Reports on NaphCare

 Bullock County Correctional Facility:

1. The facility was constructed in 1987 originally designed to house six hundred and eleven inmates. In 1991 the census has increased to eight hundred inmates and the population on the day of the audit was eleven hundred and ninety eight inmates. 

2. A review of five diabetic charts selected at random yielded no documentation of current Hemoglobin A1Cs being present in any of these five records reviewed. The QI director of NaphCare reported, at the exit conference that the Medical Advisory Committee physician was comfortable with A1C's not being completed with the diabetics are not compliant with dietary orders. There was no evidence documented in the medical record indicating that the inmates were counseled on the importance of dietary compliance. 

3. There is a backlog of approximately 40 inmates awaiting dental services. It had been reduced from 70 just prior to the audit.

4. Routine dental cleanings are not provided to inmates. It is policy to include dental hygiene instructions on admission. A copy of this sheet was reviewed and it included the importance of brushing and flossing instructions, however dental floss is not provided to inmates as per DOC policy. Dental statistics from the last 90 days show that there were a greater number of extractions than fillings provided, on a three to one ratio.

5. There is a total capacity of eight beds in the health care are termed an "infirmary." During the audit, infirmary admissions included cases that involved MRSA, paraplegia, asthma, and one inmate on a suicide watch. There are four beds that are designated as isolation rooms and one four-bed ward. A review of medical records for the infirmary indicated that an admission sheet is completed when inmates are admitted to the infirmary and required nurses and physician notes are present. The records however are stored in the pharmacy area, down the hall, approximately ninety feet away from the "infirmary" beds. There were no health providers assigned within site or sound of the inmates in the infirmary as is required by national standards. The "call light" system has been removed since the last NCCHC accreditation. Currently none of the eight beds have a call light in place. The paraplegic inmate reported that he would "shout" for an inmate "runner" if he required health care and the inmate runner would get the nurse. It is recommended that the DOC correct this area as patients should be within sight or sound of a health provider.

(Monica's note: MRSA is Methacillin Resistent Staph Aureus, a super-bug - it is a bacteria that is ONLY consistently responsive to IV Vancomycin, and is deadly. In normal circumstances a person with MRSA is kept in strict isolation. I was an infection control nurse for years, I know what I am talking about)

6. There was no documentation that the inmate "infirmary" runners had training on bloodborn pathogens, but it was reported that they processed all of the dirty infirmary linen, meal trays, and soiled clothing. The DOC staff also reported that inmate interpreters were used to translate for inmates if non-English speaking inmates required health care access.

More Highlights of other Facilities:

Hamilton Aged and Infirmed Prison Facility

There is a total capacity of 27 beds in a 2 room infirmary. The largest room is only 40X40 feet and contains 20 beds. The second room of the infirmary is 12 X 27 feet and contains 7 beds. Both of the infirmary rooms were extremely crowded. Several of the inmate beds were in such close proximity that the beds touched each other. Inmates with the following diagnosis e.g. COPD, CHF, tube feedings, nebulizer treatment, O2, glucose finger sticks, IV's, and amputations were present during the audit.

During interviews with health staff, it was reported that historically inmates with MRSA have been housed in one of these two-crowded infirmary rooms as well as inmates with required TPN and lipid administration. MRSA is an extremely dangerous condition and can be very fatal to patient with immune suppressed disorders or patients with a compromised health status. Patients with a diagnosis of MRSA should be housed in a hospital and treated with IV antibiotics. Patients that are carriers of MRSA should be housed in isolation cells. This infirmary is not appropriate house unit for MRSA patients. This extreme overcrowding of this infirmary and potential compromise of infection control procedures merits review of the infection control program by the health service provider for this institution. 

During the tour, it was noted that there is no "call light" system in place in either of the infirmary rooms. During inmate interviews, an inmate housed in the infirmary reported that he called for the inmate worker "runner" if he needed assistance or the nurse. He indicated that this was the way they "got help" if they required nursing attention. Nurses are not stationed in infirmary rooms. The current health care area would not meet NCCHC standards as an infirmary and should perhaps be reclassified as a medical observation area. 

Kilby Correctional Facility

There were 5 HIV positive inmates housed in the segregation unit on the first day of the audit. The HSA reported that it was procedure for a lab tech to advise these inmates that they are HIV positive. 

I am crying now and I can't type anymore. A freaking lab tech tells the prisoners they have HIV???? I had no idea. My heart is breaking. I can't go on right now, but I promise to get the word out on all of these reports. It is horrible, that there is zero healthcare in Alabama's prisons. 

If you want to know what's in the reports - let me know. I am, at this moment, not feeling up to typing out the rest of these atrocities. How dare they? I am so pissed right now.

The reports include the following facilities:
Bibb County Facility
St. Clair Correctional Facility
Staton Correctional Facility
Tutwiler Correctional Facility
Donaldson Prison
Bullock Correctional Facility
Hamilton Aged and Infirmed
Kilby Correctional Facility

The implications of these reports need to be out there. People with loved ones in these facilities need access to these reports!