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Audit: Massachusetts Department of Corrections Failed to Provide Timely Health Care or Reentry Services

“Inmates have a right to timely health services while incarcerated, and we all have a vested interest in their successful reentry into society,” Bump said.

She called it “concerning” that MDOC’s “lax oversight” in these two ways “may have negatively affected inmate treatment and rehabilitation.”

Under MDOC policy, each Sick Call Request Form (SCRF) received from a prisoner must be processed within 24 hours on weekdays or 72 hours on weekends.

But from July 1, 2016 through June 30, 2018 – the period covered by the audit – MDOC dropped the ball in one out of five cases, with 20% of SCRFs failing to meet that processing time requirement. Of 60 prisoners whose cases were reviewed, there were a total of 297 SCRFs, and 55 of those were processed late from one to 31 days.

Additionally, MDOC policy requires screening by a qualified health care professional (QHP) within seven days after a prisoner submits a sick request form. Yet for nearly one-third of the prisoners whose files were reviewed – 19 out of 60 – there was no evidence that they were ever seen by a QHP. In 23 of the files, 163 SCRFs were missing information: 33 didn’t have a referral to a QHP, 102 didn’t have a nurse’s triage determination, and 28 didn’t show where the prisoner was housed.

MDOC claimed that the auditors used the date a prisoner had placed on the SCRF instead of the date it was received by s QHP in order to determine whether processing was late. But the auditors responded that even using the QHPs receipt date, the SCRs were still processed late.

The audit also examined the files of 60 soon-to-be-released prisoners with an eye out for their required Individual Reentry Plan (IRP). An IRP includes physical and mental health appointments for post-release services, any needed authorization for release of medical record (ARMR), refill prescriptions for necessary medications and explanations of Medicaid coverage. Twenty-two files – almost 37% of the total – had no evidence that IRPs were even discussed with prisoners.

In addition, five of the IRPs revealed a documented physical/mental health issue, but there was no evidence that any appointments were made with external medical providers. And for the 23 prisoners who were scheduled for medical appointments after release, no ARMRs were obtained and signed.

“There certainly has been a great deal more emphasis [in recent years] in the community about reentry plans and the need to facilitate this, so we don’t just perpetuate cycles of crime in an individual’s life,” Bump observed.

The audit also examined areas specific to women’s health care, including breast and pelvic exams, as well as pregnancy-related concerns. MDOC was found in substantial compliance with its policies regarding its requirement to inform women of the availability of services and with providing those services to them. However, Bump noted that mold at the state women’s prison in Framingham prohibited her auditors from getting a look at the medical files of some female prisoners.

MDOC also runs the Massachusetts Alcohol and Substance Abuse Center, a Plymouth facility for men involuntarily committed for treatment under the state Section 35 law. Though never convicted of a crime, 10 men held there have sued MDOC for the facility’s “appalling conditions” and the inadequate treatment they received at the former prison camp, where they arrived shackled and handcuffed in a prison van to be strip-searched and monitored mainly by MDOC prison guards and even forced to wear jumpsuits like prisoners.

The auditors recommended that MDOC educate staff in reentry-service standards and retrain staff members to correctly complete SCRs and IRPs. It was further recommended that staff assigned to reentry services work solely in that area rather than doing multiple jobs.

MDOC indicated that during the period of the audit, health care to prisoners was provided by a third-party vendor, Massachusetts Partnership for Correctional Healthcare, LLC. But as of July 1, 2018, MDOC entered into a new contract with Correct Care Solutions, LLC.

As of June 2018, MDOC’s 8,741 prisoners were kept in 16 correctional facilities with a total 4,600 employees. The agency received $645 million in state appropriations during fiscal year 2018. 


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