by Nicholas Deml and Mark Levine
Vermonters are proud of the COVID-19 response that Dr. Anthony Fauci deemed a “model for the country.” This included efforts to protect those living and working in correctional facilities in Vermont—the only state not to lose an incarcerated individual or correctional officer to the virus.
But as the CDC prepares to end the nation’s COVID-19 public health emergency on May 11, Vermont’s correctional system continues to grapple with the aftershocks of the pandemic.
Our correctional system serves as an important sentinel in Vermont’s health system. Though the COVID-19 pandemic may have waned, a profound health crisis among our most vulnerable neighbors is quickly arriving on its heels. And with a legal mandate and moral responsibility to treat all in our care and custody, the correctional system remains our state’s largest care provider for our neighbors at highest—and growing—risk.
In just the last year, medical encounters within the Department of Corrections rose 27% alongside a recent spike in deaths in state custody. And for those arriving in our state’s system before trial, incarceration is often the first opportunity to access much-needed services following delayed medical care. This includes services for untreated mental health conditions and substance use disorder at a time of an increasingly lethal drug supply.
The current prison population fell by nearly a third since 2015 following reform initiatives such as justice reinvestment. But over the same period, rates of chronic illness among the incarcerated increased nearly 50%, with 1,000 of Vermont’s 1,300 incarcerated people today living with at least one chronic illness, and many suffering from multiple illnesses simultaneously. Vermont’s incarcerated population also takes more medication today than ever before, with the average incarcerated individual prescribed more than five medications. In the last year alone, the Corrections Department transported incarcerated individuals to emergency departments 354 times, nearly once every day.
Our correctional facilities mirror and magnify the trends across our state that often go unseen. And the reality is this: justice-involved Vermonters today are older and sicker than ever.
No question exists that the recent increase in deaths in Vermont’s correctional facilities is tragic. Since the beginning of 2022, sixteen Vermonters died while incarcerated, overwhelmingly of natural causes. To be clear, not every death in our state’s correctional system is unexpected. Some geriatric individuals, often serving long sentences for violent crimes, experience acute health conditions near the end of their lives. Nationally, prisons have grayed at an astounding rate, with the number of incarcerated people 55 and over growing 280% from 1999 to 2016. But nursing beds are in short supply, and despite making at times more than 40 calls to facilities, our staff often cannot find a site willing to accept justice-involved individuals who are older or in poor health.
In those instances, our correctional system acts as a palliative care provider. This responsibility takes a toll on staff, who do their best to make these individuals comfortable and treat them with compassion and dignity.
In Vermont, the Department of Health and the Department of Corrections are both housed within the Agency of Human Services. This is no coincidence. It exemplifies our values: that people in state custody are, first and foremost, people—individuals and Vermont community members for whose health and wellbeing we are charged.
Alongside community partners, our departments remain deeply committed to promoting and providing for the health of all people in Vermont. This is why the Department of Corrections recently restructured its healthcare system and will bring in a new medical provider; invested in a $13 million agreement with labor partners to stabilize correctional staffing; deployed a new electronic grievance system; updated healthcare protocols to screen individuals arriving at correctional facilities within four hours; and is forming an independent investigative unit to ensure accountability and transparency across the correctional system.
The Department of Health is a full partner in these efforts, including funding more than 360 projects with 114 partners last year to support local and regional substance use services across Vermont. The state has also expanded Medicaid coverage for Hepatitis C at opioid treatment programs and awarded grants totaling nearly $5 million to 30 local organizations in 11 counties to advance health equity.
But these initiatives in isolation cannot solve the steep health challenges Vermont’s most at-risk residents face. We are calling on all Vermonters to recognize and support our local public health and corrections workers, and for community providers to continue to collaborate with us to build on innovative programming connecting citizens reentering our communities with opportunities for healthcare, treatment, and meaningful employment.
Nicholas J. Deml
Commissioner, Vermont Department of Corrections
Mark Levine, MD
Commissioner, Vermont Department of Health
Categories: Health Care