I should clarify from my last entry that at no time did Director Ryan and I discuss the testing and treatment of prisoners with Hepatitis C or HIV - I honestly don't know Arizona's policies in that regard because we had no discussion to speak of on health care services, except for how stellar they are and how likely it is that they will be contracted out to a private provider in a process that will take the next several months.
I wasn't sure how alarmed to be about that, and am not informed enough about private medical providers in prisons to issue an impromptu judgment on it. I think a lot has to do with how the state establishes performance standards and monitors quality of care, but I'm generally opposed to privatization of services for vulnerable populations because it's almost always done for someone else's savings or profit at the poor's expense. A shining example of
So, I think it will be important for the community to pay attention over the course of the next month or two to feelers being put out by the state for private health care providers to bid on the prison system. It will be incumbent upon us to investigate those who submit bids, to inquire of the state how they plan to evaluate and monitor the quality of health care being offered, and so on. In an effort to avoid this route the Director had sought legislation (SB 1028) that allowed the ADC to pay only the AHCCCS rate to health care providers (ADC is presently billed at 200% the AHCCCS rates), but he opposed the plan written into the same bill that would have allowed the privatization of all of Arizona's prisons, so the Governor vetoed it. Therefore he needs to find another way to save what that bill would have, which is about $26 million.
Other than the possible savings that could be realized by privatizing correctional health care services, Director Ryan thinks savings can be found in moving all prisoners with serious or chronic medical and mental health problems to facilities that are closer to major hospitals and health care providers, reserving the more rural/outlying prisons for the healthier prison population.
Whether or not savings are realized by such a move, it seems to make considerable sense in terms of improving access to health care for those most in need - and perhaps even adapting facilities to better accommodate people with chronic medical and mental health issues. I'm disturbed about what I've heard and read about the environmental conditions in the prisons. Not only are there complaints that cleaning supplies are inadequate to assure containment of communicable disease (because prisoners are responsible for the cleaning, and bleach and other cleaners are considered hazardous - thus tightly controlled), but the swamp coolers and other climate controllers seldom work.
From the reports of family members and ex-prisoners, the cooling systems in the prisons are substandard (except, apparently, for the guard towers), and the only way some prisoners have to cool their cells are with personal fans. When a block or unit is on lockdown, apparently even the fans are pulled, leaving prisoners confined to sweltering cells in overcrowded conditions, and at risk of heat-related illness. Unfortunately, I didn't get a chance to address either of these two concerns with Director Ryan, but may do so with Ms. Cassiano or Deputy Director Flanagan on Monday.
I did briefly raise the question of compassionate release for critically and terminally ill prisoners and geriatrics who pose no real threat to the public. I know that not all such prisoners have homes to return to - their loved ones have died or dwindled over time, and the kind of care they need is at the level of a nursing home or hospice - which few prisoners have the resources for. This would be one important area for abolitionists to work on - the decarceration of this population by building a network of placement options for them, and by assuring that the legislative and administrative pieces are in place to allow their release as soon as possible.
There is presently a provision for home arrest of prisoners who meet certain criteria, who would have to be granted such by the Board of Executive Clemency. Home arrest for the normal, healthy prisoner would cost the state approximately $14/day compared to the $55-60/day that imprisonment averages. I don't think most octogenarian or cancer-ridden prisoners would need to be monitored with an ankle-bracelet, though - there should be clemency or community-supervision provisions for them that don't take the rest of their short lives to have approved or result in them being tethered to their deathbed.
Finally, one of the things I was most interested in as far as Director Ryan's role in reducing incarceration rates goes was not only whether or not he believed in the value of "rehabilitation" efforts in the prisons, but also whether or not he took a proactive role with the legislature or the governor when it came to addressing mandatory minimums, determinate sentencing, diversion of the mentally ill from the criminal justice system, incarceration of the elderly, the expense of maintaining the disabled and seriously ill in prison when they pose no public threat, etc.
I didn't ask him for his opinions on those things - just on whether or not he provides his opinions to lawmakers and policymakers. He seemed to hesitate on that - maybe not knowing just what I was getting at - but responded the way a good soldier does: when he's asked for information, he gives the best information he can provide; it's up to those in the legislature to decide what to do with it. His job is to implement the law, not make it.
At that, he smiled and pointed me towards the capitol building, suggesting that I should really be talking to them about some of these issues. I affirmed that much of the work involved in abolishing prisons will have little to do with him at all, and a great deal more to do with our legislators and communities. He just happens to have responded more promptly to my request to meet than any of our legislators did.
On my way out, Counselor Klausner reminded me again of the resource that Betty Cassiano can be to families who feel they aren't otherwise getting a satisfactory response from the department about their concerns; they don't need to hire anyone to access her for assistance.
I think I have been thorough; I hope I have been accurate and fair; I trust the ADC to correct me if I haven't. I was unable to get to a number of things I'd hoped to address, but I don't think they were necessary to bring up with Director Ryan anyway - I think his staff will be of much greater assistance on those issues. I actually walked away with far more questions than I had in the first place; I just now have a better sense of who to direct them to.
I do still have serious concerns about the continuing use of outdoor cages, and hope to have an opportunity to see exactly how they're used now at Perryville under the new policies. If equipped with misters and water and benches and fresh air, they could well be a welcome relief from the conditions inside the cells; we'll see what prisoners and families have to say. If that's the case, then the conditions within the prison walls may be even more worthy of protest than the cages.
7 years ago
