The newspaper says the department agreed to the investigation to stave off a lawsuit. Report by ONDeadline.

Inmates who have lost sight, had body parts amputated or been severely disfigured, among other examples, say proper medical care could have prevented needless suffering, the newspaper reports.

A legal coalition that threatened the lawsuit charges that the department has been violating state and federal laws and the U.S. Constitution.

The newspaper says its own reporting, including interviews with current and former prisoners as well as a survey of dozens of complaint letters from inmates, raised similar concerns.

Among the allegations by inmates, prisoner advocates and attorneys:

• A diabetic prisoner, waiting months for insulin, lost sight completely in one eye and partially in the other.
• An epileptic who wasn’t given his medications suffered repeated seizures for weeks.
• A man with a growth on his penis was denied medical treatment for two years. Doctors ultimately diagnosed a cancerous tumor on his penis; the organ had to be amputated, and doctors told him the cancer had spread to his stomach.
• An inmate with a cancerous growth on his lip waited seven months for treatment. Most of his lip and mouth were removed, leaving him permanently disfigured.

Corrections officials say they have found no evidence of systemic problems, although they say pending plans to privatize prison health care have made it harder to fill medical-staff vacancies, The Republic reports.

The department notes that rule changes two years ago cut payment levels to outside contractors and crimped access to care.

“To the best of my knowledge, it has never been done here in Maine,” said Corrections Commissioner Joe Ponte. “I don’t know why it has not been used even though it has been available to a limited number of inmates.” Report by Bangor Daily News.

The federal Department of Health and Human Services informed states in 1997 that inmates that leave prison facilities and are admitted to a hospital for more than 24 hours and meet the poverty and other state rules of Medicaid are eligible for coverage. The federal government pays for roughly two-thirds of Medicaid, with the state paying the rest.

“We don’t have that many cases where this would apply, but there are some,” Ponte said. “We also are limited in that the inmate has to agree to apply for the Medicaid and they certainly won’t always do that.”

He said the department is actively working to shift medical costs from the state where possible. He said a program in juvenile corrections requires parents of children in the two state facilities to continue to cover their child on their private health insurance while the child is in state custody.

“We are exploring if there are any situations in the adult side where inmates have private insurance and whether there is any thing we can do there,” he said.

Ponte said he is doing whatever he can to cut costs through policy changes. He said there are many examples of medical procedures covered in the past that no longer will be approved. He said a recent example was the case of an inmate in his 60s who wanted rotator cuff surgery even though his arm still had good movement. It was denied because it did not meet the “medically necessary” standard used by insurers.

“We have also lowered drug costs just by comparing to the national average,” Ponte said. For example, he said the state has been paying $35 for a psychotropic prescription when the national average cost of the drug was $8.

Ponte said his efforts are aimed at reducing state health costs for inmates until 2014, when the federal health care reform act will cover all inmates with incomes less than 133 percent of the federal poverty level.

“That’s 95 if not 99 percent of the inmates,” he said. “That will be a significant savings because it will cover all health care costs under Medicaid, not just the hospital part.”

Sen. Richard Rosen, R-Bucksport, is the co-chairman of the Appropriations Committee and has served several years on the panel while in the House and Senate. He was surprised that the federal government had allowed even limited Medicaid coverage for inmates and that the state had not explored that option years ago.

“It’s a question that those of us on the committee have repeatedly asked over the years, whether or not inmates are eligible and can receive services through the program. If there is an opportunity there, we should explore it,” he said.

Rosen said the fact that some level of coverage has been available since 1997 and that the state has not taken advantage of it is both surprising and troubling. Rep. Peggy Rotundo, D-Lewiston, the Democratic lead on the panel and a former co-chair of the committee, agreed.

“We certainly should be looking at this again,” she said. “This is something that some of us have been talking about for a long time.”

Rotundo said the Department of Corrections should also look at other ways to leverage federal funds to help pay for corrections costs. She said with a growing number of inmates reaching old age, there should be consideration of a nursing home-type facility to house elderly inmates.

“We are already looking at that,” Ponte said. “We are looking at doing a lot of things differently.”

Rosen said the issue is sure to come up as lawmakers consider a supplemental state budget in the January session of the Legislature.

The state has no choice but to tend to their medical needs. Report by Fox10tv.com.

“It is a constitutional obligation to provide appropriate healthcare to our inmate population, regardless of their needs, and how expensive those might be,” said Gretl Plessinger of the Department of Corrections. “Forty-four percent our hospital days were because of inmates who are over 50-years-old. It cost about $53 a day to house an average inmate in the state of Florida. Of that $53, almost $12 goes into healthcare.”

That adds up to about $19,500 per year, per inmate, and they get pricier with age. According to the DOC, when an inmate turns 60, it takes an average of $70,000 to provide for them.

River Junction Work Camp

In Chattahoochee, Florida, many fit to give back to their community head to River Junction Work Camp .

“I’m keeping all the state vehicles looking as you can see quite well, nice and shiny, yes sir,” said inmate Jimmie Lee Kirkland.

Kirkland gets to do on the inside what was one of his favorite tasks on the outside – making cars look like new again. He’s serving five years for cocaine possession, but feels taken care of.

“They don’t treat like convicts or inmates; they treat us like we human beings like everyone else,” Kirkland said. “They don’t try to run us down or try to make us feel lower than we already are, they help us.”

Kirkland is receiving an education through River Junction.

Inside the facility, Edward Childress showed us how cells are traded for dormitory-style housing, which makes it easier to care for elderly inmates’ needs.

Childress, who’s serving 19 years for armed robbery, handles maintenance at the facility. He’s happy to be around his peers.

“With the senior citizens that are here at River Junction, we’re able to interact with each other on a calmer level, and I think the officers see that, and so they treat us accordingly to that,” Childress said. “So as far as the living conditions here, everybody gets along well. A prime example is one inmate can bump against another inmate here at River Junction and he’ll say, ‘Excuse me.”

Unfortunately, though, Childress and Kirkland are the minority.

Some of the state’s most violent offenders are taking the biggest portion of taxpayer money.

The Senate Steps In

By state law, criminals must serve 85 percent of their sentence.

The Florida Senate has tried changing that, offering programs which would release inmates early – if they could prove they’ve been rehabilitated.

The programs has failed every single time.

So the question is, do we set some inmates free, or lock them up for good?

“Floridians have to make a decision, and might have to make a decision at some point about the risks involved, and what they want to do, where they want to go from here,” Plessinger said.

Childress and Kirkland

Childress still has two years before he’ll return to his Pensacola family. He’s missed his children grow up.

When we spoke to Kirkland he only had 10 days remaining on his sentence.

“We call it the junction because it’s like a cross roads, if you make it to River Junction, you halfway there,” he said.

He was released Sunday, November 13.

Where we stand

According to the DOCA, Florida’s inmate population is on the decline, as they’ve been able to close a few facilities in recent years.

They say as attrition hits the regular inmates,the elderly prison population will start to decrease as well.

“It’s an unfortunate reality of the job that correctional officers are always attacked by inmates in prisons,” says Lyle Stewart, a spokesperson with the Union of Canadian Correctional Officers. Report by The Epoch Times.

Aside from the fact that it is not a pleasant experience for correctional officers to be attacked with urine, saliva, excrement, semen, and even bloody syringes, what is more worrying is the high rate of infectious diseases among inmates, explains Stewart.

“Inmates nowadays have higher rates of HIV infection and hepatitis C infection, and many other disease infections.”

But under Canada’s privacy laws, inmates’ health records cannot be surrendered to the attacked officer.

“The correctional officer has no right to know whether this inmate is infected with a deadly disease,” says Stewart.

As a result, even though it might not be necessary, some officers choose to follow a “post-exposure protocol”—a pharmaceutical regimen of several different drugs designed to ward off infectious diseases. However, the side effects of these drugs can be highly detrimental.

“The officer is often off work for many months, because it’s impossible to work when you follow a drug regimen like this,” says Stewart. “And while there is still a fear that someone may have contracted a deadly disease such as this, there are limits with their spouse and their children, and their other normal life and interactions are severely limited.”

Forcing attackers to release their health records could also act as a deterrent for inmates, Stewart says.

“[Inmates] know that the Correctional Service now interprets privacy laws in the way that they do. … So even if they don’t have a disease, sometimes it’s happened that they would lie—they would splash someone in the face with a cup of bodily fluids and say, ‘Ha ha, now you’re going to die, you’ve got my disease,’ even if it’s not true.”

Suzanne Leclerc, a spokesperson with Correctional Service Canada (CSC), says the department does not release inmates’ medical files “in accordance with the Privacy Act and provincial legislation related to the sharing of personal health information.”

Leclerc says the department has agreements with hospitals, clinics, and other health centres in close proximity to each institution across the country so that appropriate treatment is readily available.

“CSC’s current policy requires that individuals who are exposed to blood or bodily fluids of another individual be referred for prompt assessment and medical management,” she says.

Some provinces already have a Blood Samples Act so that first responders such as emergency workers, police, and prison officers can find out if they’re at risk of contracting a disease if they’ve been exposed to someone’s bodily fluids.

Stewart says that before the 2006 federal election, the Conservatives informed the union that legislation would be implemented to address the issue. However, no action has been taken.

The Epoch Times contacted the Prime Minister’s Office for comment but no response was received.

About $3.8 million of the savings was in medical costs and the rest was the cost of incarceration, The Clarion-Ledger (http://bit.ly/qoiIHQ) reported. Report by chron.com.

Releasing terminally ill prisoners lets the state avoid costly health treatments and is more humane for inmates facing their final days, officials say. Some were released to their homes, others to care facilities.

“I wouldn’t change anything with the process,” said Dr. Gloria Perry, the Mississippi Department of Corrections Chief Medical Officer.

The department said 18 of those released are still alive, but most die within four months.

Eight have been sent back to prison for additional offenses, but Corrections Commissioner Chris Epps said he thinks the program has done well.

The state could release at least 25 more inmates under a proposed bill to extend the law to anyone who is bedridden. “We will be supporting that legislation,” Epps said.

The released inmates were just a fraction of the 21,400 prisoners in the state’s corrections system and of those released early. But they are among the most expensive to keep behind bars, so their release often yields the biggest savings.

The program does have opponents.

“I can understand the cost factor and the humane thing of letting these inmates be with their family, but the victims would have liked to be with their loved ones,” said Carolyn Clayton of Saltillo, founder of the victims’ advocate group Survival Inc.

On Sept. 26, 2008, Arnold drove his Chevy Blazer toward a police officer, who responded with gunfire, according to police reports obtained by The News Tribune.

The bullets hit the Lakewood resident but didn’t stop him. Police eventually pinned his vehicle on Gravelly Lake Drive Southwest and wrestled a bloody Arnold out of the front seat. He was arrested and taken to Tacoma General Hospital for treatment of his wounds.

Arnold was convicted 11 months later of felony harassment, attempting to elude a police vehicle and three counts of first-degree malicious mischief. He was sentenced to almost three years at McNeil Island Corrections Center. A review board deemed the shots fired by police to be justifiable.

Even so, the city was on the hook for Arnold’s hospital stay, which included surgery and other care. Lakewood leaders say his care actually cost more than $138,000, but the hospital offered a negotiated rate.

The city paid the bill last fall, and City Manager Andrew Neiditz notified the City Council in an Oct. 6 e-mail that was obtained by The News Tribune. Similar incidents have played out across Washington since the state Attorney General’s Office issued a controversial opinion on jail costs in 2005.

The attorney general placed the burden of inmates who need medical care before they are booked into jail on the agencies that arrest them, as long as the inmates have no insurance or otherwise cannot afford medical treatment.

The U.S. Supreme Court had previously ruled that people behind bars have a right to health care. It also ruled that whoever has custody of a convicted inmate – a county government or the state – must pay for that care.

But up until 2005, it was unclear who was responsible for the medical bills of people who are wounded or injured during the arrest or before being booked into jail. Since then, cities including Lakewood have had to shell out thousands of dollars.

“It’s been a big pain and cost to the cities,” said Jim Doherty, legal consultant for Municipal Research and Services Center of Washington. “It’s the hot potato. None of the agencies want to be responsible.”

COSTLY CARE
The hot potato has landed in the hands of various jurisdictions across Washington.

• In Tacoma, the city paid about $115,000 for health care for people arrested in 2008, almost all of which involved a man who had been shot, according to deputy city attorney Michael Smith, legal advisor to the police department.
• In Orting, Police Chief Bill Drake said the department had a nearly $72,000 medical bill for someone it arrested in 2008. The city negotiated a reduced price, but for a department with an annual jail budget of about $30,000, it still took a hit, he said.
• In Sequim, a man who eventually pleaded guilty to killing his girlfriend in a motel room was diagnosed with cancer shortly after his arrest. The city had budgeted $75,000 for all inmate medical costs for the entire year. But his chemotherapy treatments had cost the city about $37,000 by 2005, according to News Tribune files. The man later died.

“It does become an issue when these bills become substantial,” said Drake, the Orting chief. “It can be substantial for smaller cities.”

WHO’S RESPONSIBLE DEPENDS ON THE CRIME
Pierce County charges a daily fee of $80 per inmate to the agencies that use its jail – a fee that includes medical, dental and mental health services for felons.

But before an arrested person is allowed into jail in the first place, a nurse determines whether he or she is “stable enough to be cared for in a stabilized environment,” said deputy prosecutor Craig Adams, legal advisor to the Sheriff’s Department.

If he’s not, then the arresting agency must pay for the care that will make the alleged criminal healthy enough for jail.

Later, if an inmate is convicted of a felony, the county continues to cover health care costs – or the state does, if the person is sent to a state prison. If the person is arrested or convicted of a misdemeanor, medical care is the city’s responsibility.

Meanwhile, the cost of medical services at the jail continues to climb – even as county leaders have lowered the overall corrections budget.

Pierce County budgeted $3.6 million for medical services related to the jail in 2003. This year, it budgeted $6.2 million.

The jail provided 73,932 sick calls to inmates in 2009, 1,000 more than the previous year. It budgeted almost $441,000 to cover drug supplies for inmates this year, more than $25,000 above 2009.

Corrections Chief Martha Karr cited a number of factors for the rising costs.

“We’re getting older, less healthy inmates,” she said. “We have to treat them.”

“We are seeing offenders with significant medical issues,” she added. “When individuals are arrested, they may not have seen a doctor or dentist in years. Unlike in our community, while they are incarcerated, they have a constitutional right to health care.”

LACK OF INSURANCE
Hospitals first try to charge the medical insurance provider of the person arrested. The problem, city officials say, is that many of these people don’t carry insurance.

There have been efforts to implement reforms to help cities. The Association of Washington Cities has discussed everything from jurisdictions pooling money to lobbying the state to help with extraordinary bills. But no law has been passed to provide assistance to local governments.

The state Department of Corrections can release low-risk inmates who have costly medical conditions under electronic monitoring if their release is expected to save the state money.

In Arnold’s case, he didn’t have insurance coverage for the wounds he sustained during the chase.

According to police reports, officers initially stopped him because of improper lane travel in the 5400 block of 100th Street Southwest. Arnold wouldn’t follow the officer’s directions and sped off.

Eventually police cornered him in a parking lot at the 9100 block of Bridgeport Way Southwest, where he rammed two of their patrol cars, sped away again and got stuck on a fence, police records state.

Three officers got out of their cars to confront him, according to the records; that’s when he put his car in reverse, got unstuck from the fence and headed toward the officers. One officer fired three shots.

Arnold’s SUV was eventually pinned again and he was pulled, wounded, from the vehicle on Gravelly Lake Drive.

He already had a criminal history of burglary, theft and possession of stolen property.

EXTENSIVE CARE
Lakewood wouldn’t disclose what treatment the $138,000 paid for, but police reports indicate Arnold was in bad shape and needed extensive medical care.

“The suspect was covered in blood and was bleeding from the jaw,” one officer wrote in his report.

“When I told Arnold to get out of the car he replied, ‘No! You guys already shot my teeth out!’” wrote another officer. “At this point I noticed Arnold’s mouth had been injured and his shirt was covered in small white chunks of material that could have been teeth.”

Officer Ronald Owens guarded him on Sept. 26, 2008, hours after the chase. (Owens was one of the four Lakewood officers fatally shot by Maurice Clemmons in a Parkland coffee shop two months ago.)

“I could smell an overwhelming odor of intoxicants emitting from the room,” Owens wrote in his report. “I observed Arnold lying on a backboard. He was covered up with blankets. Arnold’s right side of his face was extremely swollen. He had on a clear plastic mask that covered his mouth and nose. He was in a ‘C collar’ and there was blood on him.”

The officer who shot Arnold was placed on paid administrative leave, which is standard procedure in officer-involved shootings.

In November 2008, the department’s review board unanimously ruled the shooting was “lawful and within LPD policy,” and the matter was closed, according to documents.

Today, Arnold is 31 years old and is serving a 33-month sentence at McNeil Island. He is scheduled for release in 2011.

SOLUTION DIFFICULT TO SEE
The $138,000 was the most Lakewood has paid for an inmate’s care. It has paid for other inmates’ treatments, but they amounted to a few hundred dollars each.

City Manager Andrew Neiditz said the money for Arnold’s care did not come out of the police budget; it was taken from the city’s operating budget, which in 2009 was $38 million.

Lakewood City Councilman Don Anderson said it’s unfortunate that inmates’ medical bills are an extra financial burden on local governments.

But Anderson said he doesn’t foresee reform soon, because any option will require the use of public dollars. Where the cost falls legally – city, county or state – is almost accidental, he said.

“I honestly don’t know a way around it,” he said.

The Ware County jail averages 348 inmates daily. Its head nurse and six licensed practical nurses provide medical care to the inmates, many of whom suffer from chronic illnesses.  “We have 200 inmates currently getting prescription medication ranging from blood pressure to psychotropic drugs for mental health conditions,” Royal said.  Many don’t have insurance or other financial means to pay for their health care. That means, under law, taxpayers must foot the bill …

The reimbursement measure is intended to help offset medical costs for inmates able to pay. It allows state and county corrections officials to deduct money from an inmate’s account to pay for some of their medical costs.  If inmates have at least $10 in their accounts, officials have the authority to deduct money to pay for medical treatment and prescription medicine for injuries the inmates inflicts on themselves or others. Authorities can’t deduct money from inmates diagnosed with a severe mental condition at the time the injuries occurred.  The law also excludes costs related to pregnancy or chronic illnesses including cancer, kidney disease, pulmonary illness, diabetes, hepatitis C, high blood pressure, rheumatoid arthritis or autoimmune disorders. Those expenses still will be borne by the county or state, according to the measure.

“I see no immediate benefits from this law for us,” Royal said. “The people we typically deal with have no insurance and few if any financial resources with which to pay” …

[Ware County's] medical costs totaled $781,344 last fiscal year. That cost averaged $6.39 per inmate per day, Royal said.  As of Wednesday, he said, they’ve spent $640,182 for inmate medical care this fiscal year, which began July 1.

• Cook County IL has limited visitors to immediate family members and attorneys.  There are currently no cases of the swine flu at the jail.
• The Louisiana Department of Public Safety and Corrections is canceling offender visitation starting Friday and continuing for up to two weeks, according to a release from the agency. There will be no visitation at any of the state’s 13 correctional facilities.
• Ventura County CA has also canceled visits.  Sheriff Bob Brooks announced Friday that all public visits to inmates are suspended until May 15.
• In Henderson County, KY, the jail is continuing visits but with changes. Colonel Freddie Rowland of the Henderson County Detention Center said, ”We are limiting the contact between the visitor and the inmate. We’re going to allow a quick hug, but we’re not going to allow them to sit as close as they normally do.”

Chief U.S. District Judge Rudolph Randa’s order came in response to an American Civil Liberties Union motion for an injunction forcing the state to make changes.   The action is part of a federal class-action lawsuit the ACLU filed in 2006 on behalf of inmates at the state’s largest women’s prison.   The ACLU contends the state is violating the rights of Taycheedah prisoners by having guards without medical training dispense drugs to inmates, routinely resulting in the wrong medications or wrong dosages being given to inmates.

The state admits there are problems but says it is working to fix them. It argued that it has a plan to hire nursing assistants to hand out drugs and that the ACLU’s timetable was unreasonable.   Randa disagreed, writing that “matters of administrative convenience must ultimately give way when constitutional rights are in jeopardy.”  Randa ordered the state to draw up a plan to hire licensed practical nurses for Taycheedah within a week and have them in place in 60 days. In the issue of computerizing the prescription system, Randa gave the state two months to take “interim steps” to improve drug distribution accuracy …

Department of Corrections spokesman John Dipko said he did not know how many nurses would be hired or how much it would cost … Dipko said agency officials had not determined whether they will appeal the order, but even if they do, they will comply with the order in the meantime.

Larry Dupuis, legal director for the ACLU of Wisconsin, said, “Judge Randa has taken a huge step toward alleviating the needless pain and suffering caused by Taycheedah’s failed medication system.”

Gov. Sonny Perdue signed a measure into law Tuesday that allows state and county corrections officials to draw up regulations to deduct the money for some medical costs from inmates’ accounts. It excludes costs related to pregnancies and chronic illnesses, which include diabetes, cancer and renal disease.