Duane Waters Health Center (DHW) is a 112 inpatient bed medical facility operated by the MDOC. It provides acute medical, outpatient, and long-term care. It is adjacent to the Charles Egeler Reception and Guidance Center and is located at the site of the old walled prison in Jackson. Opened in 1986 DWH was named after Dr. Duane Leonard Waters who worked with the Michigan Corrections Commission for 25 years to modernize health care for Michigan prisoners. This information comes from the MDOC website and sounds well and good but like so much else doesn’t tell the whole story.
In the 1980’s a number of inmate lawsuits filed in federal court regarding prison conditions and medical care were combined into a class action. The state negotiated a settlement known as the Hadix consent decree which outlined specific goals for improvement of prisoner care. Despite repeated attempts by the MDOC to convince the court to end the consent decree it is still in force, providing oversight and monitoring progress made to improve conditions.
Over the course of the first 5 years I was in prison I made annual trips to DWH for eye exams, so I have some firsthand experience. There were a lot of stories about DWH circulating and from talking with the old timers it was clear that you didn’t want to end up there. I don’t know the statistics but a lot of inmates have died there over the years. One time when I was being processed into the facility and was standing across from the elevators waiting to have my leg irons removed I watched them wheel out a body bag on a stretcher. When that happened the dozen or so inmates I was with grew very quiet and still in respect for the dead.
While prison is a dangerous place and several inmates are killed by other inmates on an annual basis, for the 95% of inmates which will likely receive parole, the fear of dying in prison is more likely related to a medical issue such as a heart attack or cancer.
DWH lost its certification to perform surgery years ago. I heard horror stories of wrong limbs being amputated, post-operative infections, patient neglect, misdiagnosis, and excessive pain and suffering. The doctors and nurses no longer work for the MDOC but for a subcontracted medical service provider, a for profit company. But that hasn’t done anything to improve medical care. doctors that work in prisons have a reputation for being poor physicians that can no longer work with the general public. Not long after I arrived at my first prison the state police showed up to arrest the doctor. They found that he had been stealing prescription medications that were supposed to be distributed to inmates.
Decisions regarding treatment are made by case managers working for the medical service provider and will routinely deny requests for testing and treatments recommended by the physicians. The medical service provider has a national reputation for providing substandard care and has faced numerous lawsuits both by innates and the states that it contracts for.
Their philosophy seems to be to delay and if possible avoid making a diagnosis and when that doesn’t work delay treatment or seek to least costly treatment option regardless of success rate. Major medical procedures required by inmates including surgery and cancer treatments are now performed at public hospitals. In Jackson and Lansing there are enough inmates in the hospital that the MDOC maintains a prison ward. In addition, inmates are transported off site for doctor’s appointments and outpatient treatments. Inmate medical expenses are one of the highest cost centers due to the aging prison population. Yet getting medical treatment can be a major ordeal with delay, denial, and a very one-sided grievance process that puts the inmate at a significant disadvantage to fight the decisions made. Inmates pay a $5 copay for medical service appointments and are charged this even when no services are provided. For those without financial resources this is just another debt added to their bill that will follow them after they get out.
My level II bunkie was a lifer that had been down since the 1970’s. He had COPD due to emphysema from smoking his whole life. It was well managed using a national brand inhaler. The health care company decided to change his medication to a cheaper alternative over the objections of his doctor. The result was an almost immediate deterioration of his condition from fit enough to work in the chow hall wiping tables for $90 per month to wheel chair bound, oxygen dependent, and indigent. Quality of life is a major concern in prison since it doesn’t take much to destroy what little you have when a major change in health status occurs. The result of going cheap on his medication is that the overall cost of his health care increased significantly.
From talking with an inmate who was suing the doctors and nurses for pain and suffering in regards to a misdiagnosis for cancer, I learned that the ability to successfully prove malpractice is not easy. The lawyers provided for the doctor were so used to dealing with prison malpractice claims that when they asked the judge to dismiss the claim during a pretrial hearing they were caught off guard when the judge informed them that the doctor was being sued under different statutes and the case was going forward. Every now and then an inmate will win, but the cost to the doctors, the medical service provider and the state aren’t great enough to cause them to change their ways and improve inmate medica1 services.
I myself had personal experience with prison medical services. Due to a preexisting medical condition I was at a high risk for heart attack or stroke and classified as chronic care for additional monitoring. This meant I got a medica1 exam every six months instead of the annual checkup that was part of routine medical care. But when I developed an unrelated non-life-threatening condition, I did not receive the same level of care.
Due to poor food quality I developed hemorrhoids as a result of hard stool and difficult bowel movements. The hemorrhoid ointment for sale in the commissary wasn’t Preparation H and did nothing to treat the painful condition I was suffering from. I was literally reduced to tears from the fiery pain I experienced from bloody swollen hemorrhoids. My first trip to medical I received a small supply of Tuck’s pads that actually worked to provide temporary relief in treating my condition, but no further supplies were provided when those were used up. Medical wouldn’t address the underlying cause and I ended up having to purchase fiber laxative powder for $5 every two weeks for the next 7 years, along with hydrocortisone cream to reduce the swelling. If I hadn’t had the financial resources available to afford this I have been in a world of hurt.