PJC In The News

Daily Record Reports on Prisoners' Rights Project

Of Service Prisoners’ Rights Project focuses on the sick, forgotten JOE SURKIEWICZ Special to The Daily Record February 19, 2008 For aspiring doctor Shahed Alam, the prospect of making regular visits to the Baltimore City Detention Center to advocate for the health care of detainees sounded like a great opportunity. “It’s an aspect of health care that’s untapped,” said Alam, 21, a junior majoring in biomedical engineering at The Johns Hopkins University. On his weekly visits as a volunteer for the Public Justice Center, however, he discovered a different world. “I was surprised to see how much people there are suffering and neglected,” Alam said. “Many of the detainees have life-threatening problems. But they don’t have the right to do what they want to correct them. For example, people with diabetes can’t get their medicine.” The PJC’s Prisoners’ Rights Project has focused on the conditions of confinement for pretrial detainees (as well as impact issues affecting access to courts and oversight of the system) since 2002. Alam is one of a cadre of JHU undergraduates who volunteer to help sick inmates get critical medical help. “It’s an uphill battle,” said PJC staff attorney Wendy Hess, who laments the lack of attention on the issue of health care for detainees. “Why is this relevant to the public? After all, there’s an inclination not to care because most people think they’ll never be arrested,” she said. “But employees are exposed to sick people not getting care. And a lot of people re-enter the community sicker than when they went in. And many have contagious diseases. It’s a public health issue.” Key complaints remain The Baltimore City Detention Center is the 18th-largest pretrial detention facility in the country and houses up to 4,000 people, most of them pretrial detainees. About 120 prisoners cycle out of the center each day — a complex plagued by overcrowding, sickly detainees and unsanitary kitchens. The state is constitutionally required to provide adequate health care to prisoners and detainees in the corrections system, the lawyers said. “Whether you agree with it or not, the state has to do it or it can be sued,” Hess said. “The state is paying a health care contractor all this money — about $110 million a year, up from $68 million a few years ago — but it’s not getting the services taxpayers pay for.” The lawyers are frustrated by the system’s self-auditing mechanism and a lack of transparency. “You can’t expect too much from an internal body — it’s not robust,” Hess said. “A lot of problems that were present in 2002 when our project was founded are still around.” There have been some improvements. For example, the state moved from paying its health care contractor a flat fee to a charge-by-service basis. “But the same key complaints remain — delays in responding to sick-call requests and interruptions in medications for chronic and acute medical conditions,” Hess said. “We have problems just getting information on what goes on in there,” added Sally Dworak-Fisher, another PJC lawyer on the project. “There’s no good oversight and the system isn’t transparent.” The project successfully lobbied for a performance audit of the new medical contractor and persuaded the General Assembly to do an audit in February 2007. The audit showed the state does a poor job of overseeing the medical contractor. “It’s outrageous,” Dworak-Fisher said. “For example, the state didn’t notice 400 inmates with hepatitis C were left off a monthly medical contractor report. It’s appalling. The state has no idea if it’s getting the service it’s paying for.” The state made promises to fix it and the legislature asked for a report, which was delivered in November 2007. The PJC submitted a critique of that report to legislators this month. “Our response pointed out that most of the recommendations of the performance audit were not implemented,” Dworak-Fisher said. “And no clear guidelines were given for when most of the changes would be made.” Limited success The project has used Maryland’s Public Information Act to obtain information from the state — but with limited success. “In the vast majority of circumstances, we never received information within the time required, or ever,” Hess said. “If you have to fight for information, it’s usually pretty stale when you finally get it. Transparency is being frustrated by the government.” For example, requests to local detention centers to find out who provides their health care, the number of complaints, and whether they track contagious diseases often went unanswered. “We had to sue four counties after making several requests,” Hess noted. “It’s costly to sue. But the government’s not being held accountable if we don’t.” The lawyers suggest that improvements will only happen after Maryland implements a statewide structure to oversee pretrial detention and correctional facilities. “There are national and international models we can study,” Dworak-Fisher said. “We need to establish an external oversight mechanism that’s independent and routinely performed. And in the meantime, we need another audit.” Alam, the volunteer who visits the detention center each week, said he’s seen no changes in the system since he started volunteering. “It’s really surprising that this is happening right around the corner, right down the street, from such a great hospital as Johns Hopkins,” he said. “I encounter laziness and neglect from many staff and corrections officers. There are some gems among them. But generally the detainees — who haven’t been found guilty of a crime — are treated like animals. Every week, it’s an eye-opening experience.” (Joe Surkiewicz is the director of communications at Maryland Legal Aid. His e-mail is jsurkiewicz@mdlab.org.)

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