Prison health care is investigated
Virginia Terry was thankful when her daughter, a drug
addict suffering from bipolar disorder, got locked up at the
women's prison in Vandalia, Mo., for a forgery conviction.
"I thought, at least she'd be safe," Terry recalls.
That changed when Terry's daughter, Al'Deana Simmons of
Camdenton, began complaining, in letters and phone calls home,
about the type of health care she was getting behind bars.
She said prison doctors changed her anti-depression
medication. She cried about blinding headaches. And Terry will
never forget what Simmons said in their phone conversation
July 1, the day before she died of an apparent aneurysm.
"She said her head was sizzling and that she was going
blind," Terry recalls. "The prison doctor saw her
for 10 minutes and said nothing was wrong."
The case of Simmons, 33, is one of many being explored this
summer by investigators with the U.S. Justice Department's
Civil Rights Division in Washington. Investigators have been
to the prison three times and interviewed 127 inmates about
the medical treatment provided by St. Louis-based Correctional
They also have met in St. Louis with inmates' relatives,
including Terry. She provided them with her daughter's letters
and medical records.
CMS won its first Missouri contract in 1992 under then Gov.
John Ashcroft, who now as U.S. attorney general heads up the
Yet, in a move rarely seen by the Justice Department,
Missouri's prison system has denied the investigators the
access they want. The investigators have wanted to see the
infirmary and talk to prisoners and staff at the prison, about
70 miles northwest of St. Louis. Prison officials wouldn't
allow it, instead telling federal investigators they could
talk to prisoners only in the visitation area during normal
That kind of restriction to a prison setting is rare,
happening only a handful of times in the Justice Department's
23 years of work using the Civil Rights of Institutionalized
The act was passed by Congress in 1980. It empowers the
attorney general to investigate the conditions at these
institutions and file lawsuits to remedy "a pattern or
practice" of unlawful conditions.
A spokesman for the Justice Department declined to comment.
Tim Kniest, spokesman for the Missouri Department of
Corrections, said investigators weren't permitted to
"walk around unescorted" because of safety concerns.
Kniest said that, if the investigators make arrangements with
the Missouri attorney general's office, they can have a tour.
The investigators work with the Special Litigation Section of
the Civil Rights Division. That section's job is to protect
constitutional rights of people confined to institutions such
as state-run nursing homes and prisons.
$80 million a year
Correctional Medical Services is the nation's largest prison
health care provider. It has contracts to provide medical care
for about 228,000 inmates and prisoners in 27 states.
In Missouri, CMS' current five-year contract, renewed in late
2001, covers medical and mental health care for the 29,500
prisoners in Missouri's 21 prisons. The cost to the state is
about $80 million a year. It is based on a fixed per-day price
(now at $7.50) for each housed inmate. That cost pays for
everything from Band-Aids and aspirin to inmates'
prescriptions and catastrophic health care.
There are about 1,700 female prisoners in the Vandalia prison.
There are women prisoners in Chillicothe, but the federal
investigators have not visited that prison.
CMS has been the subject of controversy in recent years. A
five-month investigation by the Post-Dispatch in 1998 found
more than 20 cases nationwide in which prison and jail inmates
died as a result of alleged negligence, indifference,
understaffing, inadequate training or cost cutting by private
health care companies. Many of the cases involved CMS.
After the newspaper's investigation, the state Department of
Corrections took several steps to change the way it monitors
health care in prisons, including hiring a doctor to review
all prisoner deaths.
CMS refers all news media calls to its public relations firm,
Fleishman-Hillard. Becky Vollmer, speaking on behalf of CMS,
said she could not comment Friday on the cases of specific
inmates because of confidentiality. But she said the health
care provider is cooperating with investigators.
"Our belief is, a fair review will show the health care
services at the site are responsible and beneficial to the
inmates served," Vollmer said.
Vollmer said she was unaware whether anyone from CMS had
talked to federal investigators.
A death in 1999
The Justice Department investigators used the offices of the
American Civil Liberties Union in St. Louis to interview
several witnesses. The ACLU is conducting its own
investigation into 51 complaints about health care in Missouri
prisons. Those complaints range from allegations of suspicious
deaths to botched medical care and lack of care.
Sara Gilpin of Joplin, Mo., met with federal investigators for
three hours here and gave them her sister's medical records.
Gilpin's sister Stephanie Rane Summers, 48, died in 1999 of
liver failure and bacterial pneumonia. Gilpin says that her
sister's hepatitis C went undiagnosed for 2 1/2 years and that
she never was evaluated to be on a list for a liver
transplant, although doctors outside the prison who evaluated
Summers recommended that.
A CMS summary of Summers' medical history said that she was a
"very difficult and manipulative patient" but that
"her concerns were met with appropriate medical
care." Gilpin testified before Missouri's Joint Committee
on Corrections in 1999 and has filed a lawsuit in federal
court in Springfield, Mo. "What's sad is four years
later, it's still going on," Gilpin said.
CMS updated its response to the Summers case on Friday by
saying, "A review of the records indicates that health
care professionals conducted an aggressive treatment regimen
to address this patient's multiple medical conditions."
She was seen by specialists and hospitalized several times,
Kniest said the Corrections Department has confidence in the
medical care being provided. "We have our set of
standards, based on recognized appropriate practices in the
medical community, and that's the standard we hold CMS to. We
maintain a very professional relationship with them."
Reporter Kim Bell: