Kala Kachmar

Montgomery Advertiser

In November 2012, nurses at the infirmary at St. Clair Correctional Facility sent an inmate back to his room numerous times after he complained of pain after his dialysis treatment.

A doctor had told them over the phone to give the man water and send him back to his room; they were not to hospitalize the inmate and not to bother the doctor with another phone call about his complaints.

The next morning, the inmate died.

This was one of several examples cited in a report, released by Southern Poverty Law Center and the Alabama Disabilities Advocacy Program, of inmates in need of medical care who were ignored, misdiagnosed or forced to wait long periods of time before getting treatment.

The SPLC also sent a letter to the Alabama Department of Corrections citing what it believes to be numerous violations of federal laws related to inmates who have disabilities and serious physical and mental illnesses.

"It's our position that the state needs to come up with a plan on how (ADOC) is going to address these problems," said Maria Morris, managing attorney for SPLC's Alabama office. "Because people are dying, we don't want to sit around in a lot of meetings and wait for them to come up with a plan."

The report said the ADOC is "indifferent" to the serious medical needs of inmates, and that they're condemned to facilities where "systemic indifference, discrimination and dangerous" conditions are the norm.

In the April 9 letter to Prison Commissioner Kim Thomas, the SPLC said the Alabama Department of Corrections fails to identify mentally ill patients, provide adequate mental health and medical care and properly equip the facilities for disabled and mentally ill patients. The letter also said they improperly segregate, verbally and physically harass and discriminate against inmates with disabilities.

The letter also said the contracts that ADOC has for inmate health care severely limit the resources that can be expended for their care.

"I believe that we, as lawyers, need to move these issues forward as effectively and efficiently as possible," Morris said.

Morris said SPLC staff has met with Thomas and representatives of Corizon Inc., the company ADOC contracts with for medical services, and MHM, the company that provides mental health services for inmates. She said she hopes there will be more meetings that will address how ADOC plans to improve conditions and address the problems.

ADOC spokeswoman Kristi Gates said Thomas wasn't available for comment Tuesday.

The report is based on inspections of 15 facilities, interviews with more than 100 prisoners and reviews of thousands of pages of medical records, depositions, policies and contracts with companies that provide health and mental health care.

Morris said the investigation has been going on for the past two years, but has accelerated in the past six months. During inspections, staff looked at the living conditions, medical facilities at various prisons and the level of accessibility for inmates with disabilities.

"I think one of the biggest problems as far as medical care is people who are going through extraordinary delays before there's any meaningful attempt to diagnose what's going on with them," Morris said.

According to the report, an inmate on suicide watch was burned on his legs by a flaming cloth other prisoners threw at him. The correctional officers put out the fire but refused for more than 24 hours to take the inmate to the infirmary because the burns "were nothing," according to report.

Another inmate who complained of sore, swollen testicles for five days, was only given ice for the swelling. He ended up having gangrene and had to have his testicle removed.

Inmates also reported that they had often been given the wrong medication, and also were not informed of the purpose, side effects or benefits of medications prescribed to them, according to the report.

An inmate at Bullock correctional facility slept through his morning wake-up call a few times because his seizure medication made him tired. He was taken off the medicine for missing wake-up calls and has since had two seizures, the report said.

The report also found that ADOC doesn't have an effective system for managing infectious diseases, including scabies and tuberculosis.

In the past two years — and as recently as this spring — inmates or ADOC staff have had active tuberculosis at St. Clair, Julia Tutwiler Prison for Women and Donaldson Correctional Facilities, the report said.

The treatment of inmates with disabilities or mental illness is just as egregious, Morris said.

At St. Clair, for example, there are about 60 patients who are receiving treatment for mental illness, and six who are being involuntarily medicated, meaning they are so seriously mentally ill that they're a danger to themselves or others. During the month of April, none of those patients had any contact with psychiatrists or psychologists, Morris said.

Another issue the report cited is inmates with disabilities, such as those who are blind and in wheelchairs and are classified as nonviolent offenders, who are being placed in dorms designated for inmates who require a higher level of security, Morris said.

The report even cited a case of a blind inmate with a lung condition who signed a "do not resuscitate" order after being told it was another of the property slips he was signing during the process of his transfer to another facility.

"We spoke to a number of people who are in the mental health system who are clearly just not getting the help they need," Morris said.

Health care in Alabama prisons

• There are only 15.2 doctors and 12.4 dentists for 25,055 inmates

• Each doctor has about 1,648 patients, dentists have more than 2,000

• There are only 493 medical staff members, including doctors, nurses and administrative/records staff

• The ratio of total medical staff to inmates is 1:51

• More than 3,00 inmates were recieving some form of mental health treatment in March 2013

• There are 4.7 full-time psychiatrists and 5.6 psychologists for all the inmates

• Only six facilities have psychologists available

Source: "Cruel Confinement: Abuse, Discrimination and Death Within Alabama's Prisons," Southern Poverty Law Center and Alabama Disabilities Advocacy Program, June 2014