Author: community

Posted October 13, 2023

Join us in demanding change that imposes stronger mechanisms for accountability and transparency in the Department of Correction’s medical contract this fall. 

Sign our petition at https://chng.it/CbJGKTvwGz

In the next few weeks, the MA Department of Correction (MADOC) will release a Request for Responses (RFR) soliciting bids from health care providers, one of which will be chosen to provide medical care to all people incarcerated in Massachusetts state prisons. This is a major event that could dramatically improve medical care in MA prisons, where medical neglect is rampant, or it could enable this neglect to continue. 

Organizers with DeeperThanWater have been working for years to end medical neglect in MA prisons. In 2021, DeeperThanWater worked with currently incarcerated activists to conduct a needs assessment to evaluate healthcare services from the current contract holder, Wellpath. Using the findings from this survey, DeeperThanWater released a report describing the horrific medical neglect occurring in Massachusetts prisons. We have also shared stories of medical neglect from incarcerated people.

Over the past year, we worked with people incarcerated in MA prisons to develop demands for change in the language of the upcoming RFR, which is being written by the Massachusetts Department of Correction and UMass Chan Medical School. DeeperThanWater shared these demands directly with UMass on multiple occasions; however, they have thus far been unable to confirm any amount of its incorporation. Moreover, as the ISA form discloses, compensation for UMass to revise the RFR increased from $380k to $510k following a 2020 DOJ investigation of mental health treatment which led to a 2022 agreement between the United States and MADOC. 
This moment is a chance to hold leadership accountable for the harm that their previous negligence inflicted. As always, we demand that Governor Healey and the Massachusetts Department of Correction free all incarcerated people. Until that is met, we demand that they impose stronger mechanisms for accountability and transparency by incorporating the following changes in the upcoming Request for Responses (RFR).

1. Include new language requiring the Contractor to respond to sick slips in a timely manner. 

Requested language (revised from section 4.3): 

The Contractor must confirm the receipt of a sick slip with the involved incarcerated person within 24 hours. For emergencies, appointments must be scheduled within 24 hours of receipt of the sick slip. An emergency may be defined as a life-threatening condition, or anything that if ignored would cause severe repercussions to physical and/or mental health or that would permanently or temporarily disable a person. For non-emergencies, decisions must be made within 3 days, and the incarcerated person must be notified in this timeframe as well. Decisions include rationale and reasoning. For non-emergencies, appointments must be scheduled within 7 days following the decision. Follow-up appointments with Contractor employees must be scheduled no further out than 1 month from the date the sick slip was received. Follow-up appointments with medical providers other than the Contractor must be scheduled as soon as possible, and no further out than 3 months from the date the sick slip was received. If these timelines cannot be met, the Contractor must provide documentation showing that they made multiple attempts to schedule an appointment within 3 months. Incarcerated people are able to request status checks of their sickslips. Staff is responsible for maintaining daily documentation of sick slips and must communicate with incarcerated people regarding questions on sick slip information. Incarcerated people will receive confirmation of their appointment one week and again one day before said appointment. 

2. Include provisions for incarcerated people to see providers outside of the Contractor/prison.

Requested language: 

If a person who is incarcerated wants a second medical opinion, they must be given access to a second opinion by a provider or specialist independent of the prison as soon as possible, and no further out than 3 months from the date the incarcerated person asks for a second opinion.

3. Make fines for not following treatment plans higher. (See current requirements in sections 16, 4.3, 9, 12.)

4. Ensure that staff possess valid credentials and all sites are sufficiently staffed. The ADC has considerable discretion when deciding whether or not to allow the Contractor to provide less staff than required by the contract and/or permit the hiring of personnel whose credentials fail to meet the standard laid out in the contract. As such, the future RFR must remove discretion ADC has to permit under-staffing or staffing by under-qualified professionals.

Requested language:

The Contractor must keep staffing levels at least equal to those required in the contract and personnel must be appropriately licensed, registered, certified and professionally trained without exception. A medical doctor must be onsite for at least 8 hours a day at facilities under this contract.

5. Add oversight from people who are currently incarcerated. (See section 16.) 

Note: The language below was adapted from the Investigation and Corrective Action document and the Continuous Quality Improvement (CQI) document.

Requested language:

An oversight body consisting of 3-5 incarcerated people will attend the monthly Pharmacy and Therapeutics Committee and all CQI meetings scheduled, including the Annual Review of CQI Program.

This oversight body will consist of existing councils or volunteers.

The Oversight Committee will co-lead the Investigation and Corrective Actions procedures, “helping to establish and uphold the guidelines for employee discipline actions that ensure each employee receives a reasonable opportunity to improve their efficiency, conduct, and/or performance, as determined by the” Oversight Committee.

The HSA will assign Oversight Committee counterparts to the CQI Committee Chairperson and CQI Coordinator, as well as any additional CQI committee members. These Oversight Committee members will provide and ensure perspective and feedback from those being served by the Contractor.

The Oversight Committee will participate in the Continuous Quality Improvement Program by “identifying areas for examination, determining (in advance) what constitutes acceptable performance, and re-examining the area to determine if the desired improvement has been accomplished.”

7. Increase public transparency. We request that minutes from meetings of the  Pharmacy and Therapeutics Committee and CQI Committee be made public to increase transparency and opportunities for oversight.

Requested language:

Minutes from meetings of the Pharmacy and Therapeutics Committee and CQI Committee will be available to the public, with any patient information anonymised, on the DOC website within 7 days of the meeting date.

The public will be invited and notified 2-4 weeks in advance of any public hearings involving medical care, where the Contractor will be present and available for a 30-minute minimum of public discourse. 

8. Change language on “inmate specific equipment and medically prescribed devices.” Our intention here is to increase the Contractor’s interest in providing and maintaining quality medical equipment. We also seek to remove language that puts the burden of payment for damaged equipment on incarcerated individuals. 

Requested language (language that has been edited or replaced is in bold):

The Contractor shall be responsible for the purchase or lease of Inmate-specific Equipment (e.g., special beds, wheelchairs or other Equipment not in existing inventory) and Medically Prescribed Devices, including Equipment and Medically Prescribed Devices recommended by a physician’s order or otherwise necessary to provide quality Inmate care and promote Inmate functionality (e.g., eyeglasses, orthotics, sensory therapy products). The Department shall have no obligation to reimburse the Contractor for the cost of any Inmate-specific Equipment or Medically Prescribed Devices purchased or leased by the Contractor. All Inmate Specific Equipment and Medically Prescribed Devices shall become the property of the Contractor. The Contractor shall repair and replace all Inmate Specific Equipment and Medically Prescribed Devices as necessary to ensure that Inmates may receive the benefit of such Inmate Specific Equipment and Medically Prescribed Devices. When a contract changes hands, the new Contractor will be given the opportunity to buy equipment from the preview Contractor.

If the Department determines through its investigatory, disciplinary or grievance process that the Inmate assigned the Medically Prescribed Device or another Inmate is responsible for the loss, damage or destruction of a Medically Prescribed Device, the Department shall bear the financial responsibility for its repair or replacement. Neither the Department nor the Contractor shall pursue reimbursement or payment for Medically Prescribed Devices from the Inmate found responsible for the damage or loss of said device. 

REMOVE: The Contractor shall be responsible for payment of the monthly service charges for all telephone lines designated for the use of the Personnel, for which the previous Contractor bore responsibility for payment.

Updated 4/8/23

Despite a month-long call-in for Michael at MCI-Concord by family, friends, and community members, he was denied his rightful accommodation to a CapTel phone that displays captions during a phone call – even with updated medical documentation and a recommendation for hearing aids by doctors at Shattuck Hospital. This corrupt behavior by the DOC violates national ADA standards, the Briggs v. MA DOC Settlement, and this 2022 Federal Communications Commission (FCC) order expanding communications access to incarcerated people with disabilities. While Michael’s situation is devastating, it is not unique; we are receiving reports of CapTel accommodations being removed from men over at MCI-Norfolk, too. To make matters worse, lawyers and family members have sent the DOC non-compliance letters that went completely ignored. 

For these reasons, we are reorganizing this call-in to target legislators, with the additional option to send an email.

We know that the DOC needs to cancel Wellpath’s contract. Until then, help demand that they provide Michael and others with the rightful accommodation to allow them communication with loved ones which, according to ADA standards, is an “activit[y] that [is] of central importance to most people’s daily lives.” 

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CALL SCRIPT:

Call the district office of Ayanna Pressley: (617) 850-0040
Call the Boston office of Elizabeth Warren: (617) 565-3170

If your call isn’t picked up, leave a message with the script below.

“Hello, my name is [X] and I am a concerned community member calling on behalf of Michael Moscaritolo at MCI-Concord, W113890. For over three months now, Michael has been requesting re-access to a CapTel phone, an accommodation that he was formerly granted for the past year and a half. Shortly after a federal monitor verified the DOC’s compliance to the provisions in the Briggs Settlement, the requirements for accessing the CapTel telephone were arbitrarily changed, causing Michael and many others in Massachusetts prisons to lose access to their accommodation. This is not in alignment with ADA standards, violates the Briggs settlement, and deviates from FCC practice – all of which affirms a person’s right to an accommodation that facilitates effective communication and therefore enables them to live fully. 

To remedy this, I am requesting that you contact the MA DOC and demand compliance to the Briggs Settlement, so that Michael and others have rightful access to a CapTel phone.

Will you confirm your effort to ensure DOC compliance, or contact the primary advocate on this case at sav.cadiz@gmail.com to discuss this matter further?”

EMAIL:

Send to: ayanna.pressley@mail.house.gov, jon_donenberg@warren.senate.gov, sarah.groh@mail.house.gov, demarquin.johnson@mail.house.gov, beth_pearson@warren.senate.gov, Marielle_Rabins@warren.senate.gov, Harleen_Gambhir@warren.senate.gov, jon_donenberg@warren.senate.gov

Subject: *URGENT: DOC Violation of Briggs Settlement

Dear Massachusetts legislators and team,

I am writing as a concerned community member to inform you of an issue affecting one of the most vulnerable populations we have: incarcerated people across MA prisons who are hard of hearing are losing their accommodation to effectively communicate with loved ones. 

Despite a month-long call-in for Michael at MCI-Concord by family, friends, and fellow constituents, he was denied his rightful accommodation to a CapTel phone – even with updated medical documentation and a recommendation for hearing aids by doctors at Shattuck Hospital. This corrupt behavior by the DOC violates national ADA standards, the Briggs v. MA DOC Settlement, and this 2022 Federal Communications Commission (FCC) order expanding communications access to incarcerated people with disabilities. While Michael’s situation is devastating, it is not unique; we are receiving reports of CapTel accommodations being removed from men over at MCI-Norfolk, too. To make matters worse, lawyers and family members have sent the DOC non-compliance letters that went completely ignored. 

To remedy this, I am requesting that you contact the MA DOC and demand compliance to the Briggs Settlement, so that Michael and others have rightful access to a CapTel phone.

Will you confirm your effort to ensure DOC compliance, or contact the primary advocate on this case at sav.cadiz@gmail.com to discuss this matter further?

Sincerely,

[your name]

by James Keown (MCI-Norfolk)

According to Wellpath staff, Dr. Kevin Ennis is out as medical director at MCI-Norfolk. Staff point to concerns raised by many, including DOC officials, over the doctor’s performance to explain why the doctor was released after only about six months on the job. Dr. Ennis had previously been suspended pending investigation in February due to a verbal incident involving staff according to a person familiar with Wellpath’s review of the doctor. Dr. Ennis, however, was cleared to return to work after less than a week.

Advocates at Prisoners’ Legal Services raised alarms with the DOC and Wellpath last week when without notice officials at MCI-Norfolk began moving patients out of the Clinical Stabilization Unit (CSU), the prison’s medical unit, to the prison’s general population. Some staff members at MCI-Norfolk balked when one disabled CSU patient who requires assistance dressing himself, supplemental oxygen at night, and who cannot walk up steps was told he was being moved to a regular housing unit. The patient had been classified to a medical unit from the first day of his incarceration more than two years earlier.

Dr. Ennis, who was on vacation at the time, according to staff, approved the move without conducting any evaluation of the patient’s ability to safely live in general population and without discussing the move with the patient. The move was also endorsed by at least one senior administrator at Wellpath’s Massachusetts headquarters in Foxborough who overruled nurses assigned to the CSU who had attempted to shut down the transfer of the disabled patient. Norfolk security staff ultimately ruled it unsafe to place the patient in general population and halted the move pending a review. As of March 23, the patient remains in the CSU.

MCI-Norfolk went almost a full year without a medical director before Wellpath hired Dr. Ennis in late 2022. The loss of the medical director means that only two nurse practitioners remain to serve as primary care providers for the approximately 1,100 incarcerated people at MCI-Norfolk, including the prison’s 16-bed medical unit. The lack of a full-time doctor at MCI-Norfolk is only part of an ongoing staffing crisis that has plagued Wellpath for more than a year. A recent review of the company’s staffing matrix revealed almost 30 open positions at MCI-Norfolk alone. Currently, the prison has no Director of Nursing or Nursing Supervisor. The lack of staffing was a contributing factor in the DOC fining Wellpath more than $300,000 in 2022.

Wellpath’s contract to provide health care services was set to expire on June 30, 2023. Officials in the DOC’s Health Services Division were expected in October to put out a Request for Responses (RFR), the first step in the state’s procurement process. Instead, the department has said informally that it intends to extend Wellpath’s contract for up to one year, as allowed under the current agreement, so officials can have more time to prepare the RFR said a person familiar with department’s health care bidding process.

The DOC spent more than $196 million dollars last fiscal year on health care for incarcerated people through Wellpath, LLC., a Tennessee based corporation. Wellpath earns approximately $1.7 billion annually and is controlled by the $43 billion private equity firm HIG, which also operates Keefe, the DOC’s commissary, property, email, and electronic tablet vendor. Last year, a federal court in Virginia sentenced Wellpath’s founder, former CEO, and Chairman of the Board, Gerard Boyle, to federal prison after he pled guilty to bribing Virginia officials for health care contracts. Boyle previously had spent 15 years working for the Massachusetts DOC, including as the Superintendent of Bridgewater State Hospital.

Wellpath and HIG have consistently been under fire in Massachusetts from incarcerated people, family members, and outside advocacy groups who say the level of care provided by the corporation falls well below the standards required by law. Two 2022 reports by the Disability Law Center called out Wellpath over their lack of meaningful care and the DOC for their lack of appropriate medical housing. Many, including lawmakers, also now are questioning how health care spending in the DOC has more than doubled over the past decade when the number of people incarcerated has dropped by almost 50%.

As we continue to hear more and more stories of medical neglect due to Wellpath, the incompetent private medical provider in MA prisons, we’ll be sharing some immediate calls to action. Right now, we’re seeking support for Michael, who is incarcerated at MCI-Concord.

Michael Moscaritolo has documented hearing loss in his right ear and is due to go back to the Shattuck specialists to diagnose unaddressed hearing problems in his left ear. He cannot hear on the unit telephones and is requesting accommodations. 

Under the Briggs Settlement, the DOC must make accommodations related to hearing loss for those seeking them. Shortly after the federal monitor, Elaine Gardner, came to verify the DOC’s compliance, they arbitrarily changed the requirements for accessing the CAPTEL telephone. Therefore, incarcerated people who had been granted that particular accommodation for many months and were successful in using it, were suddenly denied access. The DOC made a unilateral decision that incarcerated people must have ”severe” hearing loss in both ears.

This is not in accordance with national ADA standards and is in violation of the settlement agreement, which both state that if someone has documented hearing loss and requests an accommodation, it must be granted. Incarcerated people who have ”moderate/severe” hearing loss are being denied access to the CAPTEL telephone, and therefore are having difficulties talking to their families.

This is not right and we are asking that incarcerated people with documented hearing loss who were formerly granted accommodations be able to continue accessing them.

We know that the DOC needs to cancel Wellpath’s contract. Until then, join us in demanding that they provide Michael with the care he needs.

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CALL SCRIPT:

Call the superintendent at MCI-Concord: (978) 405-6100
Superintendent’s Office Ext. 111 or Ext. 113

Even if no one answers when you call, leave a message with the script below.

“Hello, my name is [X] and I am a concerned community member calling on behalf of Michael Moscaritolo, W113890. For the past two months, Michael has been requesting access to a CAPTEL phone, an accommodation that he was formerly granted for the past year and a half. Shortly after the federal monitor, Elaine Gardner, came to verify the DOC’s compliance to the provisions in the Briggs Settlement, the requirements for accessing the CAPTEL telephone were arbitrarily changed. This is not in accordance with national ADA standards and is in violation of the settlement agreement, which both state that if someone has documented hearing loss and requests an accommodation, it must be granted. 

To remedy this, I’m demanding that you process Michael’s ADA request to regrant him access to a CAPTEL phone.

Will you confirm that Michael will immediately receive this accommodation?”

As we continue to hear more and more stories of medical neglect due to Wellpath, the incompetent private medical provider in MA prisons, we’ll be sharing some immediate calls to action. Right now, we’re seeking support for Anthony Serrano, who is incarcerated at MCI-Shirley. He lost 28 pounds over the course of one week from vomiting, nausea, and inability to keep food down. He sought medical care, but instead was thrown into solitary, while Wellpath told him that nothing was wrong. He’s still dizzy and nauseous and in need of urgent care.

We know that the DOC needs to cancel Wellpath’s contract. Until then, join us in demanding that they provide Anthony with the care he needs.

Call the superintendent at MCI-Shirley: (978) 425-4341
You can press 2 to skip the entire intro message.
Press 2 again to dial an extension.
Press 2 a third time to connect to the medium facility.
Superintendent’s Office Ext. 4200 or Ext. 4126
Even if no one answers when you call, leave a message with the script below.

CALL SCRIPT

Hello, my name is [X] and I am a concerned community member calling on behalf of Anthony Serrano, W113379. Anthony has been seeking medical care for over a week, after losing 28 pounds from vomiting and inability to keep any food down. He also has sciatic pain and was seen at Shattuck and recommended a medical mattress and physical therapy, but hasn’t gotten it. 

This is gross medical neglect. To remedy this, I’m demanding that Anthony receive:

1.  An urgent full evaluation for his gastrointestinal illness at an outside medical facility
2. A back brace, medical mattress, wheelchair, and physical therapy appointment for his back pain

Will you confirm that Anthony will immediately receive this care?

This is the story of Yisbert Lara, age 39, an incarcerated man at MCI Norfolk.

Yisbert started experiencing severe back pain more than 18 months ago. His experience with Wellpath first began when he was seen by a nurse practitioner who diagnosed him with sciatic nerve damage despite the lack of tests, x-rays, and MRI scans. Yisbert was simply given Tylenol and then sent on his way. 

After this event, Yisbert’s back pain worsened over time. Finding it difficult to walk or sleep, Yisbert complained frequently to the medical staff about his condition. Wellpath personnel changed his prescriptions for pain medication seven times without success. On top of this, Yisbert saw a physical therapist who applied an electro stimulus to his back while restraining his legs, a procedure which provided no pain relief. Then, in late April, Yisbert saw a foot doctor who wanted to inject a shot of cortisone into his back. Lacking a proper diagnosis and information about the procedure and its effects, Yisbert refused the shot.

Since February 2020, Yisbert has submitted 15 sick slips and four grievances to the medical department, each time asking for tests, to get sent out for an MRI, or for any treatment by a doctor that would give him an accurate diagnosis for what had become chronic, debilitating back pain. As a result of his pain, Yisbert walks with a pronounced limp that requires the assistance of a cane and finds it difficult to sleep at night. Yisbert continued to file sick slips and grievances – all of which were repeatedly denied by the Wellpath provider. 

Yisbert’s experience is, sadly, very common and the state hasn’t done anything to improve these conditions. The Massachusetts Office of the State Auditor filed a report that found that the Department of Correction failed to provide timely response to sick calls from incarcerated people. Importantly, this audit occurred before the pandemic, and given the rise in healthcare needs since then, these delays are likely worse now. Even though incarcerated people are legally entitled to file grievances for this and other kinds of medical neglect, those grievances are essentially never acted on by prison officials.

Frustrated and fed up, Yisbert filed a request for medical treatment under the Americans with Disabilities Act. As a result, Wellpath finally sent him to Boston Medical Center for tests. Yisbert saw a neurosurgeon and was given an MRI that properly diagnosed him with a herniated disc – the answer he was waiting for after more than 18 months of undue suffering and pain. He was then told he would be scheduled for surgery to repair the damage.

 For Yisbert, this sad saga of neglect, inadequate and inept medical care continues, despite his diagnosis, as he is still in pain while he awaits his surgery and continues to have problems with obtaining his pain medication. 

Yisbert Lara’s inadequate and negligent care at the hands of the Wellpath medical provider at MCI Norfolk is just one of several examples that demonstrate how the institution does not provide what one needs to thrive. Instead, Wellpath’s negligence and inhuman treatment perpetuates and deepens harm. In Yisbert’s words:

“I don’t feel I should have been made to beg for my surgery. I should have been sent to a specialist two years ago. Doctors need to be consulted sooner when people complain of serious issues. I was ignored and this shouldn’t happen.”

Yisbert Lara

For more stories of medical neglect:

• Ron Leftwich’s story
• Shorty Mac’s story
• Wellpath and the pandemic
• Juan’s story of mental health neglect
• Medical neglect stories: a compilation

Loved ones lost to Wellpath’s horrific indifference

• The state murder of Roger Herbet
• Remembering Alex Phillips