Five years later, Virginia prison still not meeting terms of court-ordered settlement over shoddy medical care
The Fluvanna Correctional Center for Women. (Photo by Ned Oliver/Virginia Mercury)
A new court appointed monitor’s first review of operations at Fluvanna Correctional Center for Women suggests the state isn’t close to meeting the terms of a five-year-old legal settlement over poor health care and a spate of inmate deaths .
The report, filed earlier this year in a federal court case that’s closing in on a decade of litigation, says medical care remains spotty and questions the state’s practice of isolating mentally ill inmates for 23 hours or more a day.
But the monitor, Dr. Homer Venters, writes that one of his biggest concerns is that the Department of Corrections still relies on paper medical records to provide and track health care for prisoners.
He writes that it is likely impossible for the state to meet its court-ordered benchmarks for improving medical care without upgrading to the now-industry-standard technology, citing records that show nurses don’t always provide inmates medication they’re prescribed and inmates arrive at medical appointments to learn staff don’t have their charts.
Venters quotes a woman the department logged as refusing care: “They did not have my medical chart and do not know why I’m here. It may be an ongoing problem, they can’t treat me without my chart.”
The Department of Corrections has been in discussions about upgrading from paper to electronic medical records for years, but the effort has been bogged down by failed procurement efforts that in once case saw a vendor back out at the last minute over a dispute over the state’s security standards. A second procurement attempt advanced in 2018 but was apparently aborted. The department issued what is at least its third request for proposals earlier this year.
“We’re in the RFP process,” said corrections spokeswoman Lisa Kinney in an email. “Vendors are presenting demos.” The statement was the only comment the department provided for this article.
Venters is not the first person to note that the department’s reliance on paper records poses a growing problems. Legislative auditors who reviewed rising prison health care costs flagged the issue back in 2018. Corrections officials also acknowledge the potential of upgrading, writing in their request for proposals from technology companies that they’re seeking software that will provide “improved clinical effectiveness and improved health care for inmates.”
But the report, which followed a three-day inspection of Fluvanna in March, made clear that problems go beyond technology.
Venters writes that one patient he spoke to was denied treatment for a medical problem when she was transferred to Fluvanna’s mental health wing. “Review of her records appeared to confirm this, with staff attributing her physical illness to a mental health problem for an extended period of time until she was transferred to the hospital and ultimately received corrective surgery,” Venters wrote.
He highlighted another case in which staff documented that a patient was not receiving medication because of a disability. Venters noted that there was no evidence staff tried to accommodate or respond to the issue. “She was subsequently hospitalized with life threatening complications of her chronic health problems,” according to the report.
Venters also wrote that the prison’s mental health wing subjects patients to solitary confinement and parses out access to basic hygiene items like soap as “privileges to be earned.” He called the approach ineffective and humiliating for patients.
The report says another patient’s chart documented staff members were aware that the use of solitary conferment would worsen a woman’s mental health, citing a note he found that read, “given that her level of functioning is declining and she is going to seg and putting herself at risk with head banging, I think it’s worth starting an antipsychotic.”
Kinney did not respond to questions about the department’s use of isolation and solitary confinement in its mental health wards, but the state recently agreed to pay $150,000 to settle a lawsuit filed by a mentally ill inmate who alleged he was held in solitary confinement for 600 days.
Venters’ report was not entirely negative. He credited the work of a new medical director at the prison brought on from University of Virginia’s health system, praised teamwork by medical and security staff and called the prison’s COVID-19 response “quite strong.”
But while Venters’ report included a note of optimism, the federal judge overseeing the case warned during a hearing earlier this year that the fact that a second monitor had to be installed after the first resigned “should serve as a stark reminder about the length of time there has not been complete compliance.”
“The settlement agreement was approved in 2016,” said U.S. District Judge Norman Moon. “We are now over five years after settlement, and all the parties should take the opportunity and redouble their efforts to quickly and sustainably hit the benchmarks.”
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