Failing & Inadequate Healthcare Inside MDOC
by Ricardo Ferrell, MLMT Senior Writer

Failed policies of contractual healthcare providers have contributed to noticeable inadequacies in giving prisoners the same standard of care as those in society. Decades ago there was a focus by the Michigan Department of Corrections to stay in line with meeting the same standards for all prisoners as is provided outside prison walls. However, in an effort to save costs for that quality service, private healthcare entities were contracted out by the MDOC. The MDOC looked to save hundreds of millions of dollars in annual costs, thus, ushering in a system where it now requires a prisoner to sign and agree to a co-pay before they can be given medical, dental, optometry services.

The only time co-pay charges aren't required and deducted from a prisoners Trust Account, is when he or she is called to healthcare for the following:

1. for injuries that are work-related as documented by a prisoner's work supervisor,

2. requested for testing for HIV, STD's, infestations, or reportable communicable diseases

3. requested for evaluation, consultation, or treatment of a mental health need

4. prompted by a medical emergency (if self-inflicted may require a co-pay)

DO AWAY WITH COPAY

This practice creates a number of dilemmas for prisoners:

1. it forces inmates to go further into debt if they are indigent;

2. if a prisoner only makes on average $8.00 per month on his work assignment, he must choose to either purchase hygiene products, and other necessities, or pay the $5.00 copayment to receive healthcare services;

3. a prisoner runs a risk of having his/her medical condition worsen due to the burden placed on them to buy essentials, or agree to the ridiculous copay charges.

The inadequate services of contractual healthcare systems (such as Correctional Medical Services (CMS), Corizon) and other providers have caused an enormous burden on prisoners and Michigan taxpayers. Currently it takes roughly $2.2 billion of the State's $10 billion general fund to annually fund the Michigan Department of Corrections.

Although I cannot specifically quote the actual causes of death of nearly 55 prisoners at one prison l was housed at for six years, l do know some of those men died due to deteriorating health problems while under the care of that facility's healthcare services. In many instances prisoners health issues are downplayed and they are sent away from healthcare with a minimal amount of medical attention. In other words, if the health issue isn't dire enough, such as a heart attack, or other immediate life threatening condition, the prisoner would thereby receive inadequate health care by nurses, physician assistants, and specialists.

One must wonder why there is inadequate medical and mental health treatment for MDOC prisoners, when approximately $470 million is allocated to cover the costs of providing these very services. If the monies aren't being spent to provide a standard of physical and mental healthcare similar to the free society, then I beg the question, where are the hundreds of millions of dollars going? It would appear that the state is engaging in a wasteful pork barrel spending which is causing a financial nightmare on Michigan taxpayers. The $2.2 billion spent on the corrections budget equates to 1 in every 5 dollars of the general fund, and roughly 20% of the corrections budget is spent on the healthcare and mental healthcare of prisoners. Nevertheless, if that healthcare and mental healthcare is poor, inadequate, and failing in its effectiveness, then why have it in the first place?

The failure of the MDOC's physical and mental healthcare services has long been problematic. In December 2007, American Friends Service Committee Michigan Criminal Justice Program and Prison Legal Services of MI, released a 118 page report outlining decades of inadequate medical and mental health treatment by its providers. As J.W. Marquart and others noted in (June 1977) Health Conditions and Prisoners: A Review of Research and Emerging Areas of Inquiry: "As a public we have chosen many legislators who use "tough on crime" rhetoric to drive fear into the populace which then creates a burden on our prison system as more and more people who have serious medical and mental health problems are incarcerated. Furthermore, the people who are targeted by tough on crime measures are often people who have been neglected by our social service systems, have slipped through the cracks of those services, or have had difficulty gaining access to social services. The poor are less likely to have access to healthcare while in the free world;" and Mark Mauer wrote in (1999), "simultaneously, the poor and specifically poor people of color are more likely to end up in prison," as quoted in Race to Incarcerate.

The MDOC could change its approach to healthcare and mental healthcare policies to be more reflective of services provided to citizens in our society and begin by removing the burdensome copay for prisoners. They could equally revamp the entire prison healthcare system to give services that could improve the health of prisoners and stop the loss of lives due to an inadequately run statewide Healthcare Service.

According to the Michigan Department of Corrections the Healthcare cost per incarcerated person in 2018 was $9,076 compared to $8,899 the previous year, a 2% increase. Also, according to the MDOC, one reason the share of health care costs is rising is that Michigan has the oldest prison population in the country."

Perhaps those responsible for the healthcare of prisoners should rethink their position. This would require them to become more empathetic. They need to put themselves in our shoes. How would they feel, if those they care about were given inadequate healthcare?