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"Thank You Ladies"
VSPW INMATE FAMILY COUNCIL MEETING MINUTES
Friday, December 5, 2003
EXECUTIVE OUTLINE
1. Medical Issues question and answer session.
2. Visiting is going to two days, Saturday and Sunday, starting January 1, 2004. These changes were discussed.
3. Mail, once it arrives at VSPW, is currently 5 days behind. Overtime has been authorized to try and catch up.
4. Vendor-only boxes will be started on January 1st. This program was discussed.
5. The IFC needs family suggestions and questions, and would like to have some new members join us.
6. The problem of confiscated pillows will be checked on by the administration
7. Nominations for the 2004 executive board members for IFC were collected. A vote will be taken at the February meeting.
8. Agenda items for next meeting should be sent to the Nancy Rubinstein by January 19, 2004.
Logo Created By VSPW Graphics Art Program
"Thank You Ladies"
VSPW INMATE FAMILY COUNCIL MEETING MINUTES
Friday, December 5, 2003
EXECUTIVE OUTLINE
1. Medical Issues question and answer session.
2. Visiting is going to two days, Saturday and Sunday, starting January 1, 2004. These changes were discussed.
3. Mail, once it arrives at VSPW, is currently 5 days behind. Overtime has been authorized to try and catch up.
4. Vendor-only boxes will be started on January 1st. This program was discussed.
5. The IFC needs family suggestions and questions, and would like to have some new members join us.
6. The problem of confiscated pillows will be checked on by the administration
7. Nominations for the 2004 executive board members for IFC were collected. A vote will be taken at the February meeting.
8. Agenda items for next meeting should be sent to the Nancy Rubinstein by January 19, 2004.
VALLEY STATE PRISON FOR WOMEN
INMATE FAMILY COUNCIL MEETING MINUTES
Friday, December 5, 2003
Warden’s Conference Room
INMATE FAMILY COUNCIL MEETING MINUTES
Friday, December 5, 2003
Warden’s Conference Room
MEMBERS PRESENT:
Marvin Coolbaugh
Elizabeth Muniz
Dr. John Videen
Tammy Rust
Louisa Camorlinga
Maureen Burgess
Nancy Rubinstein
MEMBERS/ALTERNATES ABSENT:
Ruby Lockett
Wanda Patton
John Errante
Jim Gilmore
STAFF PRESENT:
Deborah Jacquez, Chief Deputy Warden
P. Callahan, Custody Captain
Javier Cavazos, Administrative Assistant
K. Eichenberger, A.W.
Michael A. Naranjo, Supervisor of Registered Nurses
R. Padilla, A.W.
The meeting was called to order at 1:03 p.m.
Marvin Coolbaugh
Elizabeth Muniz
Dr. John Videen
Tammy Rust
Louisa Camorlinga
Maureen Burgess
Nancy Rubinstein
MEMBERS/ALTERNATES ABSENT:
Ruby Lockett
Wanda Patton
John Errante
Jim Gilmore
STAFF PRESENT:
Deborah Jacquez, Chief Deputy Warden
P. Callahan, Custody Captain
Javier Cavazos, Administrative Assistant
K. Eichenberger, A.W.
Michael A. Naranjo, Supervisor of Registered Nurses
R. Padilla, A.W.
The meeting was called to order at 1:03 p.m.
A. AGENDA ITEMS:
1. Medical Issues:
Michael A. Naranjo, Supervisor of Registered Nurses, from the Medical Department, was at our meeting to answer questions about the medical care program at VSPW. It has been about a year since we last had someone come from this department to discuss medical care for the inmates with us. A list of questions received from inmates and family members was passed around (see attached), and some of the questions were discussed. Several questions were left to be answered later, as the information was not available at the meeting, and the IFC Secretary will get the answers and prepare a report later next week from Mr. Naranjo. The following items were discussed at the meeting:
a. There are inmates in CCP (Chronic Care Program) that receive 90-day prescriptions. There is a problem with CCP patients getting their prescriptions renewed on time. The IFC members had a question about on-time of patients in CCP. They are supposed to be scheduled and seen every 90 days (although there are exceptions). There have been problems prescriptions. Mr. Naranjo, the Nursing Supervisor, says there are 7 with these people having regular, on-time reviews. The medical staff is working with the WAC to come up with better ways to keep on-time. For instance, they are discussing ways to modify the number of patients being seen by the doctors, so that less people will be overlooked.
b. Medications for chronic cases should be standardized, and be renewed regularly without problems. Why are chronic med prescriptions lapsing? The Deputy Warden, Deborah Jacquez, answered this question for us. She said that this is an issue that is currently under litigation, and being reviewed by legal oversight during monthly obligation meetings. Deputy Warden Jacquez said that anyone with these type of complaints should get in touch with the lawyers that are working on some of the litigation involving medical issues. It was asked where we could get a contact list of attorneys working on these litigation cases. The Administrative Assistant who will taking over the Community Resource Manager tasks, Javier Cavazos, will be able to provide us with a contact list. Deputy Warden Jacquez also told us that the prison medical department is under a quality management program right now, as part of the litigation, and that VSPW will be monitored under this program for the next 5 to 10 years. The prison is still operating under the conditions set up under the “Coleman” litigation, and haven’t yet switched to new procedures, under the current litigation.
ACTION ITEM: ADMINISTRATIVE ASSISTANT JAVIER CAVAZOS WILL PROVIDE IFC SECRETARY NANCY RUBINSTEIN WITH A CONTACT LIST OF LITIGATORS INVOLVED WITH MEDICAL MONITORING AND MEDICAL ISSUES AT VSPW. SHE WILL FOLLOW UP AND FIND OUT FROM THE LAW OFFICES INVOLVED WHAT TYPE OF CONTACT INMATES AND/OR INMATE FAMILIES WITH MEDICAL CONCERNS ARE ALLOWED TO MAKE.
c. When can we expect the seizure medications to be back on-time? Again, this question could not be addressed without specific inquiries regarding a specific case -- in other words, that question will only be answered on a person-by-person basis. It was explained that we could fax individual problems to the administration. At this time, the administration does not feel free to make any general statements about any future date when they will be on-time.
d. Dr. Videen asked if the pharmacy could flag critical prescriptions for more certainty in timely refills? Mr. Narajno said that they are looking at specifics of “data” and “list decisions” that are being worked on right now in their computer programming for the pharmacy problem. For instance, there has been some discussion of developing a 14-day ahead of time flag for chronic medications that would give the pharmacist a 2-week warning that a prescription is about to expire, and this would trigger an action that would prevent the prescription from lapsing without notice.
e. One of the IFC members asked how the medications are currently delivered to inmates. Mr. Narajno gave us an overview of the prescription delivery procedures. The patient sees a doctor, who writes a prescription for that patient. The prescription is given to the nurse, who delivers all prescriptions the same day to the pharmacy. The pharmacy is required to fill the prescription within 24 hours, and have it sent out to the units. There are 3 deliveries daily to the units.
“Cold” medications, such as aspirin and flu meds, can go with the patients back to the units on the same day they see the doctor. “Hot” medications are controlled substances, must be distributed through the nurses. Seizure medications are considered “Cold” medications.
f. An IFC member asked what an inmate does when she realizes she is out of medicine? Mr. Narajno said that each yard has an outside medical box. The inmate gets a co-pay slip and writes down the information, including the Rx number, and puts it in this box. This co-pay then goes to the pharmacy. If the prescription is an automatic refill, the pharmacy will automatically refill it. But an auto refill can only be honored if the co-pay request comes in within a 7 day period before or after the expiration date. In other words, there is a window in which a refill can be requested. This window includes 7 days immediately before the expiration date of the prescription, and 7 days immediately after the expiration date of the refill.
If an auto refill comes in prior to the 7 days, it will be sent back to the inmate, as the pharmacist may not refill in advance of expiration. If an auto refill comes in past the 7 days after the expiration date, then the prescription will not be refilled, either. The prescription may only be refilled in the period right around the date of the expiration, from 7 days before to 7 days after.
If an auto refill has been expired more than 7 days, the pharmacist will not refill it. Instead, the pharmacist will write a note to the doctor on the yard, and also return the co-pay to the patient, which would indicate a rejection. The co-pay is sent in the regular mail, so it could take 5 to 7 days before the inmate got the rejected co-pay returned to her.
When a doctor is notified of a lapsed prescription, the doctor is to make a new appointment for the patient. Doctors on the yards have records of who is in the chronic care program.
None of the prescriptions have an auto refill that extends past 90 days. For inmates receiving chronic care prescriptions, they are supposed to be seen every 90 days. The doctors schedule these 90-day reviews for the inmates in need of them.
In cases where the patient must be reviewed before a new prescription can be written, there is a 5-day extension on prescriptions that need review, to allow the patient time to get in to see the doctor. This 5-day period is often exceeded by wait time to see a doctor, and the patient is left without a prescription in the interim. This is currently a problem.
g. Dr. Videen asked if it would be possible to lengthen the 5-day extension, to give the inmates a better chance of continuous coverage. Mr. Narajno said that this is being looked at under the “Plata” litigation. Right now, the regulations say that a patient must be able to see a nurse within 24 hours, and a doctor within 15 days. We discussed the idea that a 15-day extension in prescription coverage would fit better with the 15-day doctor review requirement. It was noted that the prison pharmacy was regulated not only by the same regulations as any pharmacy throughout the state, but also possibly by litigation, which may have created narrower guidelines. In other words, the 5 day standard for limits on extending prescriptions may not be an outside regulation, but it may be something litigation may be regulating. That would be something that has to be checked with the legal people. But it was agreed that a 15-day extension time would be a good idea.
h. There is a problem with multiple doctors prescribing medications, and with yard doctors taking away prescriptions. We asked what is causing this problem, and it was explained that during non-office hours and on weekends, patients may be given prescription changes by the evening, night and weekend staff, or during doctor sick or vacation days. This variety of prescribing doctors can create inconsistencies in medications. However, the regular yard doctors have been on the yards for the last 2 ½ years, so the regular staff has remained the same during this period. ER nurses on duty during non-office hours are supposed to let the yard doctor know of any changes in prescription, via fax. Apparently, this has failed to happen on occasion.
i. A question was asked about persons who are diagnosed as EOP (Enhanced Outpatient Program). There is some concern that EOP inmates are being housed with non-EOP inmates, and that some inmates may need to be classified as EOP and are being missed by the administration. Deputy Jacquez said that the administration tracks EOP carefully, because they don’t want to keep EOP inmates at VSPW. The EOP designation is for inmates who are diagnosed as Mental Health Access Level 1. Deputy Jacquez said that the official EOP program is at CCWF, and that VSPW tries to keep permanently assigned EOP diagnosed patients to a maximum of 6. There is an EOP hub at VSPW, a lockup unit, a different and distinct unit, kept separate from any of the general inmate population. This EOP unit is for the entire Women’s prison system.
Regarding the question about diagnosis of inmates in need of EOP treatment: we were told that it is estimated that close to 60% of the inmate population have some mental health issues, and possibly 90% of the inmates may have some impulsive issues. There are several inmates that may be slowly deteriorating from mild to more severe mental health diagnosises over time in the general population, and the administration tries to keep track of any changes so they can move these individuals into the EOP Level 1 program as needed. In order to keep diagnoses current, the employees are trained to look for bizarre or uncharacteristic behavior, and are supposed to refer escalating problems to the Mental Health department.
j. It was asked how housing staff neutralizes dangerous or escalating abnormal behaviors. The housing unit supervisor is appraised of the problem by staff, and makes decisions about moves. There are occasions when a move is made to try to find a place where an inmate can make a better adjustment elsewhere. Unfortunately, there are lots of inmates that no one wants to live with, and it is a fact that conditions don’t allow moves as much as some would like.
The procedure to get a person moved out starts with a request to the Housing Officer. This is passed along to the Unit Corrections Officer, then the Lieutenant, then the Captain, then, finally, the Assistant Warden.
There will always be a staff member who looks the other way when problems arise in the units, and this is a supervisoral problem that needs to be addressed by that staff member’s superior. A good CO will try to run a smooth housing unit, as this is to everyone’s benefit. Verbal intervention is usually the first step, and a good CO will try to communicate with the inmates having a problem, and intervene verbally with a problem inmate to try and solve the problem. A Housing Officer may call in a Sergeant for verbal intervention first. The bottom line is to make the housing situation as safe as possible for inmates and staff.
It was noted that at VSPW, a women’s prison, there is minimal violence (compared to men’s prisons), and that emotional outbursts and other acting-out behaviors are the most common. So the women’s prisons are able to house a wide population together, which can sometimes create tense living situations, especially with 8 women to a room.
k. A question was asked about contagious women being house in general population. The administration informed us that they have no authority to screen for Hepatitis C or HIV, but that they do a CBC when inmates enter the system. This may show something on the liver panel that indicates Hep C or HIV, and these diseases may be specifically tested for later -- and that further testing would be discussed with the inmate. If women are found to have an active contagious disease, they are segregated.
Dr. Videen pointed out that Hepatitis B and C are both very serious and can cause death. He said that there is a 1-4% transmission rate in US prisons, which means that up to 4,000 people in California are contracting Hepatitis B or C while in prison. The usual methods of contracting these two diseases is through sexual activity or drug use. He also explained that while Hepatitis C normally becomes non-infectious, there are chronic carriers that will always be contagious. Mr. Narajno said that they have not been tracking for chronic carriers, and after the normal incubation period, the inmates are returned to general population.
l. Dr. Videen stressed the importance of maintaining access to disinfectants and other cleaning supplies, especially during heavy bathroom use periods, like first thing in the morning, and at night during lockdown. There has been a lack of paper towels again, recently, and also complaints about not having enough toilet paper on the units. In order to combat exposure to infectious or contagious diseases, cleaning supplies are vital. The worst times seem to be in the mornings. The administration said they have not heard any staff complaints on this issue recently or from WAC, so Assistant Warden Eichenberger said he would look in to the supply problem.
m. Mr. Naranjo will write up answers to the rest of the questions on the Medical Issues List, and give them to the IFC within the next week.
ACTION ITEM: MR. NARANJO WILL HAVE ANSWERS TO THE MEDICAL ISSUES LIST QUESTIONS TO NANCY RUBINSTEIN BY THE END OF NEXT WEEK. SHE WILL COMPILE THEM AND ISSUE THEM WITH THE MINUTES.
2. Visiting
a. Visiting Hours at VSPW will be going to two days, Saturday and Sunday, starting January 1, 2004. Governor’s Executive order #2, which stalls some budget issue changes, does not relate to changes in Visiting Hours, so they will still be changed starting January 1. There are funding cuts in personnel that will occur on January 1st, and VSPW is loosing 5.23 positions in Visiting. While the positions in Visiting will be lost, the people won’t be lost. They will be transferred into areas where the prison has been having to pay overtime dollars.
b. There are lock boxes inside the Visitor Processing Center that visitors should be able to use to store items in while they go over to the Visiting Court. Some of the Visiting staff have been sending people repeatedly to their cars to leave things behind when they could be letting visitors use the lock boxes. Captain Callahan said that new staff people need to be reminded that the lock boxes should be used by visitors. He said that he will remind them.
3. Mail
a. Captain Callahan checked on the mail status before our meeting, and said that the mail room is currently about 5 days behind. It was a little further behind over Thanksgiving weekend, but some overtime was authorized, and they are a little more caught up now. There was approval for another person in the mail room, but they don’t have one in there yet. Meanwhile, they are using overtime hours.
b. Inmates are noticing that mail is sometimes over 10 days behind. Captain Callahan pointed out that the inmates are probably talking about the number of days past the date of the postmark. The postmark is put on the mail at the post office that the letter is mailed from. This can occur up to a week before the mail actually reaches VSPW. This can add several days to the actual delivery time to the inmate. One of the IFC members said that mail from the part of the state where they live regularly takes 4 to 5 days to get to its’ destination, so it is possible that it could take 10 days from the time it was mailed until it reaches the inmate. If this is the case, it could account for the delay in delivery to the inmate, especially when the mail room gets 5 or more days behind.
4. Vendor Boxes
a. VSPW will switch to Vendor-only boxes as of January 1st, 2004. Right now, VSPW has two providers to choose from. The first one is Walkenhorst, who will have 1,000 new catalogs to VSPW within the next week or so. The second vendor is D&D, out of Visalia, and is the catalog vendor that is being used by Wasco Prison. Currently, WAC is reviewing the D&D lists, and will have them back to the administration by Monday, December 8th. D&D is ¼ to ½ the cost of Walkenhorst, and may be the better deal in the long run. D&D won’t have the final lists for this next quarter until December 12th. Later on, other vendors may be added as alternative choices. It is hoped that Walkenhorst will react to competition, and drop its’ prices over time. It was noted that D&D is adding to its’ lists, and that they are using bulk purchases from WalMart to lower their prices. For instance, they are buying the 10-packs of small candy bars, and reselling them for around $1.79. A similar purchase from Walkenhorst would be over $4.00. There was some concern voiced about poor service provided by Walkenhorst, that they are hard to reach, and that they often get orders wrong, or send out defective merchandise. The administration hopes that these problems will be solved by Walkenhorst, but if they continue to give inmates bad service, it is hoped that the D&D choice will pick up and provide better service than Walkenhorst.
b.Are there problems in other prisons where the new Vendor Box program has been implemented? Deputy Jacquez said that the administration has discussed this on conference calls with other prisons, and that random checks are being done on the boxes at some prisons, and that there have been some problems with packages that have had to be sent back to the vendor, etc. They are doing random checks to make sure the vendors are providing the materials properly. Wasco has been checking randomly to keep vendors honest.
c. How many COs check boxes right now, under the old box program? Right now, the box program is assigned 1 person. This is the ‘Property Officer’. This position will be eliminated in January. Actually, the reduction is for 1.1 persons (which is actually eliminating a little more funding than VSPW actually has assigned to it right now). There will actually be no officer funded to regulate the new Vendor-only box program, at least under the title ‘Property Officer’.
d. An IFC member requested that the administration consider allowing perhaps a small box directly from the family, just on the prisoner’s birthday or some other special occasion. Deputy Jacquez said that although the individual prisons still have the power to make alternative decisions about Vendor boxes at their own prisons right now, it is going to become a state-wide regulation within the next year. Therefore, any suggestions families may have need to be made at the state level. Suggestions will not be entertained by VSPW.
e. How long will it take for a request to go to D&D, be paid, and then be delivered? Captain Callahan says he will check on this for us.
f. Will D&D be able to e-mail the invoice for the amount of the purchase to the families, or will they still be relying on the US Postal Service for delivering the invoice by mail? Captain Callahan had meant to check on that, and it had slipped his mind -- he says he will ask and let us know.
g. The old Walkenhorst catalog has several items that cannot be purchased by inmates at VSPW. Will this be changed? Yes, the new catalog will have only allowed items in it. It will show prices and actual weights.
h. If the catalog company overpacks, and goes overweight with the boxes, where will the returns be shipped to? The catalog company is responsible for making sure the order is within the weight limits. That will happen ahead of time, so the family should know ahead of time exactly what is in the box (since they’ll be billed for it), and they should know that the box is within the weight limits.
ACTION ITEM: NANCY RUBINSTEIN WILL MAKE AN INQUIRY WITH THE WASCO IFC TO FIND OUT HOW D&D IS WORKING OUT THERE, AND WILL REPORT BACK TO OUR IFC BOARD.
5. IFC Suggestion Box Key
a. Marvin Coolbaugh has obtained the Visiting Center IFC Suggestion Box Key, and is monitoring the box for suggestions or contributions.
b. We need new members, and inmates should encourage their family members to contact us through the suggestion box, through Administrative Assistant Javier Cavazos, by writing to Nancy Rubinstein, PO Box 374, Hayfork, CA, 96041, or by going to our website, at www.vspw-ifc.com . We have asked the Long Termer’s Organization to put a paragraph in their next newsletter for the IFC. This was forwarded to Lt. Moreno, who will give it to the LTO for placement in the newsletter.
B. GENERAL DISCUSSION ITEMS
1.Pillows Taken Away Without Replacement: It was reported to the IFC that a few weeks ago, the Housing Officers went through the units and confiscated all altered pillows. Even though many of the inmates were not issued pillows when they first entered, and the pillows they found were already altered, they were not reissued new pillows to make up for the deficit. Now, a good 40% to 50% of the inmates in the housing units where the confiscations occurred are sleeping on their jackets.
Assistant Eichenberger explained that there has been an ongoing problem with pillows. In order to keep better track of state-issued materials, the prison has, within the last 8 months, started a card system that checks the inmate in with a pillow, mattress, and other issued items. These items are then checked off the hard card when the inmate moves.
Nancy Rubinstein explained that many of the inmates who had pillows confiscated did not have a hard card checkoff, because they’d been at VSPW prior to the beginning of the hard card pillow checkoff system. These people never got issued a state pillow, and it was not their fault that the pillows they had been able to find were altered, as the alteration had taken place prior to their finding the pillow. She asked when these inmates would be issued new pillows. Assistant Warden Eichenberger said he would check into this and let us know.
The nominations for IFC Board officers were collected by Nancy Rubinstein. We will be voting on the executive board for 2004 at our next meeting.
1. Medical Issues:
Michael A. Naranjo, Supervisor of Registered Nurses, from the Medical Department, was at our meeting to answer questions about the medical care program at VSPW. It has been about a year since we last had someone come from this department to discuss medical care for the inmates with us. A list of questions received from inmates and family members was passed around (see attached), and some of the questions were discussed. Several questions were left to be answered later, as the information was not available at the meeting, and the IFC Secretary will get the answers and prepare a report later next week from Mr. Naranjo. The following items were discussed at the meeting:
a. There are inmates in CCP (Chronic Care Program) that receive 90-day prescriptions. There is a problem with CCP patients getting their prescriptions renewed on time. The IFC members had a question about on-time of patients in CCP. They are supposed to be scheduled and seen every 90 days (although there are exceptions). There have been problems prescriptions. Mr. Naranjo, the Nursing Supervisor, says there are 7 with these people having regular, on-time reviews. The medical staff is working with the WAC to come up with better ways to keep on-time. For instance, they are discussing ways to modify the number of patients being seen by the doctors, so that less people will be overlooked.
b. Medications for chronic cases should be standardized, and be renewed regularly without problems. Why are chronic med prescriptions lapsing? The Deputy Warden, Deborah Jacquez, answered this question for us. She said that this is an issue that is currently under litigation, and being reviewed by legal oversight during monthly obligation meetings. Deputy Warden Jacquez said that anyone with these type of complaints should get in touch with the lawyers that are working on some of the litigation involving medical issues. It was asked where we could get a contact list of attorneys working on these litigation cases. The Administrative Assistant who will taking over the Community Resource Manager tasks, Javier Cavazos, will be able to provide us with a contact list. Deputy Warden Jacquez also told us that the prison medical department is under a quality management program right now, as part of the litigation, and that VSPW will be monitored under this program for the next 5 to 10 years. The prison is still operating under the conditions set up under the “Coleman” litigation, and haven’t yet switched to new procedures, under the current litigation.
ACTION ITEM: ADMINISTRATIVE ASSISTANT JAVIER CAVAZOS WILL PROVIDE IFC SECRETARY NANCY RUBINSTEIN WITH A CONTACT LIST OF LITIGATORS INVOLVED WITH MEDICAL MONITORING AND MEDICAL ISSUES AT VSPW. SHE WILL FOLLOW UP AND FIND OUT FROM THE LAW OFFICES INVOLVED WHAT TYPE OF CONTACT INMATES AND/OR INMATE FAMILIES WITH MEDICAL CONCERNS ARE ALLOWED TO MAKE.
c. When can we expect the seizure medications to be back on-time? Again, this question could not be addressed without specific inquiries regarding a specific case -- in other words, that question will only be answered on a person-by-person basis. It was explained that we could fax individual problems to the administration. At this time, the administration does not feel free to make any general statements about any future date when they will be on-time.
d. Dr. Videen asked if the pharmacy could flag critical prescriptions for more certainty in timely refills? Mr. Narajno said that they are looking at specifics of “data” and “list decisions” that are being worked on right now in their computer programming for the pharmacy problem. For instance, there has been some discussion of developing a 14-day ahead of time flag for chronic medications that would give the pharmacist a 2-week warning that a prescription is about to expire, and this would trigger an action that would prevent the prescription from lapsing without notice.
e. One of the IFC members asked how the medications are currently delivered to inmates. Mr. Narajno gave us an overview of the prescription delivery procedures. The patient sees a doctor, who writes a prescription for that patient. The prescription is given to the nurse, who delivers all prescriptions the same day to the pharmacy. The pharmacy is required to fill the prescription within 24 hours, and have it sent out to the units. There are 3 deliveries daily to the units.
“Cold” medications, such as aspirin and flu meds, can go with the patients back to the units on the same day they see the doctor. “Hot” medications are controlled substances, must be distributed through the nurses. Seizure medications are considered “Cold” medications.
f. An IFC member asked what an inmate does when she realizes she is out of medicine? Mr. Narajno said that each yard has an outside medical box. The inmate gets a co-pay slip and writes down the information, including the Rx number, and puts it in this box. This co-pay then goes to the pharmacy. If the prescription is an automatic refill, the pharmacy will automatically refill it. But an auto refill can only be honored if the co-pay request comes in within a 7 day period before or after the expiration date. In other words, there is a window in which a refill can be requested. This window includes 7 days immediately before the expiration date of the prescription, and 7 days immediately after the expiration date of the refill.
If an auto refill comes in prior to the 7 days, it will be sent back to the inmate, as the pharmacist may not refill in advance of expiration. If an auto refill comes in past the 7 days after the expiration date, then the prescription will not be refilled, either. The prescription may only be refilled in the period right around the date of the expiration, from 7 days before to 7 days after.
If an auto refill has been expired more than 7 days, the pharmacist will not refill it. Instead, the pharmacist will write a note to the doctor on the yard, and also return the co-pay to the patient, which would indicate a rejection. The co-pay is sent in the regular mail, so it could take 5 to 7 days before the inmate got the rejected co-pay returned to her.
When a doctor is notified of a lapsed prescription, the doctor is to make a new appointment for the patient. Doctors on the yards have records of who is in the chronic care program.
None of the prescriptions have an auto refill that extends past 90 days. For inmates receiving chronic care prescriptions, they are supposed to be seen every 90 days. The doctors schedule these 90-day reviews for the inmates in need of them.
In cases where the patient must be reviewed before a new prescription can be written, there is a 5-day extension on prescriptions that need review, to allow the patient time to get in to see the doctor. This 5-day period is often exceeded by wait time to see a doctor, and the patient is left without a prescription in the interim. This is currently a problem.
g. Dr. Videen asked if it would be possible to lengthen the 5-day extension, to give the inmates a better chance of continuous coverage. Mr. Narajno said that this is being looked at under the “Plata” litigation. Right now, the regulations say that a patient must be able to see a nurse within 24 hours, and a doctor within 15 days. We discussed the idea that a 15-day extension in prescription coverage would fit better with the 15-day doctor review requirement. It was noted that the prison pharmacy was regulated not only by the same regulations as any pharmacy throughout the state, but also possibly by litigation, which may have created narrower guidelines. In other words, the 5 day standard for limits on extending prescriptions may not be an outside regulation, but it may be something litigation may be regulating. That would be something that has to be checked with the legal people. But it was agreed that a 15-day extension time would be a good idea.
h. There is a problem with multiple doctors prescribing medications, and with yard doctors taking away prescriptions. We asked what is causing this problem, and it was explained that during non-office hours and on weekends, patients may be given prescription changes by the evening, night and weekend staff, or during doctor sick or vacation days. This variety of prescribing doctors can create inconsistencies in medications. However, the regular yard doctors have been on the yards for the last 2 ½ years, so the regular staff has remained the same during this period. ER nurses on duty during non-office hours are supposed to let the yard doctor know of any changes in prescription, via fax. Apparently, this has failed to happen on occasion.
i. A question was asked about persons who are diagnosed as EOP (Enhanced Outpatient Program). There is some concern that EOP inmates are being housed with non-EOP inmates, and that some inmates may need to be classified as EOP and are being missed by the administration. Deputy Jacquez said that the administration tracks EOP carefully, because they don’t want to keep EOP inmates at VSPW. The EOP designation is for inmates who are diagnosed as Mental Health Access Level 1. Deputy Jacquez said that the official EOP program is at CCWF, and that VSPW tries to keep permanently assigned EOP diagnosed patients to a maximum of 6. There is an EOP hub at VSPW, a lockup unit, a different and distinct unit, kept separate from any of the general inmate population. This EOP unit is for the entire Women’s prison system.
Regarding the question about diagnosis of inmates in need of EOP treatment: we were told that it is estimated that close to 60% of the inmate population have some mental health issues, and possibly 90% of the inmates may have some impulsive issues. There are several inmates that may be slowly deteriorating from mild to more severe mental health diagnosises over time in the general population, and the administration tries to keep track of any changes so they can move these individuals into the EOP Level 1 program as needed. In order to keep diagnoses current, the employees are trained to look for bizarre or uncharacteristic behavior, and are supposed to refer escalating problems to the Mental Health department.
j. It was asked how housing staff neutralizes dangerous or escalating abnormal behaviors. The housing unit supervisor is appraised of the problem by staff, and makes decisions about moves. There are occasions when a move is made to try to find a place where an inmate can make a better adjustment elsewhere. Unfortunately, there are lots of inmates that no one wants to live with, and it is a fact that conditions don’t allow moves as much as some would like.
The procedure to get a person moved out starts with a request to the Housing Officer. This is passed along to the Unit Corrections Officer, then the Lieutenant, then the Captain, then, finally, the Assistant Warden.
There will always be a staff member who looks the other way when problems arise in the units, and this is a supervisoral problem that needs to be addressed by that staff member’s superior. A good CO will try to run a smooth housing unit, as this is to everyone’s benefit. Verbal intervention is usually the first step, and a good CO will try to communicate with the inmates having a problem, and intervene verbally with a problem inmate to try and solve the problem. A Housing Officer may call in a Sergeant for verbal intervention first. The bottom line is to make the housing situation as safe as possible for inmates and staff.
It was noted that at VSPW, a women’s prison, there is minimal violence (compared to men’s prisons), and that emotional outbursts and other acting-out behaviors are the most common. So the women’s prisons are able to house a wide population together, which can sometimes create tense living situations, especially with 8 women to a room.
k. A question was asked about contagious women being house in general population. The administration informed us that they have no authority to screen for Hepatitis C or HIV, but that they do a CBC when inmates enter the system. This may show something on the liver panel that indicates Hep C or HIV, and these diseases may be specifically tested for later -- and that further testing would be discussed with the inmate. If women are found to have an active contagious disease, they are segregated.
Dr. Videen pointed out that Hepatitis B and C are both very serious and can cause death. He said that there is a 1-4% transmission rate in US prisons, which means that up to 4,000 people in California are contracting Hepatitis B or C while in prison. The usual methods of contracting these two diseases is through sexual activity or drug use. He also explained that while Hepatitis C normally becomes non-infectious, there are chronic carriers that will always be contagious. Mr. Narajno said that they have not been tracking for chronic carriers, and after the normal incubation period, the inmates are returned to general population.
l. Dr. Videen stressed the importance of maintaining access to disinfectants and other cleaning supplies, especially during heavy bathroom use periods, like first thing in the morning, and at night during lockdown. There has been a lack of paper towels again, recently, and also complaints about not having enough toilet paper on the units. In order to combat exposure to infectious or contagious diseases, cleaning supplies are vital. The worst times seem to be in the mornings. The administration said they have not heard any staff complaints on this issue recently or from WAC, so Assistant Warden Eichenberger said he would look in to the supply problem.
m. Mr. Naranjo will write up answers to the rest of the questions on the Medical Issues List, and give them to the IFC within the next week.
ACTION ITEM: MR. NARANJO WILL HAVE ANSWERS TO THE MEDICAL ISSUES LIST QUESTIONS TO NANCY RUBINSTEIN BY THE END OF NEXT WEEK. SHE WILL COMPILE THEM AND ISSUE THEM WITH THE MINUTES.
2. Visiting
a. Visiting Hours at VSPW will be going to two days, Saturday and Sunday, starting January 1, 2004. Governor’s Executive order #2, which stalls some budget issue changes, does not relate to changes in Visiting Hours, so they will still be changed starting January 1. There are funding cuts in personnel that will occur on January 1st, and VSPW is loosing 5.23 positions in Visiting. While the positions in Visiting will be lost, the people won’t be lost. They will be transferred into areas where the prison has been having to pay overtime dollars.
b. There are lock boxes inside the Visitor Processing Center that visitors should be able to use to store items in while they go over to the Visiting Court. Some of the Visiting staff have been sending people repeatedly to their cars to leave things behind when they could be letting visitors use the lock boxes. Captain Callahan said that new staff people need to be reminded that the lock boxes should be used by visitors. He said that he will remind them.
3. Mail
a. Captain Callahan checked on the mail status before our meeting, and said that the mail room is currently about 5 days behind. It was a little further behind over Thanksgiving weekend, but some overtime was authorized, and they are a little more caught up now. There was approval for another person in the mail room, but they don’t have one in there yet. Meanwhile, they are using overtime hours.
b. Inmates are noticing that mail is sometimes over 10 days behind. Captain Callahan pointed out that the inmates are probably talking about the number of days past the date of the postmark. The postmark is put on the mail at the post office that the letter is mailed from. This can occur up to a week before the mail actually reaches VSPW. This can add several days to the actual delivery time to the inmate. One of the IFC members said that mail from the part of the state where they live regularly takes 4 to 5 days to get to its’ destination, so it is possible that it could take 10 days from the time it was mailed until it reaches the inmate. If this is the case, it could account for the delay in delivery to the inmate, especially when the mail room gets 5 or more days behind.
4. Vendor Boxes
a. VSPW will switch to Vendor-only boxes as of January 1st, 2004. Right now, VSPW has two providers to choose from. The first one is Walkenhorst, who will have 1,000 new catalogs to VSPW within the next week or so. The second vendor is D&D, out of Visalia, and is the catalog vendor that is being used by Wasco Prison. Currently, WAC is reviewing the D&D lists, and will have them back to the administration by Monday, December 8th. D&D is ¼ to ½ the cost of Walkenhorst, and may be the better deal in the long run. D&D won’t have the final lists for this next quarter until December 12th. Later on, other vendors may be added as alternative choices. It is hoped that Walkenhorst will react to competition, and drop its’ prices over time. It was noted that D&D is adding to its’ lists, and that they are using bulk purchases from WalMart to lower their prices. For instance, they are buying the 10-packs of small candy bars, and reselling them for around $1.79. A similar purchase from Walkenhorst would be over $4.00. There was some concern voiced about poor service provided by Walkenhorst, that they are hard to reach, and that they often get orders wrong, or send out defective merchandise. The administration hopes that these problems will be solved by Walkenhorst, but if they continue to give inmates bad service, it is hoped that the D&D choice will pick up and provide better service than Walkenhorst.
b.Are there problems in other prisons where the new Vendor Box program has been implemented? Deputy Jacquez said that the administration has discussed this on conference calls with other prisons, and that random checks are being done on the boxes at some prisons, and that there have been some problems with packages that have had to be sent back to the vendor, etc. They are doing random checks to make sure the vendors are providing the materials properly. Wasco has been checking randomly to keep vendors honest.
c. How many COs check boxes right now, under the old box program? Right now, the box program is assigned 1 person. This is the ‘Property Officer’. This position will be eliminated in January. Actually, the reduction is for 1.1 persons (which is actually eliminating a little more funding than VSPW actually has assigned to it right now). There will actually be no officer funded to regulate the new Vendor-only box program, at least under the title ‘Property Officer’.
d. An IFC member requested that the administration consider allowing perhaps a small box directly from the family, just on the prisoner’s birthday or some other special occasion. Deputy Jacquez said that although the individual prisons still have the power to make alternative decisions about Vendor boxes at their own prisons right now, it is going to become a state-wide regulation within the next year. Therefore, any suggestions families may have need to be made at the state level. Suggestions will not be entertained by VSPW.
e. How long will it take for a request to go to D&D, be paid, and then be delivered? Captain Callahan says he will check on this for us.
f. Will D&D be able to e-mail the invoice for the amount of the purchase to the families, or will they still be relying on the US Postal Service for delivering the invoice by mail? Captain Callahan had meant to check on that, and it had slipped his mind -- he says he will ask and let us know.
g. The old Walkenhorst catalog has several items that cannot be purchased by inmates at VSPW. Will this be changed? Yes, the new catalog will have only allowed items in it. It will show prices and actual weights.
h. If the catalog company overpacks, and goes overweight with the boxes, where will the returns be shipped to? The catalog company is responsible for making sure the order is within the weight limits. That will happen ahead of time, so the family should know ahead of time exactly what is in the box (since they’ll be billed for it), and they should know that the box is within the weight limits.
ACTION ITEM: NANCY RUBINSTEIN WILL MAKE AN INQUIRY WITH THE WASCO IFC TO FIND OUT HOW D&D IS WORKING OUT THERE, AND WILL REPORT BACK TO OUR IFC BOARD.
5. IFC Suggestion Box Key
a. Marvin Coolbaugh has obtained the Visiting Center IFC Suggestion Box Key, and is monitoring the box for suggestions or contributions.
b. We need new members, and inmates should encourage their family members to contact us through the suggestion box, through Administrative Assistant Javier Cavazos, by writing to Nancy Rubinstein, PO Box 374, Hayfork, CA, 96041, or by going to our website, at www.vspw-ifc.com . We have asked the Long Termer’s Organization to put a paragraph in their next newsletter for the IFC. This was forwarded to Lt. Moreno, who will give it to the LTO for placement in the newsletter.
B. GENERAL DISCUSSION ITEMS
1.Pillows Taken Away Without Replacement: It was reported to the IFC that a few weeks ago, the Housing Officers went through the units and confiscated all altered pillows. Even though many of the inmates were not issued pillows when they first entered, and the pillows they found were already altered, they were not reissued new pillows to make up for the deficit. Now, a good 40% to 50% of the inmates in the housing units where the confiscations occurred are sleeping on their jackets.
Assistant Eichenberger explained that there has been an ongoing problem with pillows. In order to keep better track of state-issued materials, the prison has, within the last 8 months, started a card system that checks the inmate in with a pillow, mattress, and other issued items. These items are then checked off the hard card when the inmate moves.
Nancy Rubinstein explained that many of the inmates who had pillows confiscated did not have a hard card checkoff, because they’d been at VSPW prior to the beginning of the hard card pillow checkoff system. These people never got issued a state pillow, and it was not their fault that the pillows they had been able to find were altered, as the alteration had taken place prior to their finding the pillow. She asked when these inmates would be issued new pillows. Assistant Warden Eichenberger said he would check into this and let us know.
The nominations for IFC Board officers were collected by Nancy Rubinstein. We will be voting on the executive board for 2004 at our next meeting.
The meeting was adjourned at 2:20 p.m.
Next Meeting:
Friday, February 6, 2004 At 1:00 P.M.
VSPW Warden’s Conference Room
Next Meeting:
Friday, February 6, 2004 At 1:00 P.M.
VSPW Warden’s Conference Room
Minutes prepared by Nancy Rubinstein
attachments:
Medical Issues Question List
Medical Issues Answers Report
Wasco D&D Report
Litigation Contact Report
attachments:
Medical Issues Question List
Medical Issues Answers Report
Wasco D&D Report
Litigation Contact Report
MEDICAL ISSUES QUESTION LIST
CCP (Chronic Care Program) patients again are not being seen within the 90-day time frame for medications therefore extended periods of time without medications are up to 30 days or more.
Inmates are not being able to have their dressings changed, from biopsies and surgeries, etc.
Inmates who are seeing more than one doctor in cases multiple doctors, each one is prescribing medications then yard doctors when seeing the patient says the other doctors are wrong and take the medications away so it appears no one takes the time to follow the patients medical chart.
Inmates on seizure meds are experiencing their meds expiring and difficulty getting them renewed for several days or more.
Inmates are having difficulty with maintaining continuity on medication.
Inmates classified as EOP are housed with general population inmates, placing people at risk.
Housing staff and GP inmates housed with CCCM’s or EOP inmates are expected to be subject to be mental health experts.
Staff submitting mental health referrals regarding these inmates who can attest to their behavior are not contacted directly therefore the inmate is able to manipulate the mental health staff.
GP inmates are placed into a position of fear ultimately because many of these inmates have violent pasts and are forced to live in rooms with these inmates.
Supervisory staff won’t make bed moves to calm situations and state “it’s only moving the problem to another room”.
Is there a way only these inmates be housed in EOP designated rooms together without GP inmates being subjected?
The OHU (Outpatient Housing Unit) area is still not being cleaned properly.
The TV room in OHU needs more books for patients to read.
Beds need repair in the OHU.
Inmates housed in OHU need scheduled linen/clothing exchange times weekly.
Dental -- the following comments are made from B-yard observations only:
Inmates who are seen in B-dental and have teeth pulled due toeither emergency infections or due to waiting so long the teeth couldn’t be saved are NOT being seen for a dental plan.
Inmates who put in dental co-pays are purportedly placed on a dental data base list -- however anywhere from 4-12 months or more pass and the inmate is not seen.
There is a purported computer database inmates are placed on when submitting a co-pay form CDC 7362. On it is listed the data given, you’ve been placed onto the database. Examples of specific, individual instances of waiting list problems were given, which are not included here.
There are more than 800+ women on B-yard with 1 dentist and because of this preventative care is not done, causing people to loose their teeth.
CCP (Chronic Care Program) patients again are not being seen within the 90-day time frame for medications therefore extended periods of time without medications are up to 30 days or more.
Inmates are not being able to have their dressings changed, from biopsies and surgeries, etc.
Inmates who are seeing more than one doctor in cases multiple doctors, each one is prescribing medications then yard doctors when seeing the patient says the other doctors are wrong and take the medications away so it appears no one takes the time to follow the patients medical chart.
Inmates on seizure meds are experiencing their meds expiring and difficulty getting them renewed for several days or more.
Inmates are having difficulty with maintaining continuity on medication.
Inmates classified as EOP are housed with general population inmates, placing people at risk.
Housing staff and GP inmates housed with CCCM’s or EOP inmates are expected to be subject to be mental health experts.
Staff submitting mental health referrals regarding these inmates who can attest to their behavior are not contacted directly therefore the inmate is able to manipulate the mental health staff.
GP inmates are placed into a position of fear ultimately because many of these inmates have violent pasts and are forced to live in rooms with these inmates.
Supervisory staff won’t make bed moves to calm situations and state “it’s only moving the problem to another room”.
Is there a way only these inmates be housed in EOP designated rooms together without GP inmates being subjected?
The OHU (Outpatient Housing Unit) area is still not being cleaned properly.
The TV room in OHU needs more books for patients to read.
Beds need repair in the OHU.
Inmates housed in OHU need scheduled linen/clothing exchange times weekly.
Dental -- the following comments are made from B-yard observations only:
Inmates who are seen in B-dental and have teeth pulled due toeither emergency infections or due to waiting so long the teeth couldn’t be saved are NOT being seen for a dental plan.
Inmates who put in dental co-pays are purportedly placed on a dental data base list -- however anywhere from 4-12 months or more pass and the inmate is not seen.
There is a purported computer database inmates are placed on when submitting a co-pay form CDC 7362. On it is listed the data given, you’ve been placed onto the database. Examples of specific, individual instances of waiting list problems were given, which are not included here.
There are more than 800+ women on B-yard with 1 dentist and because of this preventative care is not done, causing people to loose their teeth.
Inmates are not being able to have their dressings changed, from biopsies and surgeries, etc.
Inmates who are seeing more than one doctor in cases multiple doctors, each one is prescribing medications then yard doctors when seeing the patient says the other doctors are wrong and take the medications away so it appears no one takes the time to follow the patients medical chart.
Inmates on seizure meds are experiencing their meds expiring and difficulty getting them renewed for several days or more.
Inmates are having difficulty with maintaining continuity on medication.
Inmates classified as EOP are housed with general population inmates, placing people at risk.
Housing staff and GP inmates housed with CCCM’s or EOP inmates are expected to be subject to be mental health experts.
Staff submitting mental health referrals regarding these inmates who can attest to their behavior are not contacted directly therefore the inmate is able to manipulate the mental health staff.
GP inmates are placed into a position of fear ultimately because many of these inmates have violent pasts and are forced to live in rooms with these inmates.
Supervisory staff won’t make bed moves to calm situations and state “it’s only moving the problem to another room”.
Is there a way only these inmates be housed in EOP designated rooms together without GP inmates being subjected?
The OHU (Outpatient Housing Unit) area is still not being cleaned properly.
The TV room in OHU needs more books for patients to read.
Beds need repair in the OHU.
Inmates housed in OHU need scheduled linen/clothing exchange times weekly.
Dental -- the following comments are made from B-yard observations only:
Inmates who are seen in B-dental and have teeth pulled due toeither emergency infections or due to waiting so long the teeth couldn’t be saved are NOT being seen for a dental plan.
Inmates who put in dental co-pays are purportedly placed on a dental data base list -- however anywhere from 4-12 months or more pass and the inmate is not seen.
There is a purported computer database inmates are placed on when submitting a co-pay form CDC 7362. On it is listed the data given, you’ve been placed onto the database. Examples of specific, individual instances of waiting list problems were given, which are not included here.
There are more than 800+ women on B-yard with 1 dentist and because of this preventative care is not done, causing people to loose their teeth.
CCP (Chronic Care Program) patients again are not being seen within the 90-day time frame for medications therefore extended periods of time without medications are up to 30 days or more.
Inmates are not being able to have their dressings changed, from biopsies and surgeries, etc.
Inmates who are seeing more than one doctor in cases multiple doctors, each one is prescribing medications then yard doctors when seeing the patient says the other doctors are wrong and take the medications away so it appears no one takes the time to follow the patients medical chart.
Inmates on seizure meds are experiencing their meds expiring and difficulty getting them renewed for several days or more.
Inmates are having difficulty with maintaining continuity on medication.
Inmates classified as EOP are housed with general population inmates, placing people at risk.
Housing staff and GP inmates housed with CCCM’s or EOP inmates are expected to be subject to be mental health experts.
Staff submitting mental health referrals regarding these inmates who can attest to their behavior are not contacted directly therefore the inmate is able to manipulate the mental health staff.
GP inmates are placed into a position of fear ultimately because many of these inmates have violent pasts and are forced to live in rooms with these inmates.
Supervisory staff won’t make bed moves to calm situations and state “it’s only moving the problem to another room”.
Is there a way only these inmates be housed in EOP designated rooms together without GP inmates being subjected?
The OHU (Outpatient Housing Unit) area is still not being cleaned properly.
The TV room in OHU needs more books for patients to read.
Beds need repair in the OHU.
Inmates housed in OHU need scheduled linen/clothing exchange times weekly.
Dental -- the following comments are made from B-yard observations only:
Inmates who are seen in B-dental and have teeth pulled due toeither emergency infections or due to waiting so long the teeth couldn’t be saved are NOT being seen for a dental plan.
Inmates who put in dental co-pays are purportedly placed on a dental data base list -- however anywhere from 4-12 months or more pass and the inmate is not seen.
There is a purported computer database inmates are placed on when submitting a co-pay form CDC 7362. On it is listed the data given, you’ve been placed onto the database. Examples of specific, individual instances of waiting list problems were given, which are not included here.
There are more than 800+ women on B-yard with 1 dentist and because of this preventative care is not done, causing people to loose their teeth.
