The Struggle Continues for Humane Treatment inside the Skilled Nursing Facility at Chowchilla
“I have witnessed several things that are so inhuman that I just couldn’t continue to stand by and not speak out.”
— Central California Women’s Facility prisoner
The Central California Women’s Facility (CCWF) claims to play an integral role in the California Department of Corrections (CDC) by providing “specialized mental health and appropriate medical services commensurate with community standards.” Unfortunately, the actual experiences of some prisoners within CCWF differ greatly from the prison mandate. Tucked away in the California desert, the Chowchilla facility houses the state’s only Skilled Nursing Facility (SNF), where many women incarcerated there are terminally ill and sometimes critically mistreated.
Prisoners, prisoners’ rights activists, health care workers, the legal community, and scholars have long lamented the conditions in CCWF’s Skilled Nursing Facility. Over the years, many changes have been recommended to improve the quality of care. Last April nearly 100 protestors brought the fight to the prison gates. Among those in attendance were LSPC, Critical Resistance, California Coalition for Women Prisoners, California Prison Focus, Prison Moratorium Project, Amnesty International, and Justice Now.
However, despite national attention from the media and tireless work by prisoners and their advocates, the conditions within the SNF have not markedly changed. Accordingly, LSPC has been working with our incarcerated clients and other Bay Area prison groups to compel the state’s Department of Health Services (DHS) to investigate the SNF. The concerns raised include:
- Physical and sexual assault by SNF staff
- Delays in administering vital medications
- Emergency call buttons are consistently ignored
- Frequent lock-downs of up to twenty hours a day
- Sheets are not regularly changed-one patient’s sheets were not changed for six weeks
- Diaper changing does not happen on a regular schedule
- Certified Nursing Assistants do not regularly brush patients’ teeth
- Food is taken away before patients have finished eating
- Retalition directed at patients who speak out
It is of paramount importance that independent investigations are launched because the 602 appeals process?originally enacted to afford prisoners the opportunity to air their grievances?is acutely flawed. Prisoners have reported their 602s missing, tampered with, or ignored. Perhaps most egregious, an appeal may take up to a year to reach its final destination of the CDC Director’s office in Sacramento. For patients in the SNF?some of whom are terminally ill?time is of the essence. Sadly, some may never see the culmination of their courageous efforts.
Furthermore, patients in the SNF who lodge individual complaints often face serious retaliation. Recently, a diabetic who lives in the SNF where she is supposed to receive regular monitoring of her blood sugar levels spoke to a DHS representative about the facility’s quality of care. The following day she was placed in the general population and, shortly thereafter, suffered a hypoglycenic attack because her blood sugar levels were not properly managed. She has also reported to LSPC that on one occasion she approached the infirmary doctor to receive her insulin shot, only to be told that she needed a pap smear. After reminding the physician that she had been given one the previous month, he responded, “no pap smear, no insulin.” In March, Justice Now lodged a complaint on behalf of a SNF patient who was physically assaulted by a male nurse while having a seizure. After informing the nurse that she would report him, she was remanded to Administrative Segregation.
Patients in the SNF who have been the victims of retaliation often feel bullied into silence. But some prisoners, like Dee Garcia who suffers from multiple illnesses, have been courageously outspoken. After filing several complaints concerning her treatment in the SNF, prison officials transferred Ms. Garcia to Valley State Prison for Women (VSPW) located across the street from CCWF. This prison does not house a SNF and, therefore, is ill-equipped to render long-term patient care. En route, Ms. Garcia’s oxygen supply ran out, prompting her to experience severe chest pain. Once inside VSPW, prison staff prevented her from meeting with attorneys from Justice Now who, upon arriving there, were informed that Ms. Garcia had refused their visit. On another visit, LSPC staff discovered that Garcia had no personal property; missing were her eye glasses, writing materials, and legal paper work. Only after a letter writing campaign mounted on her behalf was she transferred back to CCWF. (NOTE: At the time of this writing, Ms. Garcia has once again been moved back to VSPW.)
In a letter to LSPC, Ms. Garcia writes: “If we were [on the outside] we’d be protected by the law. But we’re in here where no law exists to keep us alive.”
Early this year LSPC received a letter from a prisoner at CCWF indicating the extent of the inhumane treatment within the SNF. She wrote: “As a human being I could not stand by and watch my fellow inmates suffer and be placed in situations that deny them medical attention to the point of death.” According to the porter, a terminally ill patient was denied a breathing machine. Some have been misdiagnosed. Others have been denied medication: an outside specialist prescribed a specific medication, only to have the order changed by the internal prison staff.
Unfortunately, abuses within the SNF are not new. Complaints about the quality of care date back to CCWF’s inception in 1990, culminating in the 1995 class action lawsuit Shumate v. Wilson (see tribute to Charisse Shumate). Shumate charged that the medical staff at CCWF and the California Institute for Women in Frontera (CIW) displayed a “deliberate indifference” to the health concerns of prisoners tantamount to cruel and unusual punishment. The suit was settled in 1997 and the state was exculpated from any wrongdoing in exchange for agreeing to upgrade the prison health care system.
The post Shumate progress, however, was barely discernible. In 1998, CCWF and CIW were cited for various violations, and ultimately failed an inquiry by state-appointed evaluators. Despite opposition from plaintiff’s counsel, the case was dismissed in August 2000. Later that year, after a rash of nine deaths occurred in just eight weeks, CCWF received national attention from, among others, the Los Angeles Times, the Chicago Tribune, and Mother Jones magazine. One death involved a thirty-three year old woman with chronic asthma. Doctors at the University of California-Davis said this death could have been prevented if the woman’s inhaler had been accessible to her or if CPR been administered more quickly.
However, there has been some progress made in wrongful death suits. Represented by Justice Now, the family of CCWF prisoner Rosemary Willeby received a $225,000 settlement this year. Willeby, who died on October 22, 1999 suffered from Hepatitis C and liver disease. Although she presented no symptoms, Willeby was placed in a tuberculosis program by the CCWF staff and was prescribed anti-TB medications that have proved toxic to some patients afflicted by various liver diseases. Cynthia Chandler and Cassandra Shaylor, co-directors of Justice Now, have said that the CCWF staff ignored Willeby’s repeated requests to see a specialist until ten days before she died.
Additionally, there has been some progress in mounting class action suits. The settlement of Plata v. Davis?the largest class action lawsuit on prison conditions to date?was filed on January 29, 2002, claiming that state officials operating the largest prison population in the nation displayed a “deliberate indifference” to prisoners’ health care needs. The settlement stipulates a total reevaluation of the state’s procedures, including a significant allocation of funds over the next several years in order to meet the standards set by an independent medical panel that has been empowered to oversee the state’s progress. This suit was brought by several named plaintiffs representing all prisoners who are currently, and will be in the future, the custody of the CDC (with the exception of Pelican Bay State Prison).
However, while the Plata settlement appears to have far-reaching implications, none of the named plaintiffs was a woman so medical care issues specific to female prisoners such as gynecological/ pregnancy concerns (particularly for those also living with HIV/AIDS and Hepatitis C) were silent in the settlement. In response, LSPC filed an objection and remains committed to addressing systematic deficiencies within the CDC health care system in general, and redressing the medical-related abuses suffered by incarcerated women in particular.
Incarcerated at CCWF, Dee Garcia has asked: “I was wheeled in here in an ambulance. Will I be wheeled out in a hearse?” LSPC will focus on these issues until the women of CCWF and those housed at all California prisons will not have to ask this question. We hope that one day, women confined to the Chowchilla desert?far away from both their families and the world that exists outside the prison walls? will no longer want for justice in the SNF.