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Last revised: March 8, 1998

WELCOME TO HELL

SHUMATE V. WILSON: WOMEN PRISONERS’ HEALTH-CARE AND “REVENGE JUSTICE”

by Marcia Bunney and Charla Greene

MARCIA BUNNEY, CENTRAL CALIFORNIA WOMEN’S FACILITY, CHOWCHILLA, CA:

In the sixteen years of incarceration, I have witnessed a great deal of change. California’s prison system has not merely grown; it has metastasized, from a dozen facilities in 1982 to nearly 35 at this writing.

Part of that growth was “necessary”, of course, to accommodate the enormous increase in the number of women sent to prison. It was, and is, an increase primarily rooted in the so-called war on drugs, as demonstrated by statistics in studies illuminating the disproportionate number of women imprisoned for drug-related offenses. This manipulated rise in women’s incarceration has had devastating health-care consequences for those trapped in the system, particularly women with serious and/or chronic illnesses.

In 1982, California’s sole prison for female felons was the California Institution for Women (CIW). Already overcrowded (nearly 1,100 in space designed to house 930), the substandard quality of medical care was immediately evident to me when I arrived. It became noticeable worse over the years I was housed there, nearly a decade. The crowding became progressively more serious, reaching nearly 300% capacity by 1987-1988. This crisis conveniently coincided with the CDC’s efforts to garner support - and funding - for rapacious prison expansion.

This perversion of manifest destiny has resulted in a total of four prison facilities built to house female felons; the California Rehabilitation Center (CRC) began to house prison “overflow” in the early 1980’s, and continues to do so. All lack the capacity to meaningfully address women’s substance abuse problems - an underlying cause of many serious health problems prisoners present upon entering custody. Programs designed to educate prisoners and help them turn their lives around are predominantly short-term, classroom-oriented modules, rather than long-term, intense, residential-setting format which has proven effective in CIW’s small but acclaimed “Forever Free” recovery program.

A system burgeoning with substance abusers places a tremendous demand upon medical resources, a demand which the CDC has long failed/refused to meet, both in caring for prisoners suffering from conditions rooted in (or exacerbated by) substance abuse, and in refusing to develop adequate counseling resources to assist women attempting to overcome the underlying problems that led so many to abuse drugs and alcohol in the first place. Ironically, CRC, originally conceived as a facility for individuals under civil addict commitment, has allowed the “bed space” crisis to derail its substance abuse agenda. Only recently - particularly since the release of a scathing January 1998 report by the Little Hoover Commission - has official dialog been directed toward increasing the availability of substance abuse programs, particularly at CRC - as though this were an innovation!

What has not changed in all this time, however, is the fact that women prisoners in California receive inferior medical care, care so poor that comparable performance in a community facility would have resulted in prompt sanctions, including closure of premises and suspension/revocation of licenses, accompanied by aggressive litigation for damages. People outside prison view such action as a matter of course, and applaud the efforts of citizens who press for change.

It is different in prison, where the most fundamental personal decisions are considered a luxury, and efforts to achieve positive change are viewed as tantamount to open and violent rebellion. The decision to seek adequate medical care for oneself is a person matter; it is quite another to come to the realization that there is no hope of resolving such issues within the prison facility, and make the pivotal choice to approach outside advocates for support and assistance.

Such was my personal dilemma six years ago, upon my transfer from CIW to CCWF. During nearly a decade at CIW, I witnessed - and experienced - one medical horror after another. Like many other prisoners, I suffered:

* Delay/denial of access to a physician
* Delay/denial of needed medications
* Delay/denial of access to adequate diagnostic tests
* Delay/denial of timely referral to specialists
* Delay/denial of access to adequate follow-up care

I observed that women with treatable conditions, such as asthma, were dying. In one particularly bad year, CIW had 18 prisoner deaths, primarily related to mishandling of treatable/preventable ailments - many, in fact, from asthma.

Upon transfer to CCWF, I found myself faced with a standard of medical care that was even lower than what I had endured at CIW. The problem was aggravated by staff hostility and retaliation against prisoners who attempted to resolve issues through responsible use of the established administrative grievance procedure.

Although I suffer from rheumatoid arthritis, which is well-documented in my medical records, my prescribed medication was taken from me when I arrived at CCWF. It took weeks for me to get an appointment with a CCWF doctor, so I could be reevaluated and a new prescription issued - weeks during which I suffered excruciating pain.

During the ensuing six years, I have repeatedly found it necessary to submit grievances regarding the institution’s failure to maintain the continuity of my prescription medications. At one point, I was deprived of medication for a period of four months. The pain and sleep deprivation resulting from this needless torment very likely caused irreparable damage to my system. This chain of events is a foundation for my complaint as a named plaintiff in Shumate v. Wilson and constitutes a specific component of the settlement agreement signed in December, 1997.

In the context of Shumate v. Wilson, the term “settlement” represents an equation of sorts:

1) If the CDC can demonstrate, within the specified eight-month time frame for “assessment”, that it is in compliance with the terms of the settlement, the CDC can petition the court for unconditional dismissal of the action.

2) If, in the same assessment period, the prisoner plaintiffs can show that the CDC has not achieved compliance, a subsequent eight-month assessment period will be imposed.

3) If, after the second eight-month assessment period is completed, CDC can show compliance, it may petition for dismissal; however, if compliance is not demonstrated, prisoner plaintiffs can petition the court to restore the case to its active docket, reopen discovery procedures, and move forward to trial.

On the surface, it all appears simple enough. The provisions of the settlement agreement identify a number of areas in which deficiencies were shown to exist, and outline a host of standards, including the following:

· Intake Processing: New prisoners are to receive adequate medical screening, including tests of blood and urine; a complete physical, including a pelvic exam; tests for tuberculoses and sexually transmitted diseases (syphilis, gonorrhea). HIV testing is available but not mandatory. Medications should be continued without delay, and those who are seriously ill should have prompt access to a doctor.

Privacy: Prisoner patients’ conversations with doctors, nurses and medical technical assistants (MTA’s) should not be overheard by guards or other prisoners. The name and nature of medication is likewise confidential.

· Access to Medical Personnel: Locked boxes are provided for the collection of written requests for medical care, as a supplement to the existing sick call procedure. Only medical staff are to have access to these written requests. Within 24 hours after pick-up, a doctor or nurse - not an MTA - must review the requests and make appropriate decisions.

· Sick Call: Waiting in long lines, or outdoors, for lengthy periods can exacerbate illness and increase suffering, and should not occur.

· Emergency Care: All emergency equipment is to be in good working order. During evening and weekend hours, with no doctor on the premises, emergency care is the stated priority for RNs. An MTA is not to “screen out” emergencies. Ambulances are to arrive quickly.

· Follow-up Care: Test results must be reviewed by a doctor, and standard follow-up care provided. Prisoners must be notified of abnormal test results, which must also be entered in medical records. Normal results are to be made available upon patient request, either in writing or at sick call.

· Chronic Diseases: Monitoring conditions such as cardiovascular disease, asthma, and diabetes is to take place on a regular basis under specific modular guidelines (the Respective Chronic Care Programs, or CCPs).

· Medical Equipment and Special Needs: Special equipment and/or supplies (e.g., wheelchair, crutches; pressure bandages/garments for burn patients) should be furnished. Special diets are to be provided for those housed as inpatients; those housed in general population are allowed to obtain special portions of the regular meals (e.g., extra fruit, vegetables, milk; snacks for diabetics).

· Dental Care: Reasonable access to a dentist. Provision of dental prostheses if needed for chewing, for medical reasons.

· Preventive Care: Physical examinations should be conducted regularly, including pelvic and breast exams, and relevant diagnostic tests (e.g., pap smears, mammograms).

· HIV Patients: Access to specialized counseling is to be available through sick call.

It is far from simple, however, to ensure that the CDC will comply with the terms of the agreement, particularly in a lasting way, once officials are no longer under court scrutiny. In other prison-conditions cases - notably, such recent examples as Madrid v. Gomez (medical care and conditions at the notorious Pelican Bay Prison for men) and Coleman v. Wilson (mental health care for California prisoners, statewide) - the CDC’s compliance has been dismal.

Whoever said, “It ain’t over ‘til it’s over!” must have been familiar with prison-conditions litigation.

CHARLA GREENE, ABOLITION ROAD

In December, 1997, a settlement was “proclaimed” in the law suit of Shumate v. Wilson,which was a class action suit against the state filed by California Institution for Women (CIW) and Central California Women’s Facility (CCWF) because of the criminally negligent medical care being received at these two major women’s prisons in California. The suit did not include Valley State Prison, another large prison across the road from CCWF in Chowchilla. There are a few things that bother me about this “settlement”...that is, in addition to the fact that it does not include Valley State.

First, of course, is the fact that the women had to go to such extreme measures to get the California Department of Corrections (CDC) to admit that there was such a grave problem in the health care in prisons. The act of going for a settlement rather than fighting it out in court was really an admission on their part of the presence of a serious situation, and was also a move in this “chess game” to quiet any damning testimony that would have come out in court and been covered by a media that has already publicly revealed the misconduct of the guards in other places of the California prison system. Following the expose of the horrors of Pelican Bay’s systematic torture of prisoners in their Security Housing Unit, and Corcoran’s’ barbaric staged gladiator fights (8 of the guards were indicted by the FBI in Feb, 1998), the story of the medical neglect might have cause people to wake up to what the CDC is really doing. Best to leave the masses slumbering in the misconception that the CDC represents “justice” at work.

Interesting word, JUSTICE. I think ideally justice is supposed to be administered without being in the control of emotions that could distort a decision. This is one part of the blindfold we see on our Lady of Justice; this is so each case is considered without anger or malice and the reasons behind any individual’s actions are taken into consideration as part of the equation that will lead to the correct decision, the balanced decision that will make the scales come out even.

When I mention “reasons” I do not mean “excuses” given on the part of the defendant to throw blame around instead of practicing self-responsibility. By “reasons” I mean the chain of events that led up to the actions being judged, which will assist in the serious and honest consideration, by the judging entity, to understand, human to human, the results of this series of events. Understanding means knowing that we are all fallible and have the capability of acting grossly stupid at any given moment; therefore, the payment that is adjudicated for that act should not be decided by anger, malice or revenge.

When I make that qualification, I mean that a true justice system will not habitually feel that it is necessary to spank the child harder to teach it a lesson. That reaction is one of an angry parent, not a Lady of Justice schooled in wisdom and equilibrium. And when an individual is incarcerated, the correct application of justice will not include torture. However, in the California prison system, the sentence given by the court is often augmented by torture - by the angry jailers/parents. It is as though the guards have the attitude that if a person is in a prison that means the she or he must be bad, so obviously further punishment, beyond just time served, is OK...even necessary. And because the jailer/parents feel they know more about these BAD people than the less informed, less prison experienced people who make the rules, they have the right to go beyond the law - or ignore it.

This torture takes many forms; however, the form we are commenting on right now is the practice of denial of medical attention to women in prison, denial to such an extent that it becomes criminal malice, becomes targeted torture carried out by vengeful guards who arrogantly feel they are above the censure of the law. The denial of medical attention is also present in men’s prisons, but the rate of deaths from this in the women’s prisons was so unusually high that it became necessary, as a basic survival step, to file the law suit Shumate v. Wilson. This was just to get the bare essentials that most people would consider available without question. That the prison system had to be challenged to such a degree shows their unwillingness to treat the women as human beings. However, now that they have agreed to an out of court settlement, their compliance to the agreement of changes required will prove beyond a doubt how they respect their own justice system. How will the parents/CDC react to being told to change their ways and actually act humane? Will they be angry and lash out, or will they ignore the stipulations just as they have been ignoring the basic rules of human decency and human rights in their passive display of anger at the perceived “soft on crime” guidelines of treatment of prisoners? Actually, they’re doing both. They are retaliating against those who have come forward to complain about their treatment, and they are continuing to withhold medical care. We have the emotion card being played in the justice game...again.

If we were to treat the CDC in the same way they have treated Lady Justice (harsher spankings from Daddy if you don’t toe the line immediately, lock-down for the entire prison when one person does something wrong), then they would indeed be in for some prolonged beatings since they have shown a total disregard for the changes adjudicated by the settlement. What kind of “justice” is the CDC, and by association, the State of California, practicing? And how is it possible for them to get away with such documented torture for so long and on such a large scale? Who has the real control here, the justice system or the prison system? That last question was rhetorical because we already know the answer through the actions of the CDC - and actions speak louder than words, spoken or written in “settlements”

I don’t think the “settlement” was done in the true spirit of justice with serious intent to comply. I think the settlement was more like a mean, calculating act to divert outside scrutiny and allow the prison system to increase the level of mistreatment rather than decrease it. That is an emotional (hate) action and does not belong in a justice settlement . Obviously, there is more to come in this story....