Prison Health Care Crisis

Personnel Shortage Straining Prison Medical System

Inmate health care is in trouble, prison medical staff warns.

Prison medical care is under siege from two angles:

There are the lawsuits in inmate death cases that allege malfeasance on the part of individual practitioners, and there is a staffing shortage that the health care union says has strained the system to a point that medical care behind prison walls resembles a MASH unit.

“There’s a direct correlation” between a breakdown of the system and the more narrowly drawn lawsuits, Paul Fortier, vice president of the health care workers union, said at a rain-soaked news briefing Tuesday in which the union called on the state to fill what it says are 120 vacancies in the ranks of doctors, nurses, social workers and support personnel.

The Department of Correction itself has lent an air of credibility to the allegations of malfeasance and the union’s portrayal of an untenable strain on the system. The department has flagged 25 flawed medical cases, including eight inmate deaths, in which it has been sued or expects to be sued. The department has refused to make public a report on the 25 cases.

In a heavy downpour Tuesday, prison doctors, nurses and social workers spoke under a small canopy tent to other members huddled under umbrellas and wearing blue and yellow ponchos that were handed out. The group gathered across the street from the Hartford Correctional Center on Weston Street to bring attention to their plight.

In February, the state ended its arrangement with UConn Health to provide medical and mental health care in the prisons. The responsibility shifted to the Department of Correction, which hired more than 600 of the UConn Health employees.

Leaders of Local 1199 of the Service Employees International Union said the vacancies were inherited, and that the state cut $8 million from the prison health care budget even as the transition was starting.

Dr. Ricardo Ruiz said he is the only physician for 1,500 inmates at the Cheshire Correctional Institution, a ratio, he said, that is “totally out of control.”

“Even quarantining someone with chicken pox is an ordeal,” Ruiz said. “Access to care becomes a huge problem, getting seen, having follow-ups. We’ve got high infection rates in prison and a small window of opportunity to treat them, since most inmates are returning to the community. It would be devastating if the infections spread — it is a recipe for disaster,” Ruiz said.

Dr. Carson Wright, another correctional physician, said doctors and nurses function on the edge of a crisis every day.

“We have Hepatitis C, we have scabies, we have MRSA; if we don’t screen for it or catch it early, the whole block can be affected,” Wright said.

Janet Short, a registered nurse, said the staffing shortage has driven up the amount of mandatory overtime. She said she has worked an eight-hour shift, and then has had to drive 20 miles to another prison and work a second consecutive shift. She said the fatigue can be overwhelming.

“We’re in here saving lives — it’s irresponsible; this is [a] dangerous condition for staff and inmates,” Short said.

Lynne Munday, a nursing supervisor at the Bridgeport Correctional Center, said that at one point, she found herself alone in the infirmary, with no backup available, and 26 inmates waiting for treatment.

“These are IVs, dressing changes — they’re not just sitting there,” said Munday. “That would never be accepted on the outside.”

Ellen Durko, a registered nurse, said that while the prison population has decreased, rates of opioid addiction, mental illness and infection have increased.

“It’s a powder keg waiting to blow,” Durko said.

Correction Commissioner Scott Semple said in a statement Tuesday that he agrees “with the leadership of Union 1199’s assertion that appropriate staffing levels are the foundation for quality care within any healthcare setting.”

The department’s statement said officials are working to fill 70 positions, and asked the union to document how it arrived at a vacancy total of 120.

“We continue to actively evaluate our healthcare delivery approach in order to best serve the needs of the offenders,” Semple said, adding that this was “especially important when considering the trend of increased substance abuse; ongoing behavioral health needs; the need for and high cost of Hepatitis-C treatment; and an aging offender population.”

The department was recently hit with a class-action lawsuit alleging a failure to screen for and treat Hepatitis-C.