New York State
Department of Correctional Services
Glenn S. Goord, Commissioner
Office of Public Information
For immediate release:
Monday, March 15, 2004
Commissioner outlines decade of improving inmate medical care;
welcomes Assembly to join in making a good system even better
Commissioner Glenn S. Goord this morning addressed a joint session of the Assembly’s Health and Correction committees during their public hearing on inmate medical care held in the Legislative Office Building in Albany.
The session was called by Health Committee Chairman Richard Gottfried and Correction Committee Chairman Jeffrion Aubry.
The following is the text of Commissioner Goord’s opening statement delivered at the 10 a.m. opening of the hearing:
Chairmen Aubry and Gottfried, good morning.
Joining me are my counsel, Deputy Commissioner Anthony Annucci, and my chief medical officer, Dr. Lester Wright. I may call upon them in responding to your questions following my opening statement.
I thank both of you and your committee members for the opportunity to meet with you today.
This is the first time that I have been invited to appear before a joint meeting of these committees.
I appreciate this opportunity to go on the public record before the Assembly. I welcome this forum as a means to detail the hard work, professionalism and dedication of the 1,700 men and women who provide inmate medical care throughout the prison system.
Like them, I am very proud of our success in expanding and improving quality health care for the 65,000 inmates housed in 70 prisons across the state.
I read the committees’ announcement publicizing today’s hearing. It did not acknowledge the many program improvements and new initiatives affecting inmate medical care that we have implemented since George Pataki became Governor.
I’d like to enter them into the official record of this hearing. But we would be here all day if I were to enumerate all of them. So let me say that my list is representative and not intended to be all-inclusive. Our systemwide record includes:
- Increasing inmate health care spending by 63 percent since 1995 – while the inmate population has declined by 9 percent from its high point in 1999. That increase came even as our treatment policies allowed us to reduce inmate outside hospital days from 38,000 in 1995 down to 15,000 in 2002.
- Interviewing every incoming inmate – more than 26,000 last year alone. We record their medical histories while providing physical, dental and x-ray exams. Screening or lab work is completed as necessary for tuberculosis, Hepatitis B and C as well as for sexually-transmitted diseases.
- Exposing every inmate to educational and instructional materials about TB, HIV and other blood borne diseases. The material is targeted by gender and is offered in both English and Spanish.
- Providing inmates with one million primary care visits annually.
- Arranging nearly 113,000 medical specialty consultations each year. About 7,000 of these visits are with infectious disease specialists. Inmates have contact with nearly 1,000 specialty care providers around the state. These are the same providers who treat New Yorkers in the outside community.
- Reducing the number of AIDS deaths by 94 percent. There were 258 in 1995 but only 15 last year.
- Shipping more than one million pharmaceutical items last year and filling 78,000 prescriptions per month.
- Testing more than 15,000 inmates last year for their HIV status.
- Cutting the rate of active TB infection by 88 percent. It was 225 cases per 100,000 inmates in 1991 but only 28 per 100,000 last year. More than 66,000 inmates were tested for TB exposure in 2003.
- Ensuring all inmates who meet clinical guidelines established by the U.S. Centers for Disease Control and National Institutes of Health are receiving appropriate Hepatitis C treatment.
- Arranging thousands of hours of annual in-service training for our medical personnel. It is provided by outside sources such as medical centers and AIDS experts. Nearly 27,000 non-medical employees receive OSHA’s mandated annual training regarding blood borne pathogens and TB.
- Requiring American Correctional Association accreditation of all health care units. That includes meeting “performance-based standards.” It requires collection and use of “outcome measures” of the system and the care that we provide.
- Working with the Department of Health’s AIDS Institute. We use the same quality improvement program reviews that it employs in outside communities. Our guidelines are consistent with theirs.
- Monitoring quality infection control by reviewing inmate medical records – 25,000 of them last year alone – to ensure compliance with CDC, state health department and our own guidelines for the treatment and prevention of such diseases.
I know one of the issues on your agenda is mandating Department of Health oversight of our medical facilities and staff. I believe our record shows we do an excellent job of providing medical care to inmates. I don’t know of any state health department in the nation responsible for prison medical care. I don’t believe it is required in New York, either. I also do not believe the state health department deems it necessary.
I don’t see how it serves inmates to debate this one-house issue that has divided us for 20 years. I think the effort could be better spent advancing issues that we agree would actually improve health care.
I offer the same advice to those who disagree with our policy of limiting condoms to the Family Reunion Program. Once again, let me point out that the Department’s policy has been consistent for at least the past two decades. And 48 other states agree with our position on condoms. Let me take just a few minutes on this issue: I want to explain why what some see as a medical issue is viewed as one of security by professionals in 49 state prison systems across the country.
Vermont is that one state in the nation that makes condoms available to all prison inmates. It has fewer than 2,000 inmates. It reports a consistent pool of 15-25 HIV-infected inmates among them.
I hope no one recommends that we blindly go where Vermont’s prison policies lead. But if they do, I can save money by reducing the hours of operation in our inmate visiting rooms: Vermont limits inmate visitors to family members. Its stated goal is to reduce prison contraband, particularly drugs. Barring non-family visitors in New York prisons would reduce our inmate visits by several thousands each year.
Vermont makes no claim of scientific documentation that condom distribution reduces the spread of HIV. There is also no scientific documentation that the lack of systemwide distribution increases its spread among inmates in the 49 other state prison systems across the nation.
Since I am talking about one New England state, let me report to you on a drug bust two weeks ago in another. It was conducted by a multi-agency law enforcement task force in Maine. The Associated Press reported that police raided a heroin distribution center in Waterville. They seized $50,000 worth of heroin packaged in what they called “little balloons.” The distributors said they were all to be smuggled into the visiting room of just one, nearby prison. The “little balloons” were to be passed by visitors to inmates while exchanging a kiss.
In our own system, my staff has been vigilant in its battle to keep drugs out of our facilities. We conducted nearly 93,000 inmate drug tests last year – with a positivity rate of less than 4 percent. I think that indicates how successful we have been in reducing illegal drug use among inmates. It also indicates our success in reducing the violence that can accompany drug trafficking in our prisons as well as on our streets. Our efforts contribute to the fact that our current rates of prison violence are the lowest since 1979.
But all is not perfect. Visitors are being caught with condoms and “little balloons” as they attempt to smuggle drugs into Great Meadow, Auburn, Elmira, Attica – and virtually most other prisons you care to name. New York’s suppliers of illegal drugs use more than oral cavities when attempting to smuggle drugs into our prisons. So do inmates, when they move drugs around inside. It is a credit to our staff that they detect as much contraband as they do.
The nation’s highest court has ruled that my obligation as Commissioner includes taking the steps necessary to try to prevent crimes from occurring in prison. It also demands that I prosecute the crimes that are committed, despite out best efforts to prevent them. We all know that rape and other sexual assaults are crimes of violence and control, not of sexual gratification. Giving inmates condoms would embolden some inmates to commit aggressive and predatory attacks on weaker inmates. The attacker would know that use of a condom will reduce chances of leaving DNA evidence. Attackers would also know that chances of contracting HIV or other diseases from their victims will be decreased by the use of condoms.
Prison system policies banning condoms are also consistent with the federal Prison Rape Elimination Act of 2003. It requires that the states take the steps necessary to reduce the opportunity for, and incidence of, inmate sexual assault. If we don’t, states face a loss of federal funding for prison-related programs. I’m not certain we should become the second state in the nation to distribute condoms in the face of that law.
I have summarized our success in improving inmate medical services over the past decade. Each and every one of them flows from initiatives proposed by Governor Pataki.
Our views on oversight and condom distribution represent the almost unanimous positions of correctional health care and security professionals across the nation – many of whom also believe that New York offers inmates the best prison medical care in the country.
But I do not believe we have taken inmate health care as far as it can – or should – go.
As with health care on the outside, there is always room to improve, to expand and to fine-tune the medical care offered inside of prison.
We would welcome the Assembly majority if it now chooses to enter into a partnership with us. We invite your input on how to improve upon inmate health care.
But taking us further requires an understanding and acknowledgment of how far we have already come.
Thank you for the opportunity to make this opening statement.
I welcome your questions.