It is hard to say what was more revealing about last week’s legislative hearing on the quality of medical care in Mississippi’s prisons.
Was it the shocking testimony provided by relatives of inmates and physicians, who attested to the substandard care provided by the outside contractor, VitalCore? Or was it the hearing’s absence of any official from the Mississippi Department of Corrections, which reflects either indifference by MDOC to address the problem or contempt for the legislators who keep harping about it?
VitalCore, to its credit, did show for the Oct. 15 hearing of the Joint Committee of Public Welfare and Corrections. The Kansas-based company tried to explain away the litany of cases in which inmates suffered significant health consequences — from avoidable amputations to life-threatening complications — because of long delays in the diagnosis and treatment of their injuries and illnesses. According to VitalCore, the issues are a result of the multiple problems it inherited when it was first hired in 2020, under an emergency contract, to provide the medical care. The company claimed it started with a depleted medical staff and a backlog of health screenings that had been neglected by the previous contractor. It takes time to catch up, the company said.
Even if that excuse has some validity, it would not explain the entire situation. There have also obviously been efforts by VitalCore to hold down its costs — and maximize its profits — by putting off tests and treatment.
A glaring example: Hepatitis C is rampant in Mississippi’s prisons, although how rampant is a matter of debate, with estimates ranging from less than 1,000 to more than 5,000 infected inmates. The liver disease is serious, but it’s also easily curable if treated early enough. The eight- to 12-week course of medication, though, is expensive, and VitalCore has been trying to manage the cost by rationing out the medication. By the company’s own admission, it is treating just 50 inmates a quarter and focusing on those with the most advanced cases. At that pace, it may never get the highly contagious disease under control. Mississippi’s chief health officer, Dr. Dan Edney, told the legislative committee that VitalCore’s gradual approach runs contrary to standard medical practice, which calls for universal screening and immediate treatment when a hepatitis C outbreak has been detected.
Inmates are admittedly a difficult group of patients to manage. They are unhealthier than average and more inclined to be noncompliant with doctor’s orders. Nearly half of the total inmate population has some form of chronic illness, and more than a third has some form of mental illness.
Still, VitalCore is paid handsomely for this difficult job. Under its current contract, it receives about $120 million a year — or roughly $6,500 per inmate, the most ever awarded by the state. If that’s truly not enough to provide adequate care and still make a reasonable profit, then it can negotiate a higher price when the contract comes up for renewal next year. What should not be happening, and what MDOC is supposed to make sure isn’t happening, is for VitalCore to skimp on services it is contractually obligated to provide.
Some Mississippi lawmakers, most notably House Corrections Commissioner Becky Currie, have questioned how seriously MDOC and its commissioner, Burl Cain, take that responsibility. Cain’s failure to attend the hearing or to send a subordinate in his stead reinforces the legitimacy of Currie’s concerns.
Recent legislative efforts to address prison medical care have been stymied, in large part because there’s not much public sympathy for inmates. Both the Constitution and moral law, however, dictate that those who are incarcerated be treated humanely. To do less than that — such as allowing them to develop liver failure rather than treat their Hepatitis C with medication — is cruel. It’s also ultimately more expensive to the taxpayers.
