Illinois Prison Healthcare Still Abysmal, Getting Worse in Some Areas, Monitor’s Report Finds
Four years after a settlement agreement that was meant to compel improvements, the Illinois Department of Corrections is still failing to provide adequate care for the state's oldest and sickest prisoners.
Elizabeth Weill-Greenberg Apr 21, 2023
Healthcare in Illinois prisons continues to be abysmal, especially for those who are elderly or living with mental illness or dementia, according to a monitor’s report filed in federal court on Monday.
The report, submitted as part of an ongoing class action lawsuit against the Illinois Department of Corrections (IDOC), says the prison healthcare system suffers from “major deficiencies,” including some that have “worsened” nearly four years after a settlement agreement that was supposed to compel improvements.
“The lack of progress towards compliance with the Consent Decree can be summarized as a failure by the State to establish the foundations of an adequate medical program in the IDOC,” the report concluded.
In an email to The Appeal, an IDOC spokesperson said the department is working towards compliance with the consent decree, although they “disagree with the monitor’s findings in some areas.”
While compiling the report, the court-appointed monitor examined a sample of 17 deaths in Illinois prisons in 2022, which together provide a macabre portrait of the consequences of the department’s failures. More than 65 people died in IDOC custody last year.
In two of the deaths examined, the monitor found that medical staff prescribed medications “that contributed to a preventable death.” In another, a 63-year-old man who died of liver cancer spent the last day of his life lying on the floor in his own feces.
A man in his 70s who had dementia received such negligent care that it constituted “elderly abuse,” the monitor wrote. About five months before his death, he was hospitalized and found to be so severely malnourished that he needed a feeding tube.
In another case covered in the report, a prison physician believed an elderly patient with schizophrenia was faking his symptoms even as he decompensated. When staff finally referred the man to a hospital, he was diagnosed with Lou Gehrig’s disease—a fatal neurological disease also known as ALS—and was found to be severely malnourished and dehydrated. The monitor also reported on an incident in which an 80-year-old man with dementia drank cleaning bleach that had been left in a soda bottle in his room. A nurse encouraged him to drink water and he took Prilosec, but the nurse did not contact Poison Control or the housekeeping department to determine what was in the bottle. The man later died of unrelated causes.
The monitor also documented deaths of people with mental illness who were denied access to adequate care. IDOC is currently the subject of a separate class action suit alleging long- standing issues in its mental healthcare services.
In one instance, a man with bipolar disorder was repeatedly sent to segregation, which is known to exacerbate mental illness. Although he was experiencing psychotic episodes, staff did not place him in mental health housing.
When a supervising officer later saw that the man had harmed himself, he called for a three-person emergency response team. The officers arrived in apparent riot gear and entered the man’s cell but didn’t render aid. Instead, they handcuffed his arms and shackled his legs before checking for a pulse. When they couldn’t find one, they began CPR and called for medical assistance. The man was pronounced dead 22 minutes later.
In another case, a man with severe mental illness attempted suicide and was placed on suicide watch, which typically means a person is placed in a bare cell. After three days, a nurse documented that he was catatonic—but he was not seen by another medical provider until more than six hours later. He was finally taken to the hospital and diagnosed with liver and renal failure due to an apparent overdose of non-opioid painkillers. He died about two days later.
Severe healthcare staffing shortages have created dangerous conditions for Illinois prisoners, according to the report. Wexford Health Sources, a private contractor that provides prison healthcare, has been repeatedly accused of endangering the lives of incarcerated patients in Illinois and throughout the country. Local news outlet WBEZ reports that the company’s contract with the state has expired, and that officials are soliciting bids for a new contract.
At Dixon Correctional Center, no nursing staff was assigned to the geriatric unit, the monitor found. Many people housed at Dixon are elderly, disabled, or mentally ill. Of the more than 1,500 people incarcerated at the prison, 451 are over 50 years old, 124 are over 65, and 38 are over 75.
During a three-day visit in December, the monitoring team spoke with people on the geriatric unit who had serious medical needs, including one with diabetes who had “a baseball sized diabetic foot ulcer.” A man with brain damage had not been showering, according to his cellmate, who used a wheelchair to take him to a sink to wash up. The cellmate had tried to mask the man’s odor with homemade potpourri.
Others had survived strokes or were on continuous oxygen. Sixteen of the 21 patients who spoke with evaluators appeared to require care that was not available on the unit, including “assistance with daily living, access to more appropriate hygiene facilities, closer medical monitoring, [and] memory care.”
The men on the unit also reported significant dental issues that could jeopardize their ability to eat properly. One person had no bottom teeth and said IDOC had refused to provide him with dentures. Another had no teeth and said he hadn’t been able to see a dentist. Although Illinois law bans co-pays for medical or dental visits, IDOC policy requires people who have “lost or broken a dental prosthetic through negligence” to pay “the dental laboratory fee for replacement.” The monitor wrote that he was aware of “a modest number of individuals” who had not received denture care because of their concerns about the cost. He recommended that IDOC eliminate this provision.
The IDOC spokesperson told The Appeal that “individuals in custody can be charged the cost to replace items, including dentures,” that they “intentionally” break, but that they are not denied medical care due to an inability to pay.
There is a more than two-year wait for dental extractions, a two-year wait for dental fillings, and an almost nine-month wait for dentures at Dixon. “The access to dental care at this facility is totally unacceptable,” the monitor wrote.
The report underscores the need to release elderly and ill people from prison, says Alan Mills, executive director of Uptown People’s Law Center, a civil rights law firm involved in the class action suit that led to the consent decree. The Joe Coleman Medical Release Act, which went into effect last year, allows incarcerated people who are “medically incapacitated” or have been diagnosed with a terminal illness to apply for early release. The legislation “was intended exactly to get those people out of prison, but it’s vastly underused,” Mills told The Appeal.
The Joe Coleman Act defines “incapacitation” as someone diagnosed with a medical condition, such as dementia, that prevents them from completing more than one activity of daily living, like bathing or dressing, without assistance. Under the law, a terminal illness is likely to cause death within 18 months.
“There’s just no reason to lock people up who are this ill, this disabled,” said Mills. “Prisons shouldn’t be nursing homes. They were never designed to be nursing homes. We shouldn’t try to make them into nursing homes. We should send people home if they need to be in nursing homes.”
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