From Better Government Association: COVID-19 again hits Illinois prisons

[January 28, 2022]  By DANIEL C. VOCK
Better Government Association

COVID-19 is once again sweeping through Illinois’ prisons, sickening thousands of Illinois prisoners and hundreds of staff members. And while hospitalizations have been rare during the latest wave, state prison officials are struggling to keep a lid on the infection rate.

The prison system is better prepared for the omicron surge than it had been in previous waves of the disease, in part because the prison population has plummeted by more than 25% in the past two years.

But this latest COVID-19 surge follows years of systemic lapses by the Illinois Department of Corrections, experts say, at providing medical and mental health care to an ever-aging population deeply affected by psychiatric issues — failures that have been exacerbated by the pandemic.

“When COVID hit (Illinois prisons), it was like you had a cracked rock and took a sledgehammer to it,” said Jobi Cates, the executive director and founder of Restore Justice, a nonprofit advocating for less punitive sentencing, particularly for youths.

IDOC appeared to have the pandemic largely under control, with fewer than 160 incarcerated people and staffers infected with COVID-19 throughout Illinois as recently as early December. But the number of infections has shot up since then with the emergence of the omicron variant.

In mid-January, 3,300 incarcerated people and nearly 1,100 staff members at Illinois prisons were infected with the disease. While hospitalizations have been rare during the latest wave, according to the state, one person in custody and two staff members have died.

With the pandemic fast approaching its third year, state prison officials are facing difficulties containing the virus once again because of the lagging vaccine rate of prison staff, the main conduit of COVID-19 into the prisons.

In August, Gov. JB Pritzker ordered all guards to be vaccinated, but their union protested the mandate and took it to arbitration. The governor prevailed in late December. Now, all prison workers must have their first shot by the end of January.

By the end of December, 65% of prison staff had been vaccinated, according to department officials who nevertheless remain confident that nearly all staff will meet the January deadline, citing markedly improving vaccination rates since the end of October, when only 49% were vaccinated.

But the slow rollout means very few of them — only 12% — have had booster shots, which are administered six months after the first round of vaccines but are crucial to warding off the omicron variant. By comparison, 44% of Illinois prisoners had received boosters by the end of the 2021.
 

Over almost the past two years, there have been nearly 19,000 cases of COVID-19 among people in prison — 90 of whom died, mostly in 2020, according to figures from the state corrections department and the UCLA Law COVID Behind Bars Data Project.

“COVID has taught us a lot,” Rob Jeffreys, the department’s director, said in a December interview with the Better Government Association as omicron cases were starting to climb.

Cruel and unusual punishment
The surge of COVID-19 cases in Illinois prisons comes after federal courts in recent years have held that the mental health and medical care provided to people incarcerated in Illinois violates constitutional protections against cruel and unusual punishment. Judges have ordered systemic improvements and appointed independent monitors to gauge what, if any, progress has been made.

Despite those judicial orders, the corrections department has not found enough doctors, nurses or dentists to care for the prison population — a task made even more difficult by COVID-19 as medical personnel across the country face unprecedented strains.

Court-appointed monitors have repeatedly reported limited progress in reaching court-ordered goals for treating the nearly 12,000 people in prisons — about 43% of the prison population — who have been diagnosed with mental illness, as well as the medical care for the entire population, 23% of whom are age 50 or older.

Illinois Department of Corrections Director Rob Jeffreys testifies in March before the Senate Appropriations Criminal Justice Committee on the proposed Fiscal Year 2022 budget for IDOC. (Credit: ILGA.gov)

The monitors have expressed frustration with the department’s opaque processes, its inadequate staffing in key positions and tardy adoption of standard health industry practices.

When COVID-19 hit, those lapses became even more apparent.

According to one recent monitor’s report, staff at the Lawrence Correctional Center in southern Illinois ignored or did not respond to signs of one infected prisoner’s worsening condition for four days before he was hospitalized with a 103 degree fever, a rapid heartbeat and oxygen saturation of only 86%. He died the following month.

Dr. John Raba, the court-appointed monitor tracking IDOC’s efforts to improve medical operations, cast doubt in the report about the department’s ability to resume even the substandard care it provided before the pandemic, noting only a handful of his 235 recommendations had been addressed by September.

IDOC, Raba wrote, “does not yet have a comprehensive plan to address this consent decree; instead, it seems to primarily respond to crises and threats of legal action.”

A critical factor in IDOC’s continuing health care woes, Raba said, has been a sharp drop in the number of medical professionals working for the Illinois prison system since 2019. “Yet nothing has been done to improve the hiring process,” he wrote.

Across Illinois prisons, the vacancy rate for registered nurse positions more than tripled to 29% in 2020, up from 9% in 2019. More than half of the state’s prisons have at least one in four registered nurse positions unfilled, while vacancies at eight prisons exceed 50%, according to Raba’s report.
 

Raba said he also had “significant concerns about insufficient numbers” of physicians, nurse practitioners, physician assistants, dental hygienists, optometrists and physical therapists.

Jennifer Soble, the founder and executive director of the Illinois Prison Project, an organization that seeks less punitive sentences, said some of its clients with cancer have missed months of chemotherapy treatments since COVID-19 further overwhelmed the prison system’s medical care.

Relatively few people in prison — often very sick or elderly — take up a disproportionate share of the limited medical resources, Soble said. She blamed that in part on truth-in-sentencing laws that require people in prison to fully serve their determinate sentences. Nearly half of the people in prison in Illinois were sentenced under those laws.

“It makes me want to ask the question: Why aren’t these people at home?” Soble said.

Department officials said they have used many different tools to reduce the sentences of people in prison during the pandemic, such as good-time credits, medical furloughs and electronic detention. “We awarded hundreds of thousands of days off individual sentences,” said Alyssa Williams, the chief of programs and support services for the corrections department.

Jeffreys, the department director, said finding a place for people who need high levels of medical care to go once they leave prison has also been a challenge. Often, nursing homes won’t take them, and loved ones can’t afford to pay for their care at home. “What we found in COVID is there are not a lot of places for these people to go,” Jeffreys said.

Chronic understaffing
The lack of staffing at Illinois prisons comes at a time very different from the era when many were built in the 1980s and 1990s, amid promises of new jobs for often financially distressed areas of the state.
 

To eliminate its sizable overtime costs, the corrections department estimates it would have to hire 2,000 more correctional officers on top of the 6,000 currently on staff statewide. The department says it also is short of sergeants, lieutenants and higher-ranking supervisors. In addition, the department estimates it has to almost double its treatment officers who assist incarcerated people with mental health issues to 390 from 214.