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Prison-Industrial Complex

How Some Sheriffs Force Their Inmates Into Medical Debt

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Photo: Pixabay/Pexels

Sheriffs in multiple Alabama counties refuse to pay for some of their jail inmates’ health care needs. The inmates are personally billed, and their bills can end up with collection agencies while they are still behind bars, wrecking their credit.

In Alabama, the county in which you’re arrested could be the deciding factor in who will be financially responsible for your medical bills behind bars.

In Baldwin County, known for its white-sand Gulf Coast beaches and waterfront communities, the sheriff’s office ensures that inmates in the county jail do not have to pay anything more than a $15 copayment for medical care.

“Inmates are not billed for the full cost of any medical care either inside or outside” the jail, Sheriff Hoss Mack said in an email. “Alabama Code Title 14 assigns financial responsibility of inmates’ medical treatment to the department where they are being held.”

Just across the bay in Mobile County, home to one of the busiest ports in the U.S. and the eponymous city of nearly 200,000 people built around it, Sheriff Sam Cochran takes a different tack: Some of his inmates are personally on the hook for the full cost of medically necessary care they receive from outside doctors while incarcerated, even if they are awaiting trial.

The difference between the two sheriffs’ approaches demonstrates the unique power Alabama sheriffs have to set their own rules and answer only to voters. Legal experts and civil rights advocates say sheriffs like Cochran are likely violating both state law and the Eighth Amendment of the U.S. Constitution, which prohibits cruel and unusual punishment and excessive fines.

It’s not just happening in Mobile County. In multiple instances confirmed by AL.com and ProPublica, inmates have had medical bills sent to collections while they were still behind bars, damaging their credit and putting pressure on their family members to pay up to ensure the care continued.

Brandon DeLaFosse is among them. He was arrested on domestic violence, burglary and robbery charges and booked into the Mobile County Metro Jail in November 2018, three months after he underwent surgery on his inner ear. Since then, he has received bills totaling thousands of dollars for necessary follow-up appointments and tests, some of which have gone to collections while he remains behind bars.

“He keeps getting bills in the mail,” said Alicia DeLaFosse, Brandon’s mother, who has paid hundreds of dollars for care he has received while in custody. “It’s all money he owes from going back and forth to the doctor.”

Like many inmates, DeLaFosse doesn’t have significant income or access to public or private insurance in jail.

Alabama law is clear: If an “inmate develops a medical condition which requires immediate treatment at a medical-care facility outside the county jail, the department shall be financially responsible for the cost of the treatment of the inmate.”

But Cochran said when the jail’s doctors determine inmates need care that goes beyond what in-house medical staff and contracted outpatient providers can handle, they are often taken to private medical professionals who do not have contracts with the jail. And he allows those medical providers to bill at least some of those inmates directly.

“When that person is taken out to that private medical facility or something like that, then, yeah, they’re going to bill him for that treatment,” Cochran said during an interview in his office last month. “It’s a more than reasonable thing to do.”

Asked later about the details of Brandon DeLaFosse’s case and how the practice squares with state and federal law, Cochran provided an email written by Trey Oliver, warden of the Mobile County Metro Jail.

Oliver wrote that inmates are required to pay “when they have a follow-up procedure or visit from a surgery conducted prior to being booked.”

As for DeLaFosse, Oliver wrote, “There was a follow up visit or two and his mother agreed to pay it beforehand.”

Most jails and prisons across Alabama and the U.S. either have doctors and nurses on staff or contract with outside companies to provide medical care in their lockups. It’s not uncommon for inmates to be charged low copays — typically less than $20 — for medications and medical services.

But requiring inmates to foot the bill for their health care takes that practice to another level.

That’s “like charging them for their own food,” said John Lentine, a Birmingham criminal defense attorney and adjunct law professor at Samford University’s Cumberland School of Law and the Birmingham School of Law. “To me it’s a basic human rights kind of thing.”

Michele Deitch, a senior lecturer at the University of Texas at Austin’s School of Law and Lyndon B. Johnson School of Public Affairs, said the practice is “absolutely” unconstitutional.

“There is a constitutional obligation to provide health care that meets the serious medical needs of people who are incarcerated,” said Deitch, who co-wrote the American Bar Association’s Standards on Treatment of Prisoners. “That’s not negotiable.”

The tactic is another way in which sheriffs across Alabama are avoiding financial responsibility for inmate medical care. AL.com and ProPublica reported in September that many sheriffs in Alabama and across the country are finding ways to release inmates from jail just before they incur expensive hospital bills, a tactic known as “medical bond.”

In several recent cases, incarcerated people around the country have successfully challenged policies restricting their access to free medical care in prison.

Last year, a federal court ruled that transgender inmates in Missouri’s state prisons have a right to receive hormone therapy free of charge while incarcerated, regardless of whether they were already receiving the treatments when they were taken into custody. And this year, prisoners in Minnesota reached a settlement with the state’s Department of Corrections that requires the prison system to provide prisoners who have Hepatitis C with expensive drugs that often cure the infection.

AL.com and ProPublica attempted to contact the sheriffs of all 67 counties in Alabama via email or phone to ask whether they allow inmates to be billed for care they receive while incarcerated. Of those, 13 sheriffs and one chief deputy responded. The sheriff of Mobile County and chief deputy of Jackson County each said they allow providers to bill inmates for necessary care in certain situations. Ten sheriffs said they do not allow inmates to be billed. Two others declined to comment.

“I’m Still Getting Bills”

Days after Thanksgiving last year, Brandon DeLaFosse was arrested in Mississippi on outstanding warrants stemming from an incident earlier that month in Mobile County, Alabama.

The then-28-year-old was driven back to Mobile, where he stayed in the county jail until Feb. 28, when he was sentenced to three years in prison.

DeLaFosse’s health problems continued behind bars. Since his ear surgery last year, he has suffered from persistent ear infections and severe hearing loss.

And his bills are piling up.

In between Marlboro Lights and peanut butter-and-syrup sandwiches at her Irvington home last month, DeLaFosse’s mother, Alicia, said she spends many hours each week making calls, sending emails and conducting research to advocate on behalf of her son.

She said a steady stream of medical bills addressed to her son has arrived at her house since his arrest. Billing records show that she has spent more than $600 on his care since his arrest, and more than $1,000 in outstanding bills have gone to debt collection.

On Dec. 6, 2018, while he was in the Mobile County Metro Jail, Brandon DeLaFosse was taken to see an ear, nose and throat specialist at Providence Hospital in Mobile for a surgery follow-up visit recommended by the doctor. But first, his mother said, jail staff required her to make a payment to the doctor’s office. After the appointment, the hospital’s billing department sent a bill for $729 for tests he underwent that day to Alicia DeLaFosse’s house.

“The way the nurse at the jail explained it to me is because it was something that didn’t happen at the jail, it’s preexisting. … I had to go pay for it myself,” she said. “For the jail to allow him to go see the doctor, I had to go to the doctor’s office and pay $125 first.”

A registered nurse at the jail in Mobile noted in Brandon DeLaFosse’s medical record that his mother made a payment and that the nurse had scheduled a follow-up visit for later that month. In January 2019, a nurse practitioner at the jail wrote a note in his file stating she would request another follow-up appointment with his doctor “with the expectation that it is handled in the usual fashion with his mother arranging for payment.”

“I don’t think it’s fair. They’re responsible for my medical care, so why should it be coming out of my pockets or my family’s pockets?” Brandon DeLaFosse said in a jailhouse phone call.

Cochran, the Mobile County sheriff, said via email that he views the situation as a “legal dispute between [Brandon DeLaFosse], us and our contracted provider. I know of no complaint or claim made against us.”

“The mom agreed to pay [the] bill. Looks like she reneged,” Cochran wrote. “Otherwise if it would have been medically necessary our contracted folks would have handled.”

Alicia DeLaFosse said she “didn’t renege” and paid for all of the medical costs she knew about in advance.

Brandon DeLaFosse continued to be billed for outside medical care after he was moved to state prison. On July 23, nearly five months after his sentence began, he saw a doctor and underwent tests at Providence Hospital. He was sent a bill for $224.70 for outpatient diagnostics administered that day, plus $71.98 for the doctor visit.

That shouldn’t have happened, a spokeswoman for the Alabama Department of Corrections said in a statement.

“By ADOC’S policy, all inmates in the care, custody, and control of any ADOC correctional facility are not charged or responsible for community-based medical care or mental health services,” the spokeswoman, Samantha Banks, said.

Any state prisoners “incorrectly” billed for outpatient medical care should notify the provider that they were incarcerated at the time, the statement explained. “The medical provider should submit to the Department the appropriate paperwork and any outstanding inmate medical bills will be directed to the appropriate payer.”

State prisoners in Arizona have reported similar issues with providers billing them directly for medical care they received while incarcerated, as KJZZ radio reported this year. Like in Alabama, the Arizona Department of Corrections has said the bills were sent out in error and that the department or its medical contractor would pay the inmates’ bills.

But that’s a vastly different situation than the one facing inmates in some Alabama counties, where sheriff’s offices are not chalking up such bills to error and are in fact deliberately choosing to avoid paying medical bills for inmates in their charge.

Constitutional Question

Though the public often has little sympathy for inmates, incarcerated people do have clear rights, particularly when it comes to health care behind bars.

Alabama law states that “necessary clothing and bedding must be furnished by the sheriff or jailer, at the expense of the county, to those prisoners who are unable to provide them for themselves, and also necessary medicines and medical attention to those who are sick or injured, when they are unable to provide them for themselves.”

In another section of the state code, a definition of a county inmate includes an explicit reference to their health care being provided for: “any person being held in a public institution under the administrative control and responsibility of the county sheriff and for whom the county is responsible for the provision of medical care.”

Brandon Blankenship, an assistant professor of law and ethics at the University of Alabama at Birmingham, said that allowing inmates to be billed for care that they receive while incarcerated amounts to cruel and unusual punishment and that the bills are excessive fines.

“I don’t think it’s ever been challenged in court in Alabama, but from where I’m sitting, the answer to me is that, no, it’s certainly not constitutional under the Eighth Amendment.”

The tactics of some Alabama sheriffs stand in sharp contrast to what’s going on elsewhere in the country. This year, California and Illinois banned the practice of charging inmates copays, and a number of other states have taken, or are considering, steps to rein in the practice.

“They usually cannot afford even a $5 copay, so the idea that they could pay thousands of dollars for these services is laughable from a practical perspective and it’s downright evil on many different levels,” said Deitch, the University of Texas at Austin professor.

In 1983, the U.S. Supreme Court decided a seminal case, City of Revere v. Massachusetts General Hospital, involving a person who was hurt during an arrest and taken to a hospital. The court ruled that “as long as the governmental entity ensures that the medical care needed is in fact provided, the Constitution does not dictate how the cost of that care should be allocated as between the entity and the provider of the care. That is a matter of state law.”

But that ruling did not answer the question of whether inmates can be stuck with the bill.

“We don’t have any clear Supreme Court ruling,” said Fred Cohen, a professor emeritus at the University at Albany’s School of Criminal Justice who has decades of experience in corrections law and serves as executive editor of Correctional Law Reporter.

Cohen said he believes there is a good case to be made that the practice of allowing inmates to be billed for medical care violates their constitutional rights.

“I don’t think it’s an open policy question in that inmates should not be required to pay,” he said. “I think it could be held unconstitutional by the right court.”

Different Systems

Several days after Charles Tillman was booked into the Washington County Jail in March 2018, his left testicle became severely inflamed. He told a guard, and on March 22, Tillman was taken to Washington County Hospital for treatment and an ultrasound.

The 40-year-old, who has a long rap sheet, was driven back to the jail following the appointment and was released from the facility the following day. (The Washington County Sheriff’s Office confirmed the dates of his incarceration. But the nature of his offense was not clear based on court records, and the sheriff’s office would not discuss his charges during a phone call with Tillman and a reporter.)

It wasn’t until weeks later that Tillman learned that he had been billed directly for that visit and that the debt had been sent to a collector, upending his credit. He showed AL.com and ProPublica a copy of his credit report showing it had been negatively affected by unpaid medical bills.

“They tried to get me to sign paperwork but I refused to sign it, the hospital bill saying I was responsible for it.”

As of this month, Tillman still owed $1,856.42 for medical care he received at Washington County Hospital. The hospital confirmed that it treated him during each of his brief incarcerations in the jail in February 2017, March 2018 and September 2018.

“I got the bills at my [home] address,” said Tillman, who has since been released. “They’re on my credit report now as negative marks — that’s what’s keeping me from getting a car right now.”

Washington County Sheriff Richard Stringer was unable to explain Tillman’s situation, saying the county’s policy is to pay for all medical costs for inmates who aren’t covered by insurance.

“That’s not standard procedure,” Stringer said. “It would have to be an unusual case for that to happen, and I don’t keep up with every case that comes in. But no, that’s not our policy.“

Hundreds of miles northeast, Rocky Harnen, chief deputy of the Jackson County Sheriff’s Office, said preexisting conditions should be inmates’ responsibility.

“If it’s something preexisting, say diabetes or something, and you’ve got to go to the doctor every now and then, then that’s their responsibility to pay for that,” he said.

“If it’s going to your own doctor, they would be responsible for that. I guess they would bill them at their house. The taxpayers shouldn’t be responsible for ongoing issues that are preexisting.”

Harnen referred subsequent questions about the legality of the practice to County Attorney John Porter, who did not cite any laws that allowed it.

“I can’t say that there’s not any medical care that they have to pay for,” Porter said.

Asked if inmates sometimes have to pay for outpatient care for preexisting conditions, he said, “I wouldn’t say that that’s incorrect. … I can’t give you a blanket answer to that but it would be depending on the circumstances.”

That’s not the way inmate health care works in many county jails across Alabama. In Etowah County, northeast of Birmingham, inmates are never billed for care they receive while incarcerated, according to Sheriff Jonathon Horton.

“We provide medical services for inmates in our care so they should not receive any bills,” Horton said. “They shouldn’t be billed. That’s my understanding.”

Lauderdale County Sheriff Rick Singleton said that he would love to have inmates in his jail in northwest Alabama foot the bill for certain types of medical care, but that he is not legally able to do so. For instance, he said he would like to have avoided the $300,000 the county once had to pay for open heart surgery for “the town drunk” arrested on a public intoxication charge.

“If they’re in jail on public intoxication and they’ve got preexisting health conditions, I don’t think the taxpayer should have to foot the bill to pay for it,” Singleton said. “If they get injured inside the jail or they get sick inside the jail, we of course pay for it. But my issue is with having to pay for preexisting conditions. But we have to do it.”

This article was originally published by ProPublica. It was produced in partnership with AL.com, which is a member of the ProPublica Local Reporting Network.

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Prison-Industrial Complex

W.Va. Lawmakers Consider Taking On Parole, Civil Asset Forfeiture Reform In 2020

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Mount Olive Correctional Center in Mount Olive, W.Va. Photo: Steve Helber/AP Photo

It’s no secret West Virginia lawmakers are concerned about the state’s large incarcerated population. The Department of Military Affairs and Public Safety reports there are 5,300 people occupying the state’s 11 at-capacity prison facilities, and 4,980 people occupying its 10 regional jails, which on Monday were 19 percent overcapacity.

One solution might be presumptive parole, according to a few advocacy groups that spoke with members of a joint House and Senate judiciary committee on Monday. 

Presumptive parole is when incarcerated people are released under supervision as soon as they meet the timeline and requirements for eligibility. 

Although West Virginia’s parole board has a sort of checklist of parole requirements now — including in-person hearings and interviews — meeting those requirements doesn’t guarantee an individual will be granted parole, and there’s no state policy requiring disclosure from the parole board. 

“Instead of asking why should a person be released …. It turns that [question] on its head and says ‘Why not?’,” said Lida Shepherd with the American Friends Service Committee. “‘Why not? Why should we not release this person, and please articulate why.’”

Not only does overcrowding prompt humanitarian concerns, but it’s also costing thousands of dollars from the state and county governments, which are responsible for paying $48.25 for each regional jail inmate in their jurisdiction. 

The state covers the additional cost of housing regional inmates, according to DMAPs. According to data from the last year, each regional inmate costed $53.75 total. The state also covers all of the recently announced pay raises for regional corrections officers, and $70.90 per each inmate occupying a West Virginia prison. 

“That number adds up,” DMAPS counsel Stacy Nowicki-Eldridge told lawmakers. “You’re talking in the tens of millions of dollars.” 

Shepherd and Nowicki-Eldridge recommended reinvesting some of the savings back into the parole program to ensure low recidivism rates. 

“It would be irresponsible to talk about releasing people … without also talking about adequate support for those who really need it,” Shepherd said. 

She also recommended increasing parole transparency by livestreaming board meetings, reconsidering which technical parole violations the state will enforce and taking a second look at sentence lengths. 

On Civil Asset Forfeiture

According to a presentation to lawmakers from the Justice Action Network, a bipartisan group focused on national and state-level criminal justice reform, 33 states have updated their laws for civil asset forfeiture since 2014. 

That’s referring to an action law enforcement can take to seize property that might be involved with criminal enterprises. 

The process requires the lowest level of proof from law enforcement, and it’s expensive for the accused to obtain the legal action necessary to obtain their property back. Property can be seized with or without a criminal conviction. 

Civil asset forfeiture officially dates back to the 1980s ‘War on Drugs.’ 

In West Virginia, State Trooper Lt. Dana Chapman said the process still helps with his agency’s efforts against drug crimes. 

“We use forfeiture as a tool. It’s just a tool in our tool bag to help us fight the war on drugs,” Chapman said. “… The budgets for police are not great in West Virginia. There’s no special money set aside that says ‘State Police.’”  

In West Virginia, Lauren Krisai with Justice Action Network said 90 percent of funds from civil asset forfeitures goes into a special law-enforcement investigation fund. She added Monday that there’s no limits or guidelines on how the money is spent. 

“This is a tool,” Chapman said. “You take money from a drug dealer, maybe it will help fight the next drug dealer.”

Krisai recommended lawmakers consider requiring criminal convictions for civil forfeiture, which she reported 18 states already mandate. 

Jason Huffman, state director for American for Prosperity, told lawmakers civil asset forfeiture is more than a violation of property rights ⁠— it’s a process that demands transparency and accountability. 

While state law mandates law enforcement report what its officers seize and how much, the state doesn’t gather and centralize the reports, making the data more difficult to access. 

“Is this process of civil forfeiture unduly burdensome? [T]he answer to that question is, we just don’t know,” Huffman said. “We don’t know because we lack significant reporting requirements that would indicate to us where problems might lie.”

This article was originally published by West Virginia Public Broadcasting.

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Prison-Industrial Complex

The Phantom Promise: How Appalachia Was Sold on Prisons as an Economic Lifeline

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Photo: Thinkstock

As the coal industry declines, rural communities are seeking new economic stability—but prisons may not be the answer.

Big Sandy hides on a big hill. If you’re not looking for the federal prison, you’ll miss it easily. At first, all that can be seen above the soaring Kentucky cliffs, jagged granite dotted with green scruff, are lights. They look like the lights for a high school football field, or maybe a mall. Then the guard towers loom into view. You can’t see the razor wire from the road.

Construction on U.S. Penitentiary Big Sandy finished in 2002, one of three federal prisons built in eastern Kentucky since 1992. Plans for another federal prison, in rural Letcher County, Kentucky, appear to have fallen through; in June, the U.S. Federal Bureau of Prisons withdrew its plans for Letcher after an outcry from the community—and a federal lawsuit expressing concern both over the environmental issues of building the prison on a former coal mine site, and the fact that the public had not been able to weigh in.

In the scramble to “save” Appalachia as the coal industry collapsed, prisons—many housing incarcerated individuals transferred from distant states—have been presented as an antidote to the joblessness and poverty plaguing parts of the region, especially the more isolated rural areas. Prisons are big projects with hefty price tags, and they bring pledges of “jobs, jobs, jobs.” But more often, prisons do not deliver promised local employment, at least not initially, and carry with them a host of other issues.

Inez, Kentucky, the town nearest Big Sandy, has a population of less than 900. Multiple storefronts on East Main Street are empty, one with large pane windows covered in flaking white paint. There’s a hardware store, a rural health clinic. The pawnshop at the edge of town has a row of ATVs parked out front, near a stack of tires and a few old wagon wheels. A sign says “We Buy Gold.” It’s unclear how many locals work at the prison. Despite Big Sandy’s promise of local jobs, the largest industry employing people in Inez is still oil and gas extraction, and less than a third of the town’s total population is employed anyplace at all.

Kentucky has 12 state prisons, plus five federal prisons. The Virginia state prison in Big Stone Gap is just across the state line. In March 2019, the number of people under the jurisdiction of the Kentucky Department of Corrections reached more than 24,000, though there were not enough beds for all of them.

Kentucky has the ninth-highest incarceration rate in the nation, so much so that Kentucky radio station WMMT began producing a radio show, “Calls from Home,” in the early 2000s. The program reaches into seven prisons, broadcasting messages from inmates’ families. WMMT is housed within Appalshop, Kentucky’s media, education and arts center within Letcher County.

A prison is not like a factory. Its massive size doesn’t automatically mean jobs, especially not for a local workforce without the specialized training needed to be a corrections officer, or CO—and especially not in a federal prison, which has additional qualifications. Work as a federal corrections officer requires a college degree, or three years of work experience.

“Fifteen years in, you might be able to have more local folks because the people they start out with would have been trained up, [but] it’s not immediate work; it’s never been,” says Ada Smith of Appalshop and the Letcher Governance Project, a group that opposed the prison in Letcher County. People with military experience may have a greater chance of prison employment, says Smith, whose cousin works as a CO. When hiring for federal prison COs, the federal government looks for military experience, and as Smith says, “there’s a higher percentage of rural military people than anywhere else.”

Still, from 2014 to 2016, only 1.8 percent of Kentuckians in urban areas worked in the justice, order, and safety fields, according to the Kentucky Center for Economic Policy; and just 2.4 percent of Kentuckians in rural areas overall worked in the fields.

Appalachian prisons have overwhelmingly been built in remote places, a fact that family members of incarcerated individuals lament in Up The Ridge, Appalshop’s 2006 documentary about the prison industry, which focuses on the then-new Wallens Ridge State Prison in Big Stone Gap, Virginia. Lisa Richardson, traveling to Virginia from Connecticut to see an incarcerated loved one, asked, “Why would you build a prison so far up here and so secluded?”

Federal prisons house inmates from all over the country—often, inmates are transferred without warning—requiring family to make these costly and difficult journeys to visit their loved ones, if they can visit at all.

Some local government officials in McCreary County, Kentucky, tried to pitch the federal prison there as a generator of additional tourism dollars from families visiting incarcerated loved ones. The thought was that families would stay at hotels, eat in restaurants and take part in local recreational activities, including waterskiing. Smith characterized the pitch from officials, who suggested that traveling to the region for visitation as “going to feel like a vacation!” That did not happen, and the prison tourism dollars never came at the scale officials had hoped.

Near the Virginia state line, churches and other volunteer groups run ride-share programs where families are picked up, driven all night, fed breakfast and taken to prisons for visitation. Families spend the night locally, but usually at inexpensive motels, where they receive a discount.

Even without many local jobs or tourism dollars, prisons can potentially contribute to a rural community in the form of infrastructure. Large prisons need a lot of water. They need roads and sewage systems. These structures aren’t always in place in rural, remote Appalachia. Kentucky, West Virginia and Pennsylvania are among the states with the largest number of households without indoor plumbing, according to the Appalachian Regional Commission.

Yet a water crisis has persisted in Martin County, home of Big Sandy, for decades. In 2000, the collapse of a sediment pond, meant to hold the waste from a now-closed coal extractor company, turned several rivers black. The waste, which contained arsenic, lead and mercury, among other toxins, poisoned the county water supply.

That was almost 20 years ago, and Martin County residents still struggle to obtain clean, safe water. Pipes don’t work. They don’t have pressure; the water that eventually drips out of them is sometimes neon blue and smells of diesel. Water bills have skyrocketed, and the Martin County Water District in 2018 conducted shut-offs to conserve water, with some residents reporting their water was cut off for days.

In Letcher County, lack of basic infrastructure could have stopped the prison project before it began. Then the federal Abandoned Mine Lands Pilot Grants program pledged $4.5 million for the building of a sewage plant near the rural site, and to install the needed 9.5 miles of water lines. These basic public works projects were imperative for a prison, but they were also sorely needed by the community at large. The prison project promised water and sewer service to 100 nearby households. The future of those services is uncertain now. 

On the small main street in Inez, Big Sandy feels distant, a phantom over the shoulder of the town, miles and a mountain away. But prisons cast a long shadow over the communities in which they rest.

The Ohio State Reformatory in Mansfield, Ohio, my hometown a few hours north of Kentucky, was closed in 1990 as a result of a lawsuit over inhumane conditions and overcrowding. It was quickly replaced by a different, mixed-security state prison for men. But the Reformatory stayed standing. It was used for music videos and movies, including The Shawshank Redemption.

It’s strange to grow up in a small, rural town where one of the major industries, after the Westinghouse and General Motors factories closed, is prison tourism. One tourism website titled their review of the Reformatory “Locked Up & Lovin’ It!” Buying a ticket and wandering inside, people gawk and take pictures, laughing. Someone spray-painted “HELL” in the administration area. Paint flakes from the walls. The cell blocks are six tiers high, narrow as kennels and covered in rust. Solitary confinement looks scarier than any fiction that might have been filmed there: near-complete darkness in the damp, low-ceilinged belly of the basement.

Some of the community outcry against prisons is related to racial injustice: It’s mostly Black men in the prisons and it’s mostly white men guarding them. According to a paper on the Kentucky Policy Blog, using data from the Department of Public Advocacy, Black Kentuckians are 3.2 times more likely to be in prison than white people in the state.

In Up the Ridge, an unnamed young white man hoping to land a job as a CO acknowledges the racism of the area, but says he’s “colorblind.” He says he understands “racism probably would come up, but that’s something that hopefully they would train you for.”

Prison employees receive training on diversity in some states, such as California, but the impact of these trainings is difficult to determine.

Also, prisons may eventually bring jobs to town, but not the kind of desirable jobs that lead to advancement.

“I do not know anyone who dreams of being a prison guard,” Smith told The Appeal, an online newsletter focused on criminal justice. It’s difficult work with a culture of closed ranks, similar to the military, and there’s a high turnover rate among COs. There’s even a term coined for the specific job stress and lack of support that guards can experience: “corrections fatigue.”

As with any job, COs can bring the stress and anxiety of work home. But the stress of being a prison guard includes dealing with physical violence and emotional distress, along with the low-level anxiety of being constantly alert to potential danger. Hypervigilance can lead to post-traumatic stress disorder, a condition for which 34 percent of corrections officers fit the criteria, a rate even higher than that of military veterans.

The connection between police officers and domestic violence is widely known, but prison guards have been less studied, which a 2012 paper in the Journal of Family Violence theorizes may be because COs do less visible work than public police officers. The work and stress of prison guards is hidden away in restricted buildings, behind barbed-wire fences and away in the hills. Still, the data revealed that 33 percent of more than 700 respondents were aware of unreported domestic violence perpetrated by COs.

In Up the Ridge, activist Sister Beth Davies described officers she had met in prison “day after day, becoming more violent and more racist, the hate—and so the domestic violence rate has gone up. The divorce rate. The drug and alcohol problems. It compounded so many of the social issues here.”

In 2019, two inmates at Big Sandy were convicted of assaulting another inmate with a weapon. Two other inmates pleaded guilty the month before for attempted murder of another incarcerated person. A prison staff member was burned with scalding water thrown by an inmate. In 2009, a prisoner at Big Sandy attacked a fellow inmate with a homemade ice pick before strangling him to death.

That leads to a high rate of burnout and turn-over even after a short period of employment. “People start working at prisons and don’t try to do it at year two,” Appalshop’s Smith says. “Then it’s just like …I can’t do this.’ … It is a very intense job, and all the things that come with being in that kind of environment for eight to 12 hours.”

Sometimes in Appalachia—including Appalachian Ohio, where I have lived for much of my adult life—there is a sense that this is all we are good for, and this is our lot in life. That sense can lead to the belief that we are destined to suck it up and do the difficult, unwanted work—work that changes people. It’s the inevitability of what Smith calls “shit jobs,” referring to “this masculinity idea that, ‘Yes, we’re trash, and yet we’re the ones willing to do it—we’re the hard workers.’”

She likens this legacy to coal jobs. “I have supplied the [country with] energy and now I’m proud that now I’m the one making sure these dangerous people are off the streets … ,” she says of the mindset of some COs and others working within the prison system in Appalachia. “[We have] these labor-intensive, physically exerting, basically dangerous jobs that most people won’t work in, or the people that do work them, it’s mostly immigrant labor. What has been said over and over again [is] White men won’t take these jobs anymore. But here they will.”

“When you’re hungry, honey, you’ll take a job,” said Chuck Miller of the Big Stone Gap Housing Authority in Up the Ridge.

The Appalachian willingness to work could translate to a host of other jobs, such as manufacturing in the factories currently sitting empty, or in health care, for which the region has a dire need. Joe DePriest, president of the Letcher County Chamber of Commerce, the county where he was born, says there is a Keebler factory, call centers and mattress factories that are still open in Letcher County, home of the stalled prison project.

In September, Letcher County received a $3.5 million grant to build a sports resort, including a competitive shooting range. The county is also being considered for an airport project, which DePriest thinks would help with the accessibility of the area for potential developers: “If they say they’ll build you an airport, you should take it, you know?” Hemp and CBD oil extraction continue to flourish, sometimes on farms on reclaimed mine land.

Another much-needed industry in the region with the potential to bring jobs to Appalachia is substance abuse rehabilitation—the anti-prison, if you will. With the possible exception of rehab facilities, none of these industries have the big, sweeping allure of a federal prison. But when statistics show that prisons do little to ease the poverty of a rural county, a prison seems more metaphor than strategy, the great ghost of a promise.

“They were putting an enormous amount of hope in that federal prison project,” DePriest says. “And nobody, even the smallest guy on the street, or the biggest guy there is, nobody presented the federal prison as a cure-all for Letcher County. Nobody looked at it that way, but everybody looked at it as a shot in the arm, or something that could help … But it shocked me how much [the prospect of the prison project] affected people’s thinking and logic and the hope. It really did, and right now it still does. It’s still right there.” 

Up on the hill past the turnoff for Big Sandy prison is an office park. It winds through wild, grassy acres beside the prison. Most of the buildings sit empty, abandoned or never filled, weeds pushing through the parking lots. The prison didn’t really bring tenants to the park, just as it didn’t bring family tourists to the town.

Letcher County has an industrial park too, but because it was populated with companies primarily related to the oil and gas industry, most of those jobs were lost in the economic downturn 10 years ago. DePriest says a neighboring office park has remained full of tenants, but he doesn’t know why or how to replicate its success. “Those are the same kind of people 30 miles down the road as here,” he says. “They have the same kind of benefits, and the same kind of problems and attributes as here. And if they can generate 20 companies … 30 miles north of here, we can do the same.”

It is no coincidence that Appalachia is considered a prime place for prisons, as it was for coal, fracking and other industries that often exploit both land and people—it’s not simply a question of the terrain, but of industries no one else wants. Smith says that local officials have told her as much about the undesirability of the region, and how it is still passed over for more positive development: “If we could have got a pie factory, then we would have!” she recalls a member of the local planning commission saying. DePriest agrees that the abundance of extractive, exploitative industries in the region is no accident. “I think the thing with the whole general area—we’re talking about Letcher County, but really the whole area in general—is a loss of hope,” he says. “People need something to cling to, something to look forward to tomorrow.”

Perhaps for outlooks to change in Appalachia, the larger country’s opinion of the region needs to change, too—to view the region not only as a place to build an industry, but as a place to build a life. Smith says that highlights the importance of scaling back projects in the region to address the fundamentals. Clean water and repaired roads might not be as exciting as a prison, but the need for these services is dire and still unmet in some rural places. “If we could just get basic infrastructure for people that would be great,” Smith says.

DePriest says, “I think what we need to do, the leaders of the community, however we can, whatever needs to be done, is re-encourage people. To get their hope back.”

Otherwise, the promise of prisons may be like the promise of mines: largely empty, largely unjust.

This story was reported with support from the Marguerite Casey Foundation, which supports and amplifies stories of low-income families and the actions that make change possible. It was originally published by YES! Magazine.

Additional support for YES! Magazine’s Appalachia coverage comes from the One Foundation. 

Alison Stine is a writer and editor who lives in southeastern Ohio. She is a contributing editor for the Economic Hardship Reporting Project, the author of several books, including her debut novel The Growerto be published by Mira (HarperCollins) in September 2020.

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Prison-Industrial Complex

Profiting Off Prisoners: State Inmates Mean Big Bucks for Local Jails

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County jails make money from holding prisoners under state jurisdiction. Photo: Thinkstock

Rural jails in Kentucky are increasingly relying on income derived from payments for holding state prisoners in county facilities, according to a new report by a think tank that advocates for criminal justice reform.

To address overcrowding, states make payments to counties to hold convicted prisoners and pretrial detainees. States save money, and counties get an extra influx of cash.

In rural Kentucky, the report’s authors warn,  the dynamic speaks to a perception that incarceration is a tool for economic development. The reliance on income from state prisoners is particularly stark in cash-strapped counties suffering from a decline in another major form of revenue, the coal excise tax.

“Kentucky is one of only a handful of states that relies so heavily on local jails to hold people who have been sentenced to prison,” said Jasmine Heiss, outreach director at the Vera Institute of Justice, which authored the report. “This has deepened political and social alignment around prison,” she said. “In the coal fields, the political and social alignment has the additional context of the decline of the coal industry and needing to turn to another industry or source of revenue.”

Unsustainable Growth

Kentucky has the ninth highest rate of incarceration in the nation. As of February, 2019, Kentucky had more than 23,000 people under state prison jurisdiction but only 11,700 prison beds available, the report said. The state’s solution to overcrowding is to pay “per diem” fees to county jails to house excess inmates. The state pays eligible county jails $31.34 per inmate per day for food and medical expenses, roughly half of what the state spends to house per inmate in a state prison.

Among all states, Kentucky houses the second highest percentage of state inmates in county jails, at 49 percent.

According to the report, the number of people held in local jails for the state increased by 39 percent between 2000 and 2018. West Virginia falls seventh, at 18 percent. Ohio does not hold state inmates in county jails.

Jack Norton, one of the report’s co-authors, said that despite policies aimed at reducing Kentucky’s prison population, incarceration continues to grow at an “alarming” rate. “If the incarceration rates continue to rise in Kentucky at the same rate is has since 2000, every person in the state would be behind bars in 113 years,” Norton said.

Despite the mathematical impossibility of continued growth, the report said many county officials, particularly in rural counties, consider increasing jail capacity a solution to budget woes.

Knox County, in southeast Kentucky, has plans to build a new 350-bed jail. The report notes the current Knox County jail has space for 36 inmates but regularly holds 100 people.

“The state prison system is pushing people down to the county jail level, which is incentivizing counties in Kentucky to build bigger jails in order to take advantage of the per diem payments that the state DOC gives to county jails,” Norton said.

Coal Cuts

Harlan County, in eastern Kentucky, has seen its population decrease, but its incarcerated population has risen by 1,500 percent since 1978. A lot of that increase, the report says, is from prisoners sentenced in the state system. A Harlan County official told the Vera Institute nearly two-thirds of the county jail budget, or $1.8 million, comes from state payments for housing inmates.

Judah Schept, Norton’s co-author and a professor at Eastern Kentucky University, said the per diem payments for holding state inmates were particularly important in the state’s eastern coal fields, where budgets once boosted by coal severance taxes were flagging.

“The money that the state pays for locking up state prisoners in local jails has supplanted the role of coal as a revenue source for county budgets,” the report said.

Coal production began to decline decades ago, but around 2011, cheap natural gas caused a steep decline in coal production in eastern Kentucky. The decline in coal production meant drastic cuts to many local budgets, which have long relied on the tax on mined coal that the state distributes to mining counties.

Harlan County, a traditional coal county, saw its severance tax payments drop from $3.2 million in 2011 to $850,000 in 2016, according to the report.

Depending on Growth

The report’s authors urged county officials to be wary of relying too heavily on payments for housing state prisoners. If the state’s criminal justice policies change and the prison population begins to decline, county jails could be left footing the bill for unnecessarily large jails, even as the loss of per-diem revenue causes further hardship to local budgets.

“Rather than pursue policies that would address [over-incarceration] in some way, that would reduce the number of people behind bars,” said Heiss, “this quiet jail expansion around the state enables this limiting of the political and moral imagination around over-incarceration. The only solution that is being pursued is to provide more and more beds.”

As the federal government and states across the country pass legislation aimed at reducing prison populations, Kentucky’s incarceration rate has continued to rise. Legislation has been introduced in Frankfort that could reduce the number of people jailed before trial, potentially reducing the the state’s reliance on counties for bed space. Previous versions of the bill have been introduced but not passed.

This article was originally published by Ohio Valley ReSource.

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