When people are behind bars, the government is responsible for their health care. That’s in the U.S. Constitution. Anything less is considered cruel and unusual punishment. But New Mexico has a history of struggling to meet that obligation. Lawsuits about deaths and permanent health damage pile up.
The prison doctor gave Nancy Hadley one medication, and the psychologist gave her another. “They were clashing. I felt drunk. I was falling. I was paranoid. It was just awful,” she said.
She followed the normal procedure for trying to get help. She filled out request forms. “For 30 days, I put one in every single day," she said. "And they never saw me."
Many people who’ve left prison say when they really need health care, they have to reach out to relatives or loved ones on the outside to advocate for them. Hadley said she didn’t have that option. “I was frustrated. I put in grievance forms, and it’s like they just get lost. They throw them away. It was never answered. No nothing.”
Eventually, a month later, she had a regularly scheduled appointment with the prison psychologist, who spotted the problem. “I mean our medication’s in our file, and both of them can see it, so they should have known,” she said.
This is not the worst case of poor medical care behind bars in New Mexico prisons. Lawsuits are regularly filed over what happens when people are in the state’s hands. But Hadley’s story does point to the kind of run-of-the-mill, dangerous mix-ups that can happen in overcrowded facilities with too few physicians.
It can be hard to know what’s really going on, though. Taxpayers spent $50,000 on an audit of prison health care, but lawmakers hadn’t seen it. At a legislative committee meeting this summer, Rep. Eliseo Alcon asked where it was. We made a public records request and got ahold of it.
Lalita Moskowitz is a staff attorney at the American Civil Liberties Union. She said the audit highlights some serious deficiencies. The audit looks mostly at what does and doesn’t happen when people first get to prison.
“If somebody’s coming in from the community, and they were on some sort of medication or they were getting some sort of health care for a medical condition, very often there’s no good process and they’re not getting treated the way they should be once they’re behind bars,” she said.
So that can mean, for example, that people with diabetes don’t get insulin, or people are suddenly without other medications to treat chronic illnesses.
The audit says exam forms often have a lot of blanks. And pregnancy test results for women entering prison are missing.
“If you don’t know you’re pregnant, you can’t get an abortion if that’s what you want. But you also don’t get prenatal care,” Moskowitz said. “Also if somebody’s on medication that’s not good to be taking while pregnant, if you don’t get that test and you aren’t aware, there are various risks that go along with that.”
Centurion is the private company that makes about $40 million a year providing health care to the state’s prisoners. The company and the state created a corrective plan that includes revising the forms and putting together enough staff to handle intakes correctly. It’s unclear if those things have happened or if mid-October deadlines were met.
But maybe bigger changes are on the horizon, according to state Rep. Antonio Maestas. “We need to figure out if we can do it better, if we can provide better health care at a cheaper cost," he said.
Maestas said the Legislature is going to call for a cost analysis to see whether a state-run health care system—through the Department of Health and through the University of New Mexico Hospital—would be better than working with a private company. Centurion’s contract expires in November of next year.
“The incentives are all wrong with regards to these private prison contracts," Maestas said. "It’s a for-profit business.”
But the Legislature probably isn't going to look at providing additional checks and balances, or more transparency, on prison health care.
“Believe it or not, as a citizen Legislature, we don’t have the capacity to do all of that, particularly with DOC, because it’s such a closed system," Maestas said. "In my opinion, it’s the most unaccountable part of state government.”
Some lawmakers are trying to create an independent oversight body that would look at the Corrections Department, he said. And otherwise, his hopes are pinned on the next administration.
KUNM reached out to the state’s Corrections Department and Centurion. Despite several requests over weeks, neither would comment.
The full audit is available below.