or couldn’t compete with private practice salaries, according to The Oklahoman and Prison Legal News.

Union leaders blamed federal prison systems for mismanaging the pandemic on superiors who lack medical expertise, such as the deputy director overseeing the health services division.

For 19 years this post was held by a doctor specializing in infectious diseases. In 2016, a psychologist took over the role, and three years later, English got the job. She had previously worked as a babysitter, case manager and babysitter.

A year later, Smith returned to work. Previously, he attended Pikes Peak Community College in Colorado, spent six years in the military, and worked his way up the prison system from correctional officer to director of a federal medical prison.

Some prison officers, including Aaron McGlothin, president of the Mendota Federal Prison Union in California, said the agencies’ handling of the pandemic was proof of the need for more medical expertise among systems leaders.

They spent $ 3 million to buy UV portals, McGlothin added. They said these killed the coronavirus but were not approved by the FDA.

This is something he considered when he refused to get the vaccine at work and instead waited several weeks to get the vaccine on his own.

I don’t trust the agency, he said of the Bureau of Prisons. I don’t put my health and safety in the hands of the BOP.

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