A cancer patient lying in his own feces in the days leading up to his death. Another with ALS, slowly dying of starvation because no one has the time or inclination to feed him. Patients with dementia who are not fed, not changed, not supervised. An elderly person who died after suffering nearly two dozen falls.
These horrific acts of negligence are commonplace in prison health care units across Illinois, according to a devastating report released last month by a federal monitor.
Reviews of deaths in custody from the last year show missed appointment after missed appointment with oncologists, nephrologists, and other specialists providing life-saving care. Critical procedures were scheduled, then canceled for no apparent reason. Medications, some as common as acetaminophen, were grossly mishandled, leading to overdoses and accidental deaths.
This abhorrent treatment of sick and disabled people persists despite a new law that allows for their release from custody. In January 2022, Illinois joined 48 other states in adopting a medical release law. Incarcerated people with terminal illnesses and serious disabilities have a pathway to reunite with their families and access the life-saving care they have been deprived of for years or decades.
Illinois must put this new law to use. That means funding advocates to help transition terminally ill and disabled people out of our prison system.
Lack of staff leads to life-threatening emergencies
The horrific conditions of Illinois’ prison health care system are, in part, the byproduct of chronic understaffing and unrelenting need. Half of physician positions are vacant, as are 46% of all health care positions. As a result, patients do not receive routine care, let alone specialty care.
Worse, staffing shortages in the infirmary have led to life-threatening emergencies. One incarcerated patient with dementia, for example, accidentally poisoned himself after drinking from a bleach-filled water bottle that had been left in his cell.
At the same time, the need for robust health care in prisons has grown exponentially, and will continue to do so because of the ever-expanding population of elderly people in prison, because of decades of egregiously long sentences. Elderly people made up about 7% of people in prison in 2005. By 2022, the proportion of incarcerated elderly people tripled to more than a fifth of the state’s prison population.
One in seven people imprisoned in Illinois has a sentence so long they will die behind bars. We can expect this population to continue to rise — and with it, the number of people suffering from chronic, debilitating and terminal illness.
The irony, of course, is that people disabled, infirm or close to death pose the least risk to public safety. At the same time, their care is enormously expensive. The Illinois Department of Corrections spends hundreds of millions of dollars a year on health care, and yet is still offering care so poor it constitutes elder abuse.
A path to release for those who are no danger to the public
Our treatment of the most vulnerable and sick people in prison is an economic disaster and a moral failure. But there is a reason to be hopeful.
Widely regarded as one of the best medical release laws in the country, the Joe Coleman Medical Release Act creates a straightforward mechanism to review and release incarcerated people with terminal illnesses or serious disabilities.
Since its inception, attorneys have successfully represented people with cancer, chronic and pervasive brain damage, quadriplegia and other disabilities. Releases have been steady, but slow. With no funding in place to support legal representation, there are only a handful of attorneys who represent terminally ill and disabled people seeking medical release.
As the federal monitor’s report makes painfully clear, there is much more work to be done. Three-quarters of the geriatric unit at Dixon Correctional Center need help with multiple activities of daily living, like moving, toileting, and feeding themselves. Each deserves quality health care. Each puts enormous strain on a health care system well past its breaking point. Each Is eligible for release under the medical release law.
Passing medical release was a tremendous step toward fiscal responsibility and a more humane prison system. Now, we must use that law. That means funding attorneys to bring home terminally ill or disabled people who are overburdening the prison health care system, so they can receive the care they desperately need.
Jennifer Soble is the executive director of the Illinois Prison Project, a nonprofit legal aid organization that represents incarcerated people with terminal illnesses and serious disabilities.
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