As California prisons let in visitors and other "non-essentials," a time to reflect on disease and prisons
The closing of California prisons for the past two weeks to visitors and non-essential personnel based on one possible case of N1H1 virus in a Southern California highlights the link between infectious disease and incarceration and is yet another negative implication of California’s over-reliance on incarceration to address crime. In this case the conditions and numbers of people incarcerated may threaten the public health of California as an efficient system to transmit H1N1.California incarcerates over 170,000 people. Our prisons are filled to twice their capacity and because little forethought is given to the implications of “tough on crime” sentencing laws including mandatory minimums and three strikes. Despite the dire fiscal situation in the state, we continue to send more people to prison and for longer periods of time at exorbitant cost to California’s taxpayers.
While H1N1 is a concern in the community, in California’s overcrowded prisons where basic hygiene and medical care are difficult to maintain, H1N1 and other infectious diseases are an even greater problem because of the increased likelihood that they will spread, and without proper medical response. We know that H1N1 is highly treatable, but in a prison setting concerns that early symptoms may go without attention are real.
Prisons concentrate people who are more likely to have serious health issues: the rate of HIV, Hepatitis C and MRSA to name a few is much higher among prisoners than in the community. In prison, people at high risk for disease are placed in environments where disease is likely to spread. Outbreaks of Norovirus, tuberculosis and MRSA have all occurred in correctional facilities in California in recent years. It’s therefore unsurprising that an early case of H1N1 has occurred there, too.
Because prisoners are frequently transferred throughout the system and more than 95% of prisoners return to our community after an average sentence of two years, we should be concerned, too. It’s not unreasonable that a prisoner outside of San Diego might have just come through San Quentin’s reception center, or had contact with someone sent to Vacaville or Sacramento or any one of the 33 prisons in the state. Any of these prisoners could have come in contact with hundreds of correctional service staff and others who work in prisons daily. And, given the period before symptoms present, it’s not unreasonable to conclude that H1N1 might have been spread to others throughout the state’s prison system. The same is true of any infectious disease in this environment.
This situation highlights yet another deleterious effect of incarcerating hundreds of thousands of Californians each year in a system that can neither prevent nor treat disease at the basic level required by our federal constitution. When you think about H1N1, consider the effect California’s criminal justice laws have on the health of the broader community. It’s time for a change.
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( 3 / 776 )Everyone’s suddenly waking up to the problems and costs of California’s prisons. Recent news reports articles detail the conflict between the Receiver and the Governor’s administration, the Receiver’s new $8 billion request to improve medical care, on top of the $7.8 billion allocated last year, plus a new $810 million request, all in the context of a state budget crisis.
It’s the current economic situation that forces us to engage in a true re-thinking of our criminal justice system, rather that a concern for human rights. Regardless, it’s time to replace our “tough on crime” stance with a new one which is “smart on crime.” We need to think about how to reform the criminal justice system in California so that it does more and costs less.
There’s no question about what needs to be done. The “Little Hoover Commission” – a non-partisan state oversight agency of people appointed by the Governor and legislative leaders – conducted an exhaustive review of the California prison system and reported over two years ago that “California’s prisons are out of space and running out of time.” Among their top recommendations were to establish a sentencing commission. The American Law Institute which drafts model criminal laws that are frequently used as the basis for states’ law is developing new sentencing provisions and recommends establishing permanent state sentencing commissions.
This is not a novel approach: sentencing commissions exist in more than 20 states. Their goal is to reduce prison population growth, provide rationale to support effective and evidence-based programs and to tie policies to financial analysis. Speaker of the Assembly Karen Bass has proposed legislation declaring the intent of the Legislature to crease such a commission as “an independent multijurisdictional body to, among other things, develop sentencing guidelines and provide a nonpartisan forum for sentencing policy development.” This is an important first step, but the California Legislature should next create the commission – not to merely express its intent.
We should support the development of a Sentencing Commission if we don't want to spend another $8 billion on prisoner healthcare; if we want to stop locking up marijuana user with members of the Mexican Mafia; if we think California would be better served by funding drug treatment facilities with social workers who earn $45,000 a year, instead of funding giant prison facilities with correctional officers who earn $90,000 a year; and if we think California should spend more educating than imprisoning our fellow citizens.
We need to stop the rhetoric that has created a steady increase of offenses and prison terms, and choose instead – through the creation of a Sentencing Commission – to be "smart on crime."
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( 3 / 746 )Below is Mary's response to the Marin paper's editorial on a proposal to close San Quentin and sell the bayside property to fund the building of new prisons.
The editorial can be found at http://www.marinij.com/marinnews/ci_121 ... arinij.com
Reduce the prison population
Thanks to the IJ editorial board for recognizing the complexity of issues in California's current prison crisis.
Closing San Quentin is not the answer, nor is building more prisons in remote rural areas, as has been our trend over the past few decades.
The answer to California's prison crisis - all experts agree - is to sensibly reduce the number of people we send to prison through sentencing and parole reform.
There are many suggestions as to how the California Legislature can do this including from the non-partisan Little Hoover Commission, former San Quentin Warden Jeanne Woodford and nationally renowned criminal justice expert Joan Petersilia, who just accepted a faculty position at Stanford University.
I encourage the IJ and its readers to research what these experts have to say about common-sense solutions that will reduce prison population and reduce crime here in California, and to support legislation and policy choices that reduce the number of people sent to prison, without compromising public safety.
It's a much better alternative than the costly contentious litigation that has, for decades, resulted in little improvement in the conditions of California's prisons.
Mary Sylla, DIRECTOR OF POLICY AND ADVOCACY,
CENTER FOR HEALTH JUSTICE,
LARKSPUR
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( 3 / 589 )Editorial - NY Times
Addiction Behind Bars
Published: April 13, 2009
The United States must do more to curb the spread of diseases like AIDS and hepatitis C in prison, where infection rates are high and inmates can easily spread disease through unprotected sex or by sharing needles.
Drug treatment in prison is clearly part of the solution. But by some estimates, fewer than one in five inmates who need formal treatment are actually getting it. That’s alarming, given that about half the prison population suffers from drug abuse or dependency problems.
Addicted prisoners cause problems outside the walls. After they’re freed, addicts with H.I.V. or AIDS can infect spouses and lovers. They feed their addictions by returning to crime, which lands them back in prison and starts the terrible cycle over again.
The most effective programs provide inmates with high-quality treatment in prison and continue that treatment when prisoners return to their communities. Such programs have been shown to reduce both drug use and recidivism.
But good programs are rare, according to a report earlier this year in The Journal of the American Medical Association. Prisons typically rely on the abstinence-only model, which fails miserably with heroin addicts. Moreover, prison officials are notoriously hostile to methadone maintenance and other chemically based therapies that have long been a standard for people addicted to opiates.
Prison treatment is particularly disastrous in New York, according to a new report from Human Rights Watch. Imprisoned addicts, the authors say, are typically shut out of treatment until their sentences are nearly over because of ill-conceived policies that give priority to those who are about to be released.
New rules created earlier this month should help address these problems. The rules give oversight responsibility for prison treatment programs to the State Office of Alcoholism and Substance Abuse Services, an agency that develops treatment programs and licenses treatment providers.
The agency will be required to make sure that prison drug treatments are tailored to inmates’ needs. It will also monitor the programs, filing annual reports to the governor and Legislature. Drug-policy advocates hope that the new arrangement will improve treatment and provide timely help for addicted inmates. That would be good for public health. It could reduce crime, too.
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