Latest inspection of prison medical unit shows signs of progress

Heather Michon

Medical services at the Fluvanna Correctional Center for Women (FCCW) are meeting most of the metrics established in settlement of a 2015 Federal lawsuit, according to a report filed by the court-appointed monitor in June.

Dr. Homer Venters, an expert on medical care in correctional facilities, has been making periodic visits to the Troy facility for several years. His most recent visit in mid-April included an inspection of the medical facility, a review of records, and interviews with both staff and detained women. 

The 2015 lawsuit brought by women held at the prison showed that medical care was so lacking that it violated their Constitutional protections from “cruel and unusual” punishment. A 2016 settlement laid out 22 areas of compliance the prison had to meet, including maintenance of adequate staffing, inmate access to medical care and treatment, and prompt response to medical emergencies.    

FCCW had been slow to fix persistent problems within the medical unit, leading to at least two inmate deaths from undiagnosed health crises in July 2017. The case returned to court in 2018 and the prison was ordered once again to meet the compliance standards. 

In his April visit, he found the medical unit was compliant or partially compliant with all but two of the metrics. These two areas of non-compliance were maintenance of durable medical equipment – which includes everything from wrist braces to wheelchairs to hearing aids – and access to diagnostics and treatment. Those areas failed to meet the threshold of 90 percent or greater compliance with the settlement’s guidelines.   

Other areas of concern for Venters were the lack of routine screening for lung cancer and diagnosis and treatment of opioid use disorder. “These two health problems represent significant causes of mortality in the State of Virginia and are not measured in other parts of this settlement,” he wrote.

FCCW said they are in the process of finalizing a pilot program that would address and treat opioid use, which should be in place sometime this year. 

 Other areas were showing some improvement. In a previous report, he had noted concerns about the medical unit’s practice of holding women with mental health issues and those being evaluated for possible self-harm in what amounted to “de facto segregation units,” which he called a “harmful and counterproductive approach.” 

The medical unit has since added at least one mental health office.  “I was able to meet the first officer trained and now functioning in this role and was impressed with her understanding of the benefits of out-of-cell time and the need for clinical engagement. Speaking with her, as well as patients and other staff, made clear that the facility has made substantial progress in securing more out-of-cell time for these patients and also helping patients who had become accustomed to a lock-in approach to gradually increase their time out of cell as well as their social and therapeutic engagement.”

 The prison has seen several waves of COVID-19 since the start of the pandemic in 2020. He found that the facility’s efforts “to mitigate the impact of these infections, and detect, treat and prevent future illness from COVID-19 to meet or exceed CDC guidelines.” 

According to the Virginia Department of Correction (VDOC) records, more than 1,100 women at FCCW have tested positive since the beginning of the pandemic. There have been no reported deaths from the virus.

Among the women he interviewed and those who have written him letters since his previous inspection, the process of lodging medical grievances remains a source of stress for many inmates. If they feel they haven’t received an adequate response to a medical issue, they must first lodge an informal complaint, and if that isn’t addressed, they can then issue a formal grievance. Some reported that it could take 3-4 weeks to receive a reply to the informal complaint, at which point their formal grievance was rejected because they didn’t submit it “in a timely manner.” 

He was also concerned by a notice that had recently been posted in clinic areas that if a patient was found to have used a meeting with a medical provider for anything other than the stated purpose, they could be charged with a violation of prison rules.  “This notice reflects a potentially harmful approach to delivery of health services because it seeks to punish patients for the predictable and routine scenario in which a health problem either changes in presentation, or potentially, when new or apparently unrelated health problems poses serious risk to health,” he wrote. 

Earlier this year, VDOC canceled a longstanding contract with Armor Correctional Healthcare, which has managed healthcare in most of the state’s prisons, including FCCW, since 2014. Over the next couple of years, health care at FCCW will come under a partnership between VDOC and UVA Health.

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