MEDICAL ISSUES DISCUSSED AT DECEMBER 5, 2003 MEETING
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The following section of notes from the IFC meeting on December 5th, 2004, was left out of the last posted minutes, to give the medical staff a chance to review all of our questions. They provided us with a memo covering the more important questions on January 12, 2004. Another ACTION ITEM from our December 5th meeting included contacting the Prison Law Office, and getting some clarification on the requirements and guidelines for medical issues under the new Plata ruling. The materials in this addendum include the minutes left out of our December 5, 2003 IFC minutes, the medical staff Memo, and a brief report on the Plata Case.
BACK TO FEBRUARY 2004 MINUTES
The following section of notes from the IFC meeting on December 5th, 2004, was left out of the last posted minutes, to give the medical staff a chance to review all of our questions. They provided us with a memo covering the more important questions on January 12, 2004. Another ACTION ITEM from our December 5th meeting included contacting the Prison Law Office, and getting some clarification on the requirements and guidelines for medical issues under the new Plata ruling. The materials in this addendum include the minutes left out of our December 5, 2003 IFC minutes, the medical staff Memo, and a brief report on the Plata Case.
12-05-03 IFC MINUTES, MEDICAL ISSUES SECTION
(DELETED FROM POSTING OF 12-05-03 MINUTES)
EXCERPTED 01-20-04 TO POST WITH
‘MEDICAL ISSUES’ REPORT (RECEIVED 01-20-04)
(DELETED FROM POSTING OF 12-05-03 MINUTES)
EXCERPTED 01-20-04 TO POST WITH
‘MEDICAL ISSUES’ REPORT (RECEIVED 01-20-04)
(*Bold items were temporarily deleted from 12-05-03 minutes.)
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 prescriptions. Mr. Naranjo, the Nursing Supervisor, says there are 7 categories of patients in CCP. They are supposed to be scheduled and seen every 90 days (although there are exceptions). There have been problems 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.
PLATA CASE INFO
February 2, 2004, by Nancy Rubinstein
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 prescriptions. Mr. Naranjo, the Nursing Supervisor, says there are 7 categories of patients in CCP. They are supposed to be scheduled and seen every 90 days (although there are exceptions). There have been problems 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.
PLATA CASE INFO
February 2, 2004, by Nancy Rubinstein
I called the Prison Law Office in San Rafael (right outside San Quentin), and talked to attorney Alison Hardy about the Plata federal civil rights suit, which was brought by the Prison Law Office on behalf of California state prisoners with serious medical concerns.
The parties settled the case in June, 2002, without going to trial. Under the stipulated settlement, the CDC developed a comprehensive set of medical care policies and procedures that it agreed to implement at the prisons, on a “phased-in” from 2003 through 2008. A copy of the stipulation and of the new medical care policies and procedures should be available for you to review in your law library.
Seven of the prisons, including VSPW, CIW and CCWF were supposed to implement the policies and procedures during the year 2003. Unfortunately, training on the policies and procedures has been delayed, and none of the 2003 prisons will have been fully trained on the policies and procedures until the end of March, 2004. The Prison Law attorneys are monitoring the prisons for the required changes, and will continue to visit VSPW on a regular basis until the prison has substantially complied with the policies and procedures.
The Prison Law Office attorney says that inmates who experience problems with their medical care that they have not been able to resolve with their yard physician should submit a 602 and pursue it through the Third Level, if necessary. Then, if the problem still isn’t solved, inmates can write directly to the Prison Law Office, with a copy of the appeal and responses, and tell them about the ongoing problem.
Alison says that it’s really important for people to use the 602s. She said that when Prison Law Office attorneys come out to monitor, they go through the 602 file, and use the number of complaints about various issues to zero in on where the most problems are occurring. This helps them focus on the problems, and they really do look at those 602s. Even if you believe that 602s never get anywhere, the prison has to keep them on file. So encourage anyone with any type of medical services problem to get those 602s in.
She also said that inmates at VSPW are especially good about getting 602s in. I actually heard that from people in the administration at VSPW. It appears that VSPW inmates are good at making themselves heard, and I think it’s really going to help. So we need to encourage everyone to keep on bringing up problems in writing, and fully following up on their 602s in medical. If and when Prison Law has to go back to court to get things moving, the number and type of 602s on file will make a difference.
Finally, Alison said that anyone that is having an emergency medical care problem, like not getting their prescription for vital medications such as insulin or nitroglycerin, should write directly to Prison Law Office, in addition to following the 602 remedies.
The parties settled the case in June, 2002, without going to trial. Under the stipulated settlement, the CDC developed a comprehensive set of medical care policies and procedures that it agreed to implement at the prisons, on a “phased-in” from 2003 through 2008. A copy of the stipulation and of the new medical care policies and procedures should be available for you to review in your law library.
Seven of the prisons, including VSPW, CIW and CCWF were supposed to implement the policies and procedures during the year 2003. Unfortunately, training on the policies and procedures has been delayed, and none of the 2003 prisons will have been fully trained on the policies and procedures until the end of March, 2004. The Prison Law attorneys are monitoring the prisons for the required changes, and will continue to visit VSPW on a regular basis until the prison has substantially complied with the policies and procedures.
The Prison Law Office attorney says that inmates who experience problems with their medical care that they have not been able to resolve with their yard physician should submit a 602 and pursue it through the Third Level, if necessary. Then, if the problem still isn’t solved, inmates can write directly to the Prison Law Office, with a copy of the appeal and responses, and tell them about the ongoing problem.
Alison says that it’s really important for people to use the 602s. She said that when Prison Law Office attorneys come out to monitor, they go through the 602 file, and use the number of complaints about various issues to zero in on where the most problems are occurring. This helps them focus on the problems, and they really do look at those 602s. Even if you believe that 602s never get anywhere, the prison has to keep them on file. So encourage anyone with any type of medical services problem to get those 602s in.
She also said that inmates at VSPW are especially good about getting 602s in. I actually heard that from people in the administration at VSPW. It appears that VSPW inmates are good at making themselves heard, and I think it’s really going to help. So we need to encourage everyone to keep on bringing up problems in writing, and fully following up on their 602s in medical. If and when Prison Law has to go back to court to get things moving, the number and type of 602s on file will make a difference.
Finally, Alison said that anyone that is having an emergency medical care problem, like not getting their prescription for vital medications such as insulin or nitroglycerin, should write directly to Prison Law Office, in addition to following the 602 remedies.