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Two bills before the legislature aim to improve medical care in prisons

The Louisiana Legislature will consider two bills this session that seek to address the troubled state of health care in Louisiana prisons. One, Bill 175, would eliminate copayments for incarcerated individuals, and another, Bill 517, would create a medical advisory board that would approve health care policies for the Department of Public Safety. and correctional services and the hiring of a prison medical director. , among others.

Health care in Louisiana prisons is in high demand, in part due to an aging population, but the state has long been criticized for not providing access to adequate care for those in its custody.

According to a 2021 Health Care Adequacy Report in Louisiana prisons produced by Loyola University New Orleans College of Law, LSU Health, and the nonprofit group Voice of the Experienced, a majority of prisoners — between 58% and 95% depending on the facility — in the ‘State take medicine. Forty percent of those incarcerated in Louisiana have suffered from mental illness and 20 percent have been diagnosed with serious mental illness, such as schizophrenia,

Last year a the federal judge ruled that the state’s largest prison, the Louisiana State Penitentiary in Angola, was “deliberately indifferent to the serious medical needs of inmates” and violated the Eighth Amendment’s prohibition against cruel and unusual punishment.

In another lawsuit, against the David Wade Correctional Center, plaintiffs claim that the conditions and lack of mental health care for those held in restrictive accommodations at the facility – which means being locked in their cells until 23 hours a day – causes them to continue to deteriorate and can lead to self-harm and further disciplinary action. Lawyers for the state Department of Public Safety and Corrections argue that mental health care at the facility is constitutionally adequate. A weeks-long trial in the case ended last month.

Some of these problems, critics say, stem from a lack of leadership and oversight. And the bill to create a medical advisory councilpresented by Rep. Larry Selders, Democrat of Baton Rouge, aims to address this issue.

In the Angola trial, federal judge Shelly Dick found that the Department of Corrections and Angola’s medical director at the time – Dr. Randy Lavespere – failed to ensure that detainees received adequate health care.

“There was no evidence of medical oversight by DOC central office,” Dick wrote. “The buck stops with Dr. Lavespere, and his medical supervision and quality review were woefully inadequate.”

But Lavespere has since been promoted from medical director of the LSP to overseeing health care across the Louisiana prison system following the 2020 resignation of Dr. John Morrison, who previously held the position.

Like many doctors working in Louisiana prisons, Lavespere was able to work behind bars despite having a suspended medical license. Due to a provision of the Louisiana State Board of Medical Examiners, physicians who have been barred from practicing at many medical facilities can still work in an institutional setting — like prisons.

Lavespere had his medical license revoked following a 2006 conviction for possession with intent to distribute methamphetamine, for which he served time in federal prison. But in 2009, he was placed on “indefinite probation”, which only allowed him to practice medicine in an institutional setting.

The medical advisory board’s role in approving a future prison medical director would help ensure a qualified candidate is selected, said Bruce Reilly, deputy director of Voice of the Experienced, which worked on the legislation.

Reilly said health care delivery in the prison system should ideally operate as a “series of community clinics,” and he fears that Lavespere and others who have held leadership positions in health care administration at the Department of Corrections have not been taken into account. qualified for such a position outside the prison environment.

“If it worked like a series of community clinics, would they even stand a chance?” said Reilly. Would they even get an interview? Or are they just a person with an MD? »

The board, under the proposed legislation, would be made up of representatives from various medical fields, as well as the deans of the Tulane and LSU medical schools or their designees, the dean of Xavier University College of Pharmacy or their designate, and the director of the Louisiana Department of Health, or their representative.

The board would also have an advisory and consenting role in approving DOC medical policies, post-mortem examinations, implementation of an electronic medical records system, and any other “responsibility reasonably related to the institutional oversight”.

A spokesperson for the Department of Public Safety and Corrections did not respond to requests for comment on any of the prison health care laws that are pending during the current session.

Bill seeks to eliminate medical debt from prisons

Another bill, introduced by Rep. Mandy Landry, Democrat of New Orleans, would eliminate medical co-payments which are frequently necessary for prisoners to have access to health care. According to the Loyola, LSU and VOTE report, prisoners must pay $3 for a sick call, $6 for an emergency visit and $2 for a prescription.

Although the amount may seem relatively small, prisoners can be paid as little as two cents an hour for the work they do behind bars.

“The real-world minimum wage equivalent of these rates for incarcerated individuals earning an incentive wage of $0.02/hour is: $1,087.5 for a routine visit, $2,175 for a emergency and $725 for a prescription,” the report said.

Further, the report also states that although DOC policy is to provide health care regardless of an individual’s ability to pay, co-payment charges are still assessed against the prisoner’s account and may put him in debt.

“I was furious when I found out that we had incarcerated people with medical debts,” Rep. Landry said in a statement. “It is counterproductive and as a matter of principle, the state is responsible for all health care needs of the people we incarcerate.”

The report warns that medical co-payments in prison “can cause people to delay or avoid receiving health services.”

“Ultimately the state has a responsibility to keep people alive and well if we choose to detain them,” Reilly said. People are suffering and people need proper medical care. It’s just kinda plain and simple.

On Wednesday, both bills were awaiting a hearing by the Committee on the Administration of Criminal Justice.

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