In mid-December, Cindy Andrews got a call from the Vermont Department of Corrections. Her 37-year-old son, an inmate at Southern State Correctional Facility, was in critical condition at Dartmouth Hitchcock Medical Center.
Though the call panicked Andrews, it did not surprise her. For more than a month, she had been on the phone with her son and corrections staff trying to get him medical care for liver disease.
Andrews has concerns that her son was not properly cared for in prison; she believes his current medical condition could have been avoided with earlier medical care. She raises a refrain of frustration about being left in the dark as the family member of an inmate with serious medical issues.
When Andrews’ son, Jason, went to prison three years ago on an aggravated assault charge, he knew that he had liver disease, according to his mother. Cindy’s mother died from the same affliction, and she encouraged all of her children to be screened for symptoms. At the time he went to prison, his condition was not very advanced, she said.
Jason Andrews’ completed his minimum sentence requirements in September, and he reaches his maximum sentence in September 2018. Cindy Andrews has found it difficult to keep tabs on her son’s condition while he has been incarcerated.
When he was held out of state in Kentucky, he went through a medical procedure related to the disease that she only learned about weeks later. He has since been transferred to Southern State Correctional Facility in Springfield.
Several months ago, Cindy Andrews drove from her home near Plattsburgh, New York, to visit her son in Springfield. She noticed marks on his arms that she recognized as possible symptoms related to liver disease.
The second week of November, she got a call from her son who told her that his legs and abdomen were swollen — a report that frightened her. She recognized the symptoms as signs that his liver condition could be significantly progressing. She began calling the commissioners’ office of the Department of Corrections and others in an attempt to ensure her son would be treated.
Later in the month, Jason Andrews did receive some medical treatment. Records from the DOC confirm he was brought off-site to Dartmouth Hitchcock Medical Center for a couple hours on Nov. 23.
A few weeks later, on Dec. 10, Jason Andrews’ condition worsened to the point that he needed to be brought to the emergency room. Two days later, his mother was notified that he was at Dartmouth Hitchcock, she said.
Cindy Andrews was astonished at her son’s condition when she saw him. His eyes were “bright yellow” from jaundice, his stomach was so swollen it “looked like he was ten months pregnant,” she said. He was unconscious for days, she said.
She believes that the serious nature of his condition could have been avoided, and raised concerns about care from Centurion of Vermont LLC, the private company that provides health care in Vermont’s prisons.
“He should not be where he is especially because I called them and told them exactly what was going to happen to him,” she said.
Health care in the prison system
A corrections official declined to speak about medical care provided for Jason Andrews, citing laws prohibiting disclosure of protected health information. DOC Deputy Commissioner Cheryl Elovirta addressed the situation broadly.
“It is the Department’s goal to ensure that all inmates receive timely and appropriate medical treatment and the Department’s contract with the medical services provider requires that it provide such care to inmates,” Elovirta said.
Elovirta said inmates who believe they are experiencing a serious health situation can submit a request to see a health care provider on-site, notify any staff member, and file an emergency grievance, which requires a response within eight hours.
Additionally, the DOC keeps an emergency toll free hotline that inmates can use, she said.
Prisoners’ health records are tracked electronically within the prison system, Elovirta said. Health providers outside of the prison do not have access to those records. If a prisoner is admitted to a hospital, medical staff at the prison typically contacts the hospital to share relevant health records.
She said the DOC monitors Centurion, the prison health care contractor, through several avenues, including holding quarterly improvement audits and requiring monthly, quarterly and annual reports.
The department receives daily status updates on all inmates who are admitted to a hospital, and can access all of Centurion’s electronic inmate health records.
Under Vermont law, prisoners are entitled to receive medical care that is on par with treatment available outside out of prison.
Defender General Matt Valerio did not comment specifically on Jason Andrews’ situation.
In general, Valerio said “unfortunately, sometimes if you don’t complain to the right people you don’t get the right result.”
Valerio advised inmates with health concerns to reach out to the Prisoner’s Rights Office, a division of the defender general’s office that works with people who are incarcerated. The attorneys on staff often can get more information about someone’s records more easily, he said.
“You really need to come to us because we have much better access than you do,” Valerio said.
Seth Lipschutz, who heads the prisoners’ rights office, has some concerns on a broad level about contracting health care services to a private, for-profit company.
“There’s just an innate, in my view, tension between needing to make a profit for the company and needing to provide health care,” Lipschutz said.
However, Lipschutz noted that Centurion employees often provide high quality health care to those incarcerated in Vermont.
“This is an area that’s filled with gray. It’s not black and white,” Lipschutz said. “It’s an imperfect world with a lot of players. There’s room for improvement but it also could be a lot worse than it is.”
Lipschutz said that families are often not kept up to date with the health condition of their incarcerated relative. In part it could have to do with bureaucracy, in part, with legal restrictions on who can access protected health information.
He said it is not different from how health information is shared with family members outside of the prison system.
A few days before Christmas, Cindy Andrews was sitting with her son at Dartmouth Hitchcock, preparing to spend the holiday week in the hospital. He remained in critical condition, but she anticipated that his condition would be downgraded soon. Still, she said, a lot of damage had been done to his liver.
She said she understands that those who commit crimes need to be held responsible. But she argued that more health services should be provided.
“It is not his punishment to die because somebody didn’t take care of him,” she said.
