been there, done that.
'sides, I’m on vacation and soon will be getting offline
I vaguely remember reading something a few years ago about somebody who did just that. It was an older guy who was down on his luck, and he murdered his letter carrier (of all people) so that he could get the medical treatment he needed.
For the sake of clarification:
are you talking about 1983 suits or med-mal suits?
There’s an important distinction there, and if it’s one or the other the 99.9% figure can be misleading if applied improperly.
Ok. But I was thinking about gender change operations, and things like that.
Some folks are not convinced that a gender change is not “elective” in nature.
QtM’s state, Wisconsin, has a law which specifically bars the state-funded provision of gender reassignment surgery to inmates. A suit challenging the law (the only one of its kind) had been appealed to a federal district court as of 2007, and I can’t tell what happened after that.
Most prisoners’ gender reassignment requests are denied, which usually results in a lawsuit.
Wisconsin and other states do provide hormone therapy for gender identity disorder sufferers.
QtM, what about care for elderly prisoners?
Given sentences for ‘life’ and for many, many years, there have got to be prisoners who are well up in years. Ones who in the outside world, would often be moving into nursing homes or other care facilities. How do you deal with them in prison? Do they just stay in the regular prisons, or do you have a ‘nursing home prison’ for them?
It’s more complicated than that. We’re waiting on the court ruling. The state law also bars us from prescribing hormone therapy for these folks. I consider this a bigger problem than barring us from doing gender reassignment surgery, since the latter was rarely ever offered.
I wish we had a geriatric prison. We were supposed to get one, but the funds got cut. We try to get by with our skilled nursing facility, but it’s more than many geriatric guys need, and at a much higher cost. Yet we don’t have a good middle ground. Too many rules prevent one inmate from touching or caring for another one.
It’s an increasing problem which will suck up more health care dollars.
I’m talking about getting served notice that an inmate has filed any sort of suit complaining about health care. The vast majority get dismissed before I even need to do affidavits.
A number of our inmates have half a dozen or more suits filed against the Dept of Corrections at any one time.
I am by no means a prison doctor. However, I do have some experience in this area. I know a person in the Texas prison system who is in his late 50’s or early 60’s. He committed a serious crime and will be a guest of the state for a long time. He is a well-behaved offender and is not a flight risk.
Not too long ago, he needed hernia surgery. He requested a visit with the doctor at his unit and the doctor diagnosed the hernia and determined that surgery was required. Texas only performs this surgery at one hospital. Therefore, the surgery must be scheduled and transportation to the facility must be arranged. On the appointed day, the offender I know had to remove all of his personal effects from his cell. He will not return to that cell, and may not even return to that unit. A prison bus was arranged and transported several people from the unit to a unit near the hospital. This is a distance of a couple hundred miles. Once at the new facility, he entered a new cell and waited for his scheduled surgery. Well, other issues ran long and the surgery was never performed. So, he was transported back “home” to his unit and placed into a new cell. His stuff was returned, but all of it had been gone through (he has no contraband) and some was missing. (Other offenders handle some of this and, well, some of them steal stuff.)
So, on the next available surgery date, this whole process is repeated. After three or four tries, I think he finally did get his hernia fixed, I think. There is a strong incentive not to make too many medical complaints that might require leaving the unit. It is simply too much of a pain in the ass. Offenders don’t have much, so when you take away something that seems unimportant in the real world, it can be very important in the prison. For example, suppose you are in a cell with good air flow (no units in Texas are air conditioned). Is your medical situation worth giving up a good spot? You might be returned to a cell with stagnant air. What is it worth to you?
Now, all of that was for actual surgery. Even getting an eye-glasses prescription filled, however, is a giant pain in the ass. It also requires transportation and overnight waiting at the ophthalmologist. All of these medical trips are away from your “friends”, your job, your stuff, etc. Then you get the exam and get to wait for glasses. Then you get returned to God knows where.
Like most other everyday things, medical care that would be a quick outpatient procedure for us on the outside is a giant hassle on the inside. However, I don’t want to seem to be criticizing our good Dr. Qagdop here. I am sure that he and his staff do heroic work with extremely limited resources. Offenders are human beings. No matter how heinous the crime, they must be treated as human beings. It’s not about them – it’s about us. It’s about what our values are. We know what they’ve done. Some of the offenders are monsters. Does that give us an excuse to be monsters with them?
Just wondering…what percentage of your inmates have “classic” mental illness (ie scheizeophernia, bipolar other stuff) as opposed to substance abuse (and yes…it’s a real mental illness) Just wondering.
Regarding mental health care in jails: My wife works for the county public mental health provider in our county. She is not a doctor, but she works with one. When the county jail collects someone who requests mental help or, in the opinion of the officers or jailers, requires mental health assistance, my wife gets called. She will go over to the jail and do a psych eval similar to what she might do at the hospital emergency room. If she determines that the inmate requires a doctor visit, she arranges the appointment. The inmate is transported (in chains and hobbles) at the appointed time to her office here in town to visit with the doctor. The doctor can then prescribe medication or other treatment as required. The inmate is then taken back to jail.
I should point out here that the inmate may not have been convicted of any crime. He/She simply can’t make bail. Or, the person may not have had the opportunity to appear before a magistrate yet.
If the police or sheriff arrests someone who already is receiving psychiatric care, my wife may transport the medication over to the jail for the person. In a town such as ours, the jailer often knows the person being brought in.
With a person on the outside, my wife might recommend treatment in a public or private mental hospital. However, none of these hospitals will accept someone with a felony arrest. In cases where the person requires hospitalization, the jail simply does the best they can.
I have no idea what happens regarding mental health once they have been convicted of a serious crime and moved into the state DoJ system.
My wife’s office treats major depression, schizophrenia, and bipolar disorder. They do not treat substance abuse and I don’t think the state hospitals (our public mental institutions) treat substance abuse either. That is true whether you’re involved with the DoJ system or not.
Drum God’s description of travels out is fairly accurate.
Hernia repairs: It’s an elective procedure, with the hernia posing little risk to one’s health in the majority of cases, especially if the guy has been living with it on the street for years. So we’re in no rush to repair them while the person is incarcerated, unless it becomes medically necessary: Causing dysfunction, at increased risk for strangulation, etc. So if the guy is getting out within a few years we’d rather he wait and get it dealt with after release.
Eyeglasses: We employ an optometrist who sees the inmates in the prison.
Mental health: 30% of our inmates have an Axis I diagnosis, and close to 10% are seriously mentally ill, being incredibly impaired functionally by their illness. 70% have a substance abuse history.
As to elderly convicts, I remember reading an article in law school suggesting much more aggressive use of pardons by state governors to release elderly, now-nondangerous felons sooner, in cases where the original sentence was life without parole. The article’s author conceded that the political costs of pardoning even, say, an 80-year-old murderer or rapist could be high.
Why wouldn’t the state just pardon convicts who have a terminal medical condition? IE if they know they won’t be able to get treatment on the outside, they’d save themselves a lot of money.
Is the state obligated to pay for medical care even if the person is under house arrest, say? Or on parole of some kind?
I think the post from Elendil’s Heir right before you answers this question - sure, plenty of prisoners ask for a compassion-based release if they’re terminally ill in one way or another, but that may be extremely unpopular with the voters depending on who it is.
Illinois’ former governor, George Ryan, asked for similar consideration due to his old age and his wife’s poor health, but then-president Bush did not issue a pardon.
I don’t know about house arrest, but I suspect a parolee is liable for his or her own health care, as they’re free. (I would guess the same is true for anyone on probation.)
Missed the edit window - I had intended to include this as an example not for terminal illness, but advancing age and not-the-best of health in the convict. Also, I don’t know why the pardon wasn’t issued - both men were Republicans, but Ryan’s misdeeds included a link to his employees giving out licenses for bribes, and one of these mislicensed truckers essentially caused an accident that killed several children of a minister. So that was a very problematic issue with the public.
A petition for compassionate release for an inmate requires (among other things) that they have a life expectancy of about 6 months or less. Even then they may be turned down, depending on how long they’ve been in prison, the seriousness of their crime, the possible public outrage over their being released, etc. The voters have generally spoken in favor of having felons die in prison. (97% of inmates do not die in prison, however)
I’m not sure they recognize just how expensive that is for the voters.
Once they’re on parole/probation/house arrest, they’re responsible for their own healthcare.
On the subject of compassionate relief for terminally ill and/or very elderly prisoners; what if they have no where to go to on the outside? What happens if no one in their family will agree to take them in? Is the prisoner just dumped in a halfway house?