Facing soaring health care costs, inmate deaths linked to shoddy care and a subsequent federal lawsuit with no end in sight, Virginia’s prison system is turning to the state’s university hospital systems for help.
It’s a partnership that could end with the University of Virginia Health System taking over the medical wing of Fluvanna’s Women Prison – a facility under strict and ongoing scrutiny by a federal judge, who made clear during a hearing last month he was not impressed by the department’s efforts so far to improve the situation.
“The prison system’s position seems to be that because it could take a long time, it will take a long time,” Judge Norman Moon, irked that the state has not yet complied with the terms of a consent order it had agreed to, told DOC lawyers.
Lawmakers, who ordered corrections and state-funded teaching hospitals to work together to improve prison health care earlier this year, are similarly frustrated.
“Every couple of months we hear about somebody else dying in Fluvanna,” Sen. Creigh Deeds, D-Bath, told prison officials during a budget retreat in Harrisonburg last week. “Why would we continue to hear about inmates needlessly dying there? Tell us what you’re doing to make things better.”
Steve Herrick, the DOC’s director of health services, pushed back on the notion that there are ongoing inmate deaths that are attributable to poor health care, but described an inmate health system that’s under extreme pressure.
Health care costs for inmates increased 40 percent over the past five years to $223.6 million – a number that would have been even higher had the state not expanded Medicaid, which now covers prisoners’ inpatient hospital procedures and stays.
Herrick attributes the increase to an aging inmate population combined with overall increases in costs of providing care and prescription drugs.
Lawmakers are weighing several approaches to tamp down rising costs, improve care, or both.
First, the department is requesting $71 million to add a new 112-bed infirmary in Powhatan and a 115-bed nursing home, skilled nursing and assisted living facility in Deerfield. Herrick told members of the Senate Finance Committee that the department’s existing facilities are overcrowded, forcing the department to keep inmates in the hospital even after they’ve been discharged at costs as high as $1,300 a day. “That’s one of the places where the money is kind of bleeding,” he said.
Lawmakers are also considering loosening the state’s compassionate release policies. Virginia has the second most restrictive policy in the country, allowing inmates to be released early only if they are given a prognosis of three months or less to live. And it’s the only state that doesn’t have a policy that considers serious illnesses that are not terminal or permanently incapacitating.
Advocates have argued it makes no sense to keep dementia patients, for example, behind bars — where they have no idea where they are — when they can be taken care of more humanely in community facilities.
Finally, members of the General Assembly will decide whether they want to pursue a deeper partnership with the state’s teaching hospitals. General Assembly auditors suggested the state pursue such an arrangement last year, citing success in Texas, which, like Fluvanna, was also facing judicial scrutiny and operating under a consent order that mandated ongoing oversight.
Talks over the summer yielded tentative agreements that paired UVA Health with Fluvanna. VCU Health with would be paired with State Farm Correctional Center. However a report detailing the discussions says neither university felt it had the expertise to fully take over health operations at either facility and the earliest a full-fledged partnership could be implemented is 2025.
In the interim, the department says that if lawmakers want to proceed, they’ll need to budget money for a consultant, further study and interim partnerships in which VCU would establish an orthopedic clinic in Powhatan and UVA would begin providing hepatitis C treatment for offenders at Fluvanna.
Secretary of Public Safety Brian Moran, who pushed for the partnership last year, said there are still details that need to be worked out, but that the requests struck him as doable.