Illinois taxpayers pay a private company more than a hundred million dollars a year to give health care to prison inmates.
Yet no one in Illinois knows how good, or bad, the care is.
But that will likely change soon.
As part of our series “Of natural causes: Death in Illinois prisons,” WBEZ’s Robert Wildeboer reports.
On July 28, 2012 Elawndoe Shannon put in a request for sick call at the prison where he was housed in Lawrence, Illinois.
Two days later, he died.
The day after his death a nurse in the health care unit finally got his request slip for medical care.
JACKIE SHANNON:That mean somebody took it and just said, ‘oh it don’t matter, ain’t nothing wrong with him.’ That’s crazy!
Jackie Shannon is Elawndoe’s sister.
JACKIE SHANNON: Everybody’s entitled to see a doctor. I don’t care, you could live in a hole somewhere. If you come out of that hole and you sick, you should be able to see a doctor. How many other ones in there that need to see the doctor are not seeing a doctor?
It’s not unusual for Illinois inmates to complain that they have trouble seeing doctors.
Yesterday we heard about Anthony Rencher, who went to the health care unit in the middle of the night where he was observed in the waiting room for an hour before he returned to his cell where he died.
Alonzo Nevarez’s brother had a similar story.
NEVAREZ: We got the letter after Danny passed, and it was, it’s him talking from the grave actually.
Nevarez sits on the front stoop of his dad’s bungalow near Midway Airport and reads through a letter his brother Danny wrote from prison.
It’s in Spanish and Alonzo translates while he reads.
NEVAREZ: The reason for this card, to beg you to help him, he’s sick, and the people from this facility, no me quieren, they don’t want to help me. These people are not taking me serious. I need help.
According to medical records, in March of 2010 Nevarez complained to a prison health care worker of pain in his knee.
The prison took an X-ray but found nothing.
The doctor prescribed some drugs and told Nevarez to exercise as much as possible.
A year later Nevarez was still complaining about his knee.
He was prescribed Motrin and referred to a doctor.
The next two appointments with the prison doctor were cancelled, one because of understaffing and another one because there was no security escort.
NEVAREZ: He called when he was in prison complaining that they were ignoring him. They wouldn’t let him see the doctor.
The medical records also show that on several occasions Nevarez refused to see health care workers.
In one instance he’s quoted as refusing to see the prison doctor because he wants to be immediately taken for surgery on his knee.
On another occasion he refuses to pay the two-dollar co-pay and is therefore denied care.
When the mass on his knee was diagnosed as cancer 15 months after his first complaints, the tumor was hard to miss.
It was 5 centimeters by 5 centimeters by 3 centimeters.
Salvador Nevarez is Daniel’s father.
SALVADOR NEVAREZ: You know he was complaining about he want to see the doctor and the doctor, they keep getting no to him. So what we had to do go in touch with his lawyer so this lawyer talked to them according to get treatment.
Nevarez went to an outside hospital where the tumor was removed.
He also went for 33 radiation treatments.
A year after his treatments on December 13, 2012, Nevarez once again sought medical care.
According to records he appears to have fainted and gotten a cut above his eye when he fell.
He told doctors his head hurt and he couldn’t remember things.
A doctor at the facility seems to have decided Nevarez was lying in an attempt to get drugs.
The way it’s recorded in the medical record is quote, “appears to be med seeking.”
Nevarez was sent back to his cell.
He fell into a coma.
A CT scan of his head was taken and it showed he had two large, dense brain tumors and swelling in his brain.
He died that day at the age of 31.
The autopsy states quote, “given the lack of follow up care and systemic chemotherapy for this patient… it is not surprising that he developed widespread metastases a year after diagnosis.”
In the death review the department handed over to WBEZ, where it asks, ‘was an earlier intervention possible?’ the answer is redacted.
On the non-redacted version given to the family, it says the cancer diagnosis could have been made sooner, though it says it was quote, “probably too late for significant intervention.”
MILLS: It’s a symptom of an overloaded system that it takes forever to, get over to a doctor. And then once you’re there you don’t see the doctor right away you go through two or three screening processes before you finally get to see a doctor. So that can take months!
Alan Mills is an attorney who specializes in prison lawsuits.
MILLS: Yes there are red flags all over the place. But without the details, you have to get beyond just saying, ‘well this person died too soon.’ You don’t know that unless a doctor looks at the medical records and says, no ‘this test was done’ or ‘this test wasn’t done, this is what the follow should have been and it wasn’t.’
That work is now being done by a doctor appointed by a federal judge as part of the class action suit Mills filed over health care.
The state of Illinois pays a company called Wexford Health Sources more than a hundred million dollars a year to provide health care in the prisons.
Wexford did not return repeated calls for comment over the last two weeks.
That’s just the most recent refusal--I’ve had an ongoing request for an interview with the company for almost two years now.
Alan Mills has studied the contract between Wexford and the state.
MILLS: Wexford gets paid the same amount whether they provide a lot of care or a little care, so therefore, every time they provide care their stockholders lose money. So that is a fine model but you have to have some control to make sure that they’re actually providing the care that you’re contracted to giving them. Nobody in the state of Illinois regularly audits the Wexford contract, either financially, or more importantly, a health audit to see what the outcomes are that we’re getting.
SHAER: I’m not going to discuss anything that Alan Mills says because Alan Mills has been proven to state things that are false, so I’m going to respectfully decline to include any information coming from Alan Mills in this interview. Anybody else you want to talk about, fine, not him.
Tom Shaer is the spokesman for the Illinois Department of Corrections.
The medical director who oversees more than a hundred million dollars Illinois pays Wexford for medical care refused to speak to WBEZ.
Regular listeners will recognize a pattern here on the part of Governor Pat Quinn’s administration to be less than eager to discuss or shed light on unflattering issues in the state’s prison system.
Shaer says focussing on just a few cases does not give an accurate picture of health care in the department.
He points to Bureau of Justice Statistics showing Illinois’ prison system has one of the lowest death rates in the country compared to other prison systems.
SHAER: We have pretty high standards here. We do the best we can within our ability to monitor that and if we felt that our ability wasn’t adequate, we would find a way to address that.
HARRIS: I see enough things that tell me there are really some warning signs here. I mean there are problems.
Illinois state representative Greg Harris held committee hearings last year to dig into allegations of poor care.
HARRIS: You know in the testimony, in the contacts from individual families, in the lawsuits that have been settled and paid by the state for deaths that should have been preventable, I know there are things that we should have done that we did not do and that there are probably things that we ought to be doing better now.
As a result of the hearings, Harris concluded that no one in Illinois is paying close attention to the hundred million dollars the state pays Wexford every year.
Harris brought in the National Commission on Correctional Health Care to audit health care, both the finances, and the health outcomes.
He says independent experts who know how to evaluate health care in a prison setting are looking at the system and should provide some answers soon.
That audit is in addition to a federal court monitor who is also evaluating Illinois’ prison health care system in response to complaints.